While on call, you cover a community hospital 25 miles away. This hospital has a small NICU and pediatric ward. The neonatologists and hospitalists are the same group you work with at your children’s center. There are no additional pediatric specialists at this hospital. You are called in the middle of the night by an experienced neonatologist that a full-term, 3 kg baby girl was born and incidentally found to have a proximal esophageal atresia (EA) and distal tracheoesophageal fistula (TEF). The patient had some respiratory distress and was just intubated. The baby is stable and now on minimal ventilatory settings. You inform the neonatologist that the most appropriate management is
A Extubate the patient
B Transfer to a children’s center
C Immediate repair of EA/TEF
D Immediate TEF ligation only
E Wait until the next morning for repair of EA/TEF
A Extubate the patient
B Transfer to a children’s center
C Immediate repair of EA/TEF
D Immediate TEF ligation only
E Wait until the next morning for repair of EA/TEF
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