Saturday, September 20, 2014

MIAMI PHOTOS: CPR Rescue Baby Celebrates Birthday

Sebastian de la Cruz with his mom Paola Vargas. Her sister Pamela Rauseo

rescued the infant by performing CPR when he stopped breathing while

traveling on the 836 expressway in February. AL DIAZ/MIAMI HERALD STAFF

By Audra D.S. Burch

By Audra D. S. Burch
aburch@MiamiHerald.com

For his first birthday, Sebastian de la Cruz is having a pool party Saturday with a bounce house and a donated Little Dumbo cake topped with a single candle.

It will be the birthday celebration that almost wasn’t.

But for the random nature of Miami’s clogged highways — which happened to be filled with just the right strangers on a February afternoon — and an alert aunt who remembered CPR just in time, Sebastian might not have made it past five months.

Born prematurely, with some respiratory issues, the infant had stopped breathing and was turning blue when his aunt, Pamela Rauseo, revived him on the shoulder of State Road 836 in a dramatic roadside rescue that was captured by a Miami Herald photographer in an image beamed around the nation.

With the baby in her arms, Rauseo had jumped out and run into the traffic jam begging for help. Miami Herald photographer Al Diaz captured one of the most powerful moments: Rauseo crouched over the baby, blowing into his mouth. The photo and rescue became a national story, rooted in an aunt’s bravery and the importance of CPR.

“So many things had to come together in such a way for there to be a positive outcome,’’ says Anthony Trim, a Miami-Dade Fire Rescue captain who happened to be near the scene as it unfolded in traffic and pitched in to help.

Had anything changed in the sequence of events that afternoon, Sebastian might not have lived to see this first birthday. Had he not stopped breathing, doctors might not have discovered he had life-threatening cysts on his trachea. But he is here now, all gums and giggles and bursting with energy. Even as the family prepares for his party, his mother, Paola Vargas — Rauseo’s younger sister — worries about her firstborn, and still tears up wondering about the what-ifs.

“I think a lot about all he’s been through and I wonder why all this had to happen to him,’’ Vargas says. “But I know he is my biggest gift. He is my little survivor.”

‘NOT MOVING AT ALL’

For months, Vargas, 28, had woken up before sunrise to Sebastian’s gentle kicking — thump thump, thump, thump — in her belly. But on the Wednesday morning of his birth, Sebastian was silent. Vargas began to walk and drink orange juice to rustle her unborn into kicking.

As a nurse at Jackson Memorial Hospital, she knew the risks of a

premature birth. Sebastian wasn’t due until December.

“It was a normal pregnancy. There were no warning signs of anything,’’ she says. “I knew his routine of movement and that day he was not moving at all.’’

By the time Vargas arrived at Jackson, Sebastian still had not moved. She met with an obstetrician who ordered a sonogram. It showed the unborn child had ascites, a fluid buildup in his stomach and Vargas had no amniotic fluid, the nutritional lifeline to babies in the womb. This meant Sebastian had to be delivered immediately by c-section.

Less than a half hour later on Sept. 18, 2013, Sebastian de la Cruz was born prematurely at 28 weeks, five days.

He arrived with complications: Hydrops Fetalis, a serious condition in which newborns retain abnormal amounts of fluid. At the time, the doctors also worried that his kidneys might not be functioning properly.

“The doctors said if there was something wrong with his kidneys, that he had very little chance of making it,’’ Vargas says, tears welling in her eyes.

Complications mounted. The next day, doctors discovered Sebastian had a skull fracture that caused a brain bleed. Fortunately, it would not require surgery. Two days later, he was diagnosed with necrotizing enterocolitis, a condition among premature newborns in which the intestines cannot hold waste.

“One minute, you think everything is going to be OK, the next you don’t know because something else has come up,’’ Vargas says.

As the uncertainty continued, Rauseo attempted to baptize the newborn. With rosary beads and holy water gathered from her church, the aunt stood over the nephew as he lay in an incubator in the neonatal intensive care unit.

“I knew that when someone is at risk, if they haven’t been baptized, you can make the sign of the cross and say certain words and that will suffice. I tried. We were very scared,’’ said Rauseo, who is Catholic. “I remember telling my sister that you need to prepare yourself for whatever fight is in front of us.’’

Sebastian was in the hospital the first two months of his life. The day before Thanksgiving, he went home for the very first time to an elephant-themed nursery. And things were good for a while, as Vargas and her husband, Robinson de la Cruz, settled into their roles as new parents.

