Accidents Happen When you Least Expect Them
By Robin O’Connor
Children love the playground. Swinging, going down the slides, and goofing around on the monkey bars.
Claire is an active, athletic 8-year-old. She takes ballet and ballroom dancing classes, does gymnastics, plays tennis, and is on a soccer team. So when Claire said, “Look what I can do” while flipping around on the monkey bars, the last thing her mother Jane thought of was surgery. As Claire was doing her “monkey-bar flip,” she twisted and broke her arm. Jane applied an ice pack and headed straight to the pediatric emergency room at Sutter Health’s California Pacific Medical Center.
The California Campus Pediatric Emergency department opened in November 2008. Now seeing an average of 1,000 emergencies a month, the department’s prompt service and short wait times have made it popular with families. Approximately three-quarters of the physicians are double-boarded in pediatrics and pediatric emergency medicine, while the others are board-certified in emergency medicine. “At a general emergency room, only about 10-20 percent of the patients are children. We care for children exclusively, so we know how to work with kids,” explains Daniel McDermott, M.D., emergency medicine specialist. Child Life staff helps to comfort and positively distract children, making it easier to draw blood, take blood pressure, and perform X-rays. All of the private pediatric emergency department exam rooms are equipped with a TV/DVD player, as well as other age-appropriate items like puzzles, books and dolls to keep kids occupied. “It’s easier to work with a child when they’re not focused on their injury,” explains Dr. McDermott.
Enroute to emergency, Claire’s mother Jane called the emergency room, so they were ready for her on arrival. “At the time I didn’t have the pediatric emergency room programmed in my phone, but I do now,” says Jane.
Claire was seen immediately by the triage nurse. One look at Claire’s broken arm and Claire was moved into an exam room. Unable to find a pulse in Claire’s arm, Scott Green, M.D., orthopedic surgeon, was called in to assess Claire’s injury and set her broken bone. While Claire waited for Dr. Green to arrive, Child Life staff helped Claire understand what would happen in surgery, providing a distraction for Claire and Jane. “The Child Life staff was amazing,” says Jane.
In the operating room (OR), Dr. Green set Claire’s arm but still could not find a pulse. Claire’s circulation was blocked somewhere. Dr. Green called the pediatric microsurgery team for consultation. Brian Parrett, M.D., pediatric microsurgeon, arrived within minutes. Using a surgical microscope, Dr. Parrett began looking for the blockage and found a blood clot in Claire’s brachial artery.
A bone fragment had injured her brachial artery and a clot had formed. “It was a freak accident,” explains Jane. “This only happens once in a blue moon. If they didn’t find the clot, Claire could have lost the use of her arm.”
After surgery, Claire stayed in the pediatric intensive care unit (PICU) for 10 days. Claire’s mother spent just about every moment with her, relieved for a few hours each day by Claire’s father Gennadiy. Claire’s classmates and teachers visited, bringing homework and hugs; even her P.E. teacher came to see how she was doing.
When Claire was able to move to the general pediatric floor, she didn’t want to go. “She had made friends with the nurses in the PICU. The Child Life staff had helped support her and helped her forget about her arm,” Jane adds. “They helped her heal faster.”
Two months after her monkey-bar injury, Claire is back to being a normal 8-year-old girl. Through physical therapy, she has regained nearly the entire range-of-motion in her arm. Claire is playing tennis, taking ballet and ballroom dancing, and is even back part-time in her gymnastic class.
At a recent birthday party, Claire was back on the monkey bars. “I couldn’t stop her if I wanted to,” states Jane.