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A Piece of My Mind
August 13, 2003

A Little Bit Longer

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2003;290(6):716. doi:10.1001/jama.290.6.716

Just before dawn we received a call that an unresponsive infant was being brought by emergency medical services to our hospital. As the medical team—the pediatric resident, intern, respiratory therapist, nurse, and me—prepared for the incoming patient, an eerie silence enveloped the trauma room, an event that frequently precedes a pediatric resuscitation.

The child arrived in our emergency department pulseless and cold, with compressions being performed on him in the arms of the paramedic. Further history obtained by the paramedics indicated that the mother had left the infant alone in the home with two young children to watch the child, and upon her return the infant was found in bed not breathing and cold. As a medical team we simultaneously performed multiple procedures (intubation, insertion of intraosseous lines, administration of epinephrine, cardiac compressions), all to no avail. Twenty minutes after he arrived, I declared this 2-month-old child dead with a high suspicion of abuse or neglect. Everyone vacated the room almost immediately, except for the nurse, who never left the child's bedside. I asked her why she needed to stay, and she looked at me and smiled. "Why of course, to be with my patient a little bit longer."