May 13, 2010

  • 365 Days

    A year may be just a split second in God’s eyes, but to a mere mortal, it can seem to last forever. For our family, the past year has been one for the record books.

    On May 13, 2009, our two-year-old, William, fell at church and crushed his trachea. After phenomenal life-saving actions employed by the childcare workers and the volunteer medical team at our church, William was taken to LeBonheur Children’s Medical Center, where he underwent emergency surgery to repair his trachea. Eleven days later, he was discharged from the hospital, and was sent home with a van full of tracheostomy care equipment. Six weeks after his injury, the injury had healed and the trach was removed. Within a few more weeks, the trach hole had healed over as well.

    In past FB notes, I have described the incredible miracles that took place in the process of William’s rescue and surgery, as well as his recovery period. There is no question that he had an incredible surgeon, and that the hospital care team was excellent. The team that transported William in the ambulance made all the right decisions, and delivered him to the hospital in stable condition. Penny Williams and the childcare staff acted quickly and decisively to get William to the nurse’s station where he could receive immediate care. These people all played a vital part in saving William’s life. But I haven’t talked about the real hero that God placed in William’s path that day. I haven’t done so, because until Tuesday, I didn’t have all the pieces to the puzzle.

    One question that the surgeons asked me more than once while William was in recovery was, how long was it between the actual injury and William’s arrival at the hospital? The reason for their question is based in science and medicine: any severe trauma to the trachea is expected to result in the area becoming inflamed. It is not uncommon for someone to badly injure their trachea, feel better for a few minutes, and then suddenly asphyxiate and die. This happens because within about thirty minutes of such an injury, the trachea swells up and blocks any airway. If a breathing tube isn’t inserted before the swelling occurs, there may not be time to save the patient. William crushed the cartilage in his trachea, the smallest part of the airway. Any swelling should have closed off that area first, both due to its tiny circumference and the point of injury. My answer to the surgeons was that as best I could tell from the various accounts I’d heard, William made it to the hospital within 40 to 50 minutes of his injury. The look in their eyes told me this was not soon enough. And yet, when he arrived, he was able to be intubated before any significant loss of oxygen to the brain. Later CT scans to the brain showed no long-term effects whatsoever. A second full-body scan was equally clean. When they went in to do surgery, they were able to see the injured area and fix it. A trach tube was inserted in his throat below the injury to give that area time to heal, and of course, to allow the swelling that finally did occur, to subside. Why didn’t William asphyxiate before he even arrived in the ER? And how did he survive without brain damage? It was a miracle.

    The miracle was in the form of an EMT volunteer at Bellevue named David Chadwick. Mr. Chadwick will modestly insist that William is alive today due to the efforts of the entire first response team, and he’s partly right. Each person involved was in exactly the right place at the right time.

    Holly Irving, a volunteer in the children’s department at Bellevue Baptist, was not normally assigned to William’s classroom. One of the regular teachers was out, so she was filling in. After William fell down, he stood up and put up his arms to her. She saw his distress and carried him into the hallway, handing him to the first volunteer she saw, Penny Williams.

    Penny wasn’t supposed to be there, either. She was expected in another part of the church at the time. But God put her in that hallway, because she would know what to do next. Penny’s daughter had spent much time at LeBonheur with a heart condition, and had needed a tracheostomy at one point. Penny saw that William was turning color, and could tell that air was escaping from his trachea into the surrounding tissues. She attempted CPR, and the air would not push through, so she recognized that there was a blockage. His neck had a red line across it, and the shape of it wasn’t right. She alerted the children’s department that he needed to see the nurse, immediately!

    Gwen Kaluzny, the department director over childcare, Paula Hise, her assistant, and Shari Raynor, the coordinator for the department, all flew into action. The preferred procedure was to have the nurse come to the children’s hallway, in order to keep the area secure and not remove the child. But Penny saw that there wasn’t time to wait. Paula ran ahead of her to clear the way, and somebody called ahead to the nurse’s station, where Catherine Mills, an RN, was on duty. Penny was wearing sandals, and kicked them off so she could run at full speed. William was held against her shoulder. The emergency personnel suggested to me later that the jolting of William’s chest against her during Penny’s full-out run may have helped keep his lungs pumping as best they could through the injury.

    David Chadwick was sitting in the service when he heard a chatter on the radio he wore. A child was on his way to the nurse’s station, and might not be breathing. He stood up and quickly made his way to the back of the sanctuary, where he arrived at the same time as Penny and William. Catherine Mills sprang into action, working over William as Penny held him in her lap. The room was filled with frantic women and a desperate child, as Mr. Chadwick assessed the situation. William was scratching at his shirt, and at Penny’s, fighting to breathe. His color was gray, and his eyes rolled back in his head a couple of times, before he came to again. It was at this time that Mr. Chadwick heard what he called “a still small voice from God.” This boy didn’t just need oxygen; he needed a breathing treatment.

    The nurse’s station held a variety of emergency care equipment, including albuterol for asthma attacks or other bronchial issues. The doctor in charge also liked to keep xopenex on hand for children, which is considered the “mirror image” of albuterol. This is what David Chadwick reached for. He put a mask on William that had very few openings for the treatment to dissipate, so that most of the breathing treatment along with the pure oxygen went right into his lungs. This is when William started to relax. When the paramedics arrived, they strapped him on a child-sized body board, where he lay relatively calmly until he arrived at the hospital.

    In the hospital, William appeared so calm that the ER nurses removed him from the board and let him sit up. William’s injured trachea closed up even more, and he struggled again to breathe. He began to throw himself around the room, fighting for air. One of the paramedics shouted to a nurse he knew to get a doctor “NOW” and she reached over and yanked at the first doctor she saw. It took several people to hold William down. They attempted to give him an emergency tracheostomy, which on a child is difficult in surgery, much less on a wide-awake and panicked one. The attempt was aborted, and a tube was inserted orally instead. It went through without causing additional injury, long after his trachea should have been completely swollen shut. William began to breathe again through the tube. They were then able to prep him for surgery and successfully performed a tracheostomy and repaired the injury.

    Had it not been for the quick thinking of David Chadwick, William would not have survived long enough for his skilled surgeon to repair his injury. The efforts of the childcare workers, emergency dispatchers, and paramedics would have been in vain, had he not been given the breathing treatment that saved his life. This is so significant, that what Mr. Chadwick did may be officially put into the procedural manuals in the future. The medical community has lauded him for thinking outside the box, even as he carefully followed written procedures.

    And on Tuesday of this week, the entire first response team received a Star of Life Award for the 8th district in Tennessee. We went to Nashville with William and the team to see them win their award, and were thrilled to learn that William’s team also won the Star of Life Award for the entire state of Tennessee. (John’s Facebook Photos contains an album of the event.)

    This event has understandably been the focal point of our year. We will never, ever forget the miracle that happened to us. The Star of Life certificate William received this week commemorating the first day of the rest of his life will serve to remind us. To God be the glory, great things He has done.

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    William, being held by David Chadwick, EMT-P, FF Paremedic at the Star of Life Awards.

     

    http://www.facebook.com/note.php?note_id=393689892107

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