ISPP 2015

Career Opportunities in Pharmacy
Mayo Clinic Health System: “Special Delivery – Madelyn’s Story”

– He said, right away, “You’re kidding”. And I said, “No, I’m positive
my water just broke”. – [Female Narrator] Lizzie
Stoltz was definitely not kidding the afternoon she called
her husband Shaun at work on Sunday, June 30th, 2019. What had been a normal pregnancy up until now had suddenly changed. Just two days before, the
elementary school teacher had been in a family wedding. – Then we realized that this
is–there’s no reversing this now and that this
is actually happening. – [Female Narrator] And
happening way too early. Lizzie was only 30 weeks pregnant. The couple lives in the
small Northern Wisconsin town of Bloomer: population roughly 3,500 with their son Noah. Lizzie had planned on
delivering their second child at the Mayo Clinic Health System hospital in Eau Claire, about 30 minutes away. However, it soon became very clear they wouldn’t be making that trip. – It went so fast that I needed
an ambulance from our house to the Bloomer hospital
which is three minutes away. – [Female Narrator] That
hospital three minutes away was Mayo Clinic Health System in Bloomer, a critical access site with a 24/7 staffed emergency room, but because of its size, there’s no labor and delivery service or a neonatal intensive care unit. Physician assistant Jon Farm was working the emergency room and
only had about five minutes to prep for Lizzie’s arrival. He called on-call family
medicine physician, Phil Skaar, to assist. – “We’re gonna have two
patients here, can you come in?” and I said, “Obviously, I’m on my way”. – [Female Narrator] Back at
the hospital, Jon knew he had to take an aggressive approach
with such an early delivery. – I didn’t know if was
gonna make it in time so I thought I was gonna
end up managing two patients at the same time, so I was glad
to see him walk in the room. That’s the first thing
that crosses my mind is some of the appropriate
resources and team to be able to take care of the
patients that are coming in. So that’s what I did, I called Dr. Skaar and then I called the
transfer line in Rochester and told them that I’m gonna need some telemedicine help as well. – [Female Narrator]
Telemedicine is a tool that, through the advancement
of modern technology, allows medical providers to
communicate and see patients from an off-site location
through a machine just like this. Dr. Christopher Collura, a
Mayo Clinic neonatologist in Rochester, Minnesota, suddenly appeared on the telemedicine machine in Bloomer, ready to immediately
assist Dr. Skaar and Jon. – I was able to then log on
to, actually my home device, and connect directly
into the emergency room in Bloomer and get a brief update about what their current situation was – He was online prior to
the baby being delivered so we kinda had a plan before
the baby was delivered. So, very helpful. – [Female Narrator] Lizzie
arrived at the Bloomer emergency room just in the nick of time. – She was definitely ready to push. – [Female Narrator]
Amazingly, through it all, Lizzie remained calm. – ‘Cause I remember my
legs were shaking so much so you were helping to
hold one of my legs. You thought I was gonna break
his ring, his wedding ring. – It’s a lot to take in. – So fortunately the mom and
dad were distracted enough that we just kinda moved
two steps aside and said, “Yeah, this is gonna happen”. You know, I took the easy part and said I’ll deliver the baby,
John go over to the warmer and resuscitate the baby. – But I do know that I was just like “I have to just give it
everything I’ve got”. Like she has to be able
to be delivered here. – Mom was focused on being
in the moment, you know, I’m gonna be delivering
this baby so she was working through the labor pains and pushing and Dad was attentive
right at the bedside. – [Female Narrator] By now,
more than a dozen people had joined the room to work as a team. The Mayo One flight crew from Eau Claire, Bloomer nurses and doctors,
and Dr. Collura in Rochester, nearly 100 miles away, still
consulting via telemedicine on the screen next to Lizzie’s bed. – So the technology’s really good, it brings us right in to
the moment with the team at the health system sites
and in the care of the baby and so we have controls in
order to zoom in on different areas of the room, improve
our audio, talk to providers with a handset if needed, short
of us standing right there with the team, it’s the next best thing. – It was literally like
having a specialist looking over your shoulder
and there is times where he would pan the camera
and have a conversation like, “Hey, what’s your
name, okay, we’re gonna do– this is what I want you to do”. It was remarkable, absolutely remarkable. – [Female Narrator] However,
there were complications. Hopes for a fast delivery were dashed because the baby was presenting face up, but finally, the tiny baby was delivered. The baby girl’s umbilical cord was quickly clamped, her
face was badly bruised, she was not crying, and she was blue. – I just remember yelling “She’s out,” which is so funny because
obviously they know that. – [Female Narrator] Resuscitation
measures began immediately – She’s very limp and
blue and not breathing. – [Female Narrator] Jon
now took over with the baby and the warmer, he began intubating and getting an umbilical
line started for medication. Dr. Collura remained by his
side on the telemedicine screen taking the guesswork out of caring for such a premature newborn. – Clearly they had a great team model, and though neonatal
resuscitation is something that they may not do often, they clearly had a very strong inter-disciplinary team. – [Female Narrator] While
this was all going on, Lizzie was unable to see or hold her baby, but, suddenly, she heard sounds. – What was neat is that I
could hear her, kind of, making those cooing noises
so I knew that she was okay. – Like, she could fit
in the palm of my hand. I mean, I’m a big guy, but three pounds. – [Lizzie] 16 inches. – 16 inches, like I felt
like I could hold her like I was cupping water out of the sink. – [Female Narrator] By now the
Mayo Clinic neonatal flight crew from Rochester had
arrived on the scene and prepared to take the tiny
baby, named Madelyn Grace, to Mayo Clinic in Rochester
where she would receive care in the neonatal intensive care unit. Madelyn had just become the
first baby born at the Bloomer hospital in years, and the
first to be born at the hospital with the support of tele-neonatology. – I felt that the team was well prepared and we had, kind of, worked
through those steps together. – I was very overwhelmed,
like “What just happened”? – [Female Narrator] Lizzie
and Shaun followed their baby to Mayo Clinic, little did they know then that the world-renowned
Mayo Clinic would become their second home for the
next 44 days before returning to Bloomer with baby
Madelyn on August 13th. – You know, you hear when you’re there, you see their banners saying
number 1 in the world. Well, yeah, they hold that
true to be the best of the best and we’re fortunate to have them so close. – [Female Narrator] When all
members of the Stoltz family had left the Bloomer
emergency room for Mayo Clinic Dr. Skaar and Jon Farm
finally had time to reflect on what had just happened and the role telemedicine
played in the case. – I just think that’s the most
amazing medical situation, scenario I’ve been involved with. When I got home that night,
it was a while to get to sleep because it was like, “Wow, we
really did some good today”. That was a great feeling. – It gets the patient the right care at the right place, at the right time. That’s what telemedicine does. – [Female Narrator] The
Stoltz family agrees. – It was just a great
peace of mind knowing that there was another set of eyes and somebody that’s, you know, experienced and is able to kind of take on that role and to help other people in this situation where this not their everyday and even having babies
is not their everyday. So it’s just, so grateful
that telemedicine is out there and that’s its being
implemented in small towns. – Hopefully it gets the
telemedicine into more communities and hopefully it helps
more people down the road. – [Female Narrator]
Madelyn is now thriving, eating well, growing,
and getting used to life with big brother Noah,
protective dog Kennedy, and life at her real
home with mom and dad. – It’s broken sleep with a lot
of smiles, that’s what it is. She’s gonna be demanding. (laughs) She’ll be a fighter, that’s for sure. (baby coos) (upbeat music)

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