We ended up removing the endotraheal tube, getting his mouth well suctioned out, and breathing for him briefly with a bag and mask. As soon as we did so, his heart rate and oxygen level improved. By this time, though, mother was sobbing and gasping, and soon thereafter left sounding like she was about to vomit. We then replaced the endotracheal tube and the baby stabilized and did well for the rest of the night. When mother returned, we tried to reassure her that her baby was now doing okay and that what she had witnesssed was a typical scene in an NICU - which is true, but of small comfort to a mother who has to see her baby in such distress, even if it is for a brief time.
I'm not sure how much to let parents observe in the NICU. In general, I'm in favor of them seeing a lot. It's good for them, in many ways, to see us all working together for the benefit of their baby and to have as complete and honest information as possible. I also like them to be at the bedside when we're rounding, so they can hear the plan and understand some of the problems with which we're dealing. But there is a limit. Some procedures parents shouldn't have to see done to their child, not because we're doing bad things, but simply because it's too much trauma for a parent to observe. For instance, when we place an endotracheal tube, we put an instrument called a laryngoscope into the mouth and sort of pry the throat forward, so we can see to place the tube. Although pretty safe in the hands of an experienced person, it looks horrible, and I certainly would have trouble watching that done to my own kids.
A few weeks ago a mother asked me if she could watch me do a spinal tap on her child. I said okay, but that I didn't recommend it, and she ended up taking my advice. I can understand why parents want to be present, and we let them observe us starting IV's and drawing blood. But for some other things, like spinal taps and intubations, I'm not sure it's good. For one thing, a parent observing could make the operator more nervous, lessening the chances of a successful procedure, but mainly, it's just a difficult thing for a parent to have to see.
It's a tough question. Parents have heard about the problems with medical errors and want to avoid them in their kids. But I don't know if watching procedures is the way to do it.