Then about a week after New Year’s Day, Sebastian started coughing. His voice became hoarse, his breathing labored.

“We had traveled to North Carolina for the holidays. I thought it was the change in temperature,” Vargas said. “It was like he had a cold that would not go away.”

Doctors determined he had croup, inflammation of the throat. He was treated but after a few days, he started coughing again.

Still, Sebastian was a happy, playful baby with chubby cheeks and hazel-colored eyes; he loved to touch sparkly things, play bouncy and to eat Cream of Wheat. But always the coughing would return, sometimes accompanied with difficulty swallowing.

Sebastian was scheduled for another appointment with a pulmonary specialist the day he stopped breathing.

A SECOND MOM

With a 10-year age gap, Rauseo has been like a “second mom” to Vargas as long as she could remember. The oldest of four siblings, Rauseo moved from New York to South Florida in 1997, followed by Vargas seven years later. Rauseo, a preschool owner, took care of Sebastian, or Seba as she called him, when her sister was working. So when Sebastian’s dad had to take a business trip to Atlanta and Vargas had to work, it was Rauseo who took him to see a doctor working on Jackson’s campus.

As Rauseo and the baby waited for for the pulmonologist, Vargas and her mother, also a nurse at Jackson, found a couple of minutes to visit the infant.

“Sebastian was fine. He was watching the movie Frozen in the waiting room,’’ Vargas says. “He was so happy.’’

Afterward, Rauseo and Sebastian headed home on the 836, known locally as the Dolphin Expressway. It was about 2 p.m. and Sebastian was in the back, in a car seat facing the rear. Rauseo was listening to a Spanish language radio program discussing the social unrest in Venezuela. Sebastian had fallen asleep. As traffic slowed, he woke up and started crying. Somewhere between the Northwest 45th Avenue and Northwest 57th Avenue exits, he became quiet. Too quiet.

“We are at a dead standstill, not a single car is moving. The moment he stopped crying, I said to myself, this is not right, but I couldn’t see him because he was directly behind me,’’ she says.

Rauseo pulled the car partially onto the shoulder from the left lane. She checked on Sebastian. He was pale. His eyes were closed. His limbs were limp. She tried calling 9-1-1 but her fingers wouldn’t — couldn’t — move. So she did the only thing she could think of: grab the baby, get out of the truck and run like hell, looking for help.

“I started screaming but I made sure to point to the baby so people wouldn’t think I was some crazy woman,’’ she recalled.

“I need help!”

“Please someone help me!”

“Someone help me!”

She remembers a woman and a man rushing toward her — Lucila Godoy and Diaz, the photographer. She remembers dropping to her knees and trying to save her nephew’s life.

In the blur, Rauseo at first did not remember she knew CPR. Then it kicked in, the lessons learned seven years before in a class. She placed Sebastian on his back, then placed two fingers on his chest and counted out compressions while breathing into his mouth. Godoy helped and comforted the distraught Rauseo.

At first, Sebastian did not respond.

“I was getting tired and he had not yet started to breathe. I remember at one point, pounding on the pavement and saying ‘please God don’t let this happen,’ ” she says. “My sister had trusted me with her baby. I could not let him die.”

The mother of three knew something about this kind of panic. Her own son had stopped breathing eight years earlier as an infant. She and her husband were racing to the hospital when he began to breathe again on his own.

As Sebastian struggled to breathe, Amauris Bastidas, a Sweetwater police officer at the time, rushed over. He had been sitting in his squad car a few lanes over.

“I lifted him up in the air and moved him up and down,” Bastidas said in an earlier Miami Herald interview. “He started breathing and crying.”

Then he stopped again.

They frantically started CPR again, reviving Sebastian for a second time. By that time, more help — officers from the City of Miami and two from Miami-Dade, also stuck in traffic — had arrived.

Sebastian finally began breathing again. Rauseo crumbled.

“Fear. Terror. Panic,” she says. “I really thought we were losing him.’’

A MUFFLED SCREAM

Diaz had been returning from a photo assignment when he ran into the crush of traffic on the 836. He happened to be right behind Rauseo.

“I had just hung up the phone when I hear a muffled scream. I am not really sure where it’s coming from. I am thinking it’s the phone. I think it’s the radio. I look in the rear-view mirror and there’s nobody around me,’’ Diaz says. “I look up and she pops out of the car with a limp baby. With a blue baby. And she comes running toward me.’’

Diaz jumped out of his car. So did Godoy who left her own 3-year-old son in the car.

