Graphic: An aircraft with RFDS logo. A patient is lying on a wheeled stretcher, being pushed by a person wearing a high-visibility jacket.
When every second counts...
My name is Michael Penno and I’m the Senior Flight Nurse at the Royal Flying Doctor Service (RFDS) in Adelaide. I want to tell you about a patient who I will never forget.
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One afternoon last February we received an urgent call from Mount Gambier Hospital concerning a patient named Shelley Hatch, who had gone into labour at just 24 weeks into her pregnancy. Whilst medication was temporarily slowing her labour, Shelley needed to get to Adelaide – and fast.
You might be aware that a ‘normal’ pregnancy is classed at 40 weeks. For a baby born at just 24 weeks, there’s a 40 per cent chance that the baby will not survive.
Amongst those who do, many experience significant health challenges.
To give a baby the best possible chance, it's absolutely vital that they're born in a major metropolitan hospital with a Neonatal Intensive Care Unit (NICU).
Shelley explains: “It was my first pregnancy. Everything had been progressing fairly normally, until one afternoon whilst I was home alone my waters broke suddenly.I was in shock. I called my husband, Patrick, and separately we drove ourselves to Mount Gambier Hospital where I had expected to give birth some four months later.
The look on the midwife’s face confirmed my worst fears. I was in the early stages of labour."
I couldn’t stop crying – all I could think was 'my baby is going to die.'
For Shelley’s baby to be given the best possible chance of survival, Shelley needed to give birth in Adelaide.
The 430-kilometre journey from Mount Gambier to Adelaide takes four-and-a-half hours by road – but a RFDS ‘flying intensive care unit’ covers this ground in just 60 minutes.
I remember mentally preparing myself for what lay ahead, calling on my training and years of experience in critical care and midwifery.
Meanwhile, Shelley’s labour continued to progress.
“Patrick arrived at the hospital. I remember sobbing ‘what if our baby dies, Pat?’ He tried to stay calm, telling me ‘let’s not think about that yet.’
We were told the Flying Doctor was on its way and from that point on, my focus was on making it to Adelaide before delivering my baby.”
Upon our arrival in Mount Gambier, Shelley’s contractions had increased in strength and frequency. She was in significant pain.
We quickly loaded Shelley onto the aircraft, determined to do all we could to give her unborn baby the best possible chance.
“I barely remember the flight. I was just so scared. Michael was amazing – he was incredibly calm. Patrick held my hand the entire way, trying to be brave enough for both of us. When we landed at the RFDS Base at Adelaide Airport, an ambulance was there waiting to speed us to the Women’s & Children’s Hospital.”
We reached the Women’s and Children’s Hospital (WCH) just in the nick of time. Shelley’s cervix was now fully dilated – she was ready to push. What’s more, the baby’s heart rate had dropped to a dangerously low level.
The WCH Doctor now in charge of Shelley’s care examined Shelley and announced ‘I need to deliver your baby right now.’
Intuition took over – mother’s instinct, perhaps – as I tearfully said ‘yes'."
I will never forget the next words I was asked as I was wheeled into theatre: ‘Do you want me to do everything in my power to save your baby?’
The enormity of the situation hit me as I waited outside the theatre. I’ve been a RFDS Flight Nurse for more than ten years and it’s second nature to remain calm in the most challenging situations. Our patients are often acutely unwell or critically injured – but it’s so important that we keep our own emotions in check.
But today I found myself choking back a tear as I waited nervously for an update. On the other side of the theatre doors, Shelley faced yet another unexpected challenge.
“As the surgical team prepared for my emergency Caesarean section I was examined a final time. There was no time to perform the C-section – my baby had started to be born naturally.
My baby was born – less than an hour after we’d landed in Adelaide.
Seeing our son for the first time was very confronting. He didn’t look like a live newborn – his eyes were fused shut and he was a strange colour. I was asked if I wanted to give him a kiss. I couldn’t do it – he was just so tiny. I didn’t dare do anything that might risk making him sick.”
I dared to breathe a small sigh of relief when I heard the baby had been transferred to the NICU. Weighing just over 600 grams – not much more than a small block of cheese – he was incredibly vulnerable.
I went home that night feeling very scared for Shelley and Patrick and what might lie ahead – but drew comfort knowing we had airlifted them to Adelaide in time. Their newborn son was exactly
where he needed to be.
A few days later, I learnt that Shelley and Patrick had named their tiny son Charlie. I went to visit, aware that these frightened new parents were at the beginning of a long and potentially difficult journey.
Through tears, Shelley expressed her gratitude.
“I don’t like to think about what might have happened had I given birth before we got to Adelaide. I will be forever thankful to the Flying Doctor for being there on the scariest day of my life.”
Today, Charlie is a chubby one year old with big blue eyes, blonde curls and a bright smile.
I recently had the pleasure of meeting baby Charlie once again. As I bounced him on my knee he looked up and gave me a big gummy smile. I felt thrilled that Shelley and Patrick got to experience their happy ending.
I know that if Charlie had not been born in a hospital equipped with specialist staff and facilities, the outcome would likely have been very different.
I hope you know that you play a vital part in helping us to save lives, every day (and night) of the year.
RFDS and SA Ambulance Service are service delivery partners and the inter-hospital transfers we undertake – the kind of aeromedical flight that we performed for Shelley – are funded by the SA Government.
We need your help to bridge the gap in our operational funding and to purchase our fleet of ‘flying intensive care units’ – at a cost of more than $7 million each.
Thank you for everything you do for people like Shelley, Patrick and baby Charlie. It means so much to me and I know it means the world to them. Please, can you give a gift today to help us continue to save lives?