Pediatric Transport

On December 12, 2009, West Michigan Air