“She runs over and asks if the baby was eating anything or if he is choking. Pamela says no, he just stopped breathing,’’ Diaz explained.

One of the women turned the baby over, patting him to clear his airway. He went for additional help.

Diaz dashed through the stalled traffic, head on, flagging down Bastidas who was in a marked police car. It is that second round of CPR that is captured in Diaz’s picture.

‘SOMETHING ATYPICAL’

Capt. Anthony Trim and Lt. Alvaro Tonanez of Miami-Dade Fire Rescue’s hazardous materials bureau — also stuck in stop-and-go westbound traffic in separate vehicles — were returning from a training session in Miami Beach when they heard the emergency call come over the radio. They were both in the center lane, about a half-mile away from the scene.

The dispatcher was sending units to respond to “kid in respiratory distress or cardiac arrest.” Both hit their light switches and started trying to navigate the traffic jam.

“Something atypical happened. The cars actually moved out of the way for us, which is sometimes hit or miss,” Trim recalls. “Typically in congested situation, we encounter a handful of motorists who are hesitant or downright obnoxious.’’

They found Sebastian barely breathing.

“I saw Pamela on her knees and the baby on a mat on the shoulder of the road,’’ says Tonanez. “As I came up, she grabs Sebastian and passes him to me.’’

Tonanez, a paramedic and firefighter, quickly assessed the infant’s condition the way he was trained: He is breathing. He is blue-ish or purple-ish. His eyes are open. He is making noise trying to breathe. This is good. His arms are limp.

“I start by blowing air around his nose and mouth. The aunt did pretty much all we needed to do to get Sebastian back. Did I help by blowing a little bit? Hopefully I did help clear the passageway,” Tonanez says. “His appearance was improved considerably by the time we passed him onto the rescue truck.”

Trim said their job was to keep the infant alive until help arrived. About seven minutes after the first call, a City of Miami paramedic unit — which was closer than the county unit — arrived and rushed Sebastian to Holtz Children’s Hospital at the University of Miami/Jackson Memorial Medical Center.

“He was breathing, but he wasn’t in good shape,’’ Trim says. “We were hopeful.”

Trim and Tonanez have nearly 40 years of experience between them, including many life and death situations. But cases involving babies are always different.

When Tonanez got back to his office he picked up the phone.

“I called my kids to make sure they were OK,” Tonanez said. “It kind of hits home when you are dealing with kids.”

When Trim got back to the office he received a call. His 77-year-old mother had been in a car accident. He rushed to her side. She is still recovering from a leg injury.

TWIST OF FATE

Vargas was in the seventh hour of her nursing shift when she called Rauseo to find out about Sebastian’s doctor’s appointment. What she didn’t know: her sister and son were in an ambulance rushing to the hospital. “I didn’t tell her at first.”

Vargas was pregnant at the time. Her sister was worried about her reaction. “I am thinking, how do I tell my sister what we just experienced?’’

At the hospital, Rauseo called Vargas and told her to go to the emergency room.

“By the time I got to him, he was already crying so I knew if he was crying, he was breathing,” Vargas said.

Doctors discovered and removed three cysts from the baby’s trachea that were blocking his airway. Vargas said they may have never known the procedure was necessary had Sebastian not stopped breathing that day.

Sebastian was in the hospital for a week. Since then, he has had a few respiratory issues, but nothing severe and he is developmentally up-to-date. The hope is that as his trachea grows and lungs mature, the last of the breathing issues will subside. For now, Vargas suctions his nose regularly to clear any congestion and keep the passageway clear.

In the months that followed that day in February, Vargas would give birth to a little girl named Chloe. Sebastian was officially baptized. Diaz won awards for the stunning photo that captured the rescue. And Rauseo walked away from the experience convinced that more people need to know CPR. She hopes to launch an initiative requiring infant CPR education for parents before they are allowed to take their newborns home from a hospital.

The focus now is on Sebastian’s first birthday party Saturday, a celebration of the promise of life.

“I believe he is meant for a big purpose,’’ says Vargas. “He was given back to us twice.’’

APME PHOTO OF THE YEAR

Miami Herald photographer Al Diaz, a 30-year veteran, shot photos of Pamela Rauseo’s dramatic CPR rescue of her nephew, Sebastian de la Cruz, after he first flagged down help in traffic. In July, that image was named the Associated Press Media Editors’ Member Showcase Photo of the Year. He also received the 2014 National Press Photographers Association’s Humanitarian Award.

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