OB Mishap and You

[MmacFN]

You enter a room where are 23 y/o patient is requesting an epidural. This is her first baby and she is having alot of pain. Her birth plan included an epidural and she is glad you are here. She has no other history and this is an uncomplicated pregnancy.

You notice as you are localizing her she is dodging the needle, not uncommon but it will make insertion more challenging. At one point during a contraction she literally stand bolt upright. This stuff can happen, it makes you work harder but the best you can do is verbally reassure her.

One she stops moving you get a quick loss of resistance without difficulty. You inject the 3 cc test dose and wait a minute for a response, there isnt any.

You grab your 8cc of 0.2% bolus with 100 mcg of fentanyl in it and start a slow injection. Between pushing this in you tape your epidural in.

Over a period of a minute or 2 the whole bolus is in. As you are preparing to claim victory and lay her back down she starts to tell you she cannot breathe. She looks like it too. Then she immediately passes out.

What do you do?