Stop the infusion and change prescription

You pick up that prostacyclin was prescribed on the drug chart, and not prostaglandin. Prostacyclin (also known as Epoprostenol or Flolan) is used as a pulmonary vasodilator, NOT to maintain ductal patency. The infusion is stopped and the baby is started on prostaglandin infusion. Within 5 minutes the oxygen saturations improve to above 70%.

Soon afterwards your consultant arrives to review the baby and congratulates you on identifying and dealing with the problem so effectively. Hypoxia can often lead to brain damage in such children before diagnosis and treatment.

Bella is transferred to the cardiac referral centre, where she is a diagnosed with Fallot’s tetralogy with critical pulmonary stenosis. She undergoes an emergency balloon valvotomy, before having a modified Blalock-Taussig shunt.

Bella is reviewed in the local developmental clinic at 12 months of age, where her she is found to have reached her age appropriate milestones. She is also well from a cardiac perspective.

Outcome: well child