A Kaiser Permanente Vacaville team was able to provide high-quality care partly because of trainings on emergency situations. Pictured above: On Feb. 26, the Castillo family reunited with the first responders and the medical center care team.

Pregnant with her fifth child — a girl — Renee Castillo of Vacaville thought she knew what to expect when she started having contractions and feeling pressure a few days before her due date.

“My whole pregnancy with her was very calm,” she said.

Castillo didn’t feel the urgency to go to the hospital just yet.

But that changed later in the day when Castillo’s water broke, and the umbilical cord started to come out.

“I knew that was bad, so I called the hospital labor and delivery unit,” Castillo said of first contacting the Kaiser Permanente Vacaville Medical Center.

She was told to call 911.

Castillo’s baby was suffering from cord prolapse — an obstetrical emergency that could have had severe and lasting effects on her baby if she didn’t deliver immediately.

A Baby Born

Vacaville Fire Department paramedic crew quickly responded, stabilized the laboring mom, and transported her to the Kaiser Permanente Vacaville Medical Center. Waiting for her at the Emergency Room ambulance entrance was a team that included an obstetrician, a certified nurse midwife, a pediatrician, nurses, technicians, an anesthesiologist, and a respiratory therapist.

“I’ve been a labor and delivery nurse for 15 years, and I have never seen (cord prolapse) in my career,” said Alison Landis, RN, an assistant nurse manager who advised Castillo when she called the unit.

While this condition is rare, the team was prepared to care for her because of ongoing simulation training that readies them for emergencies such as Castillo’s.

“Everyone knew their roles, and there was no panic,” said 41-year Neonatal Intensive Care Unit (NICU) nurse Chris Samayoa, RN.

Within minutes, Castillo had an emergency Cesarean section. Baby Isabel Castillo was born just two minutes later.

In Distress

But she wasn’t breathing.

Isabel was resuscitated and put on a ventilator. She also suffered from seizures and received a blood transfusion, according to newspaper reports.

There was concern about brain damage because there may have been a lack of oxygen to Isabel’s brain, said pediatrician Danette Lebaron, MD.

But the team had a plan.

“Studies show cooling the brain for 72 hours after an injury improves neurological outcomes,” said Dr. Lebaron.

The team cooled Isabel’s body to 93 degrees, more than five degrees below the normal body temperature of 98.6 degrees.

As that process began, Isabel was transferred to the NICU at the Kaiser Permanente Roseville Medical Center for specialized treatment and monitoring.

A Happy Ending

After 11 days in the hospital — and, most important, no sign of brain damage — Isabel was discharged.

“We were at the mercy of the unknown,” said Castillo, who credits the Kaiser Permanente team with saving her daughter.

From the field to the hospital, more than 50 people were involved in Isabel’s birth, 10 times more personnel than a delivery without complications.

“Everyone was at the right place, at the right time, doing exactly what they were supposed to be doing,” Castillo recalled.

Samayoa remains amazed at the positive outcome. “It was a miracle,” said the NICU nurse. “It makes me want to be a nurse for another 41 years.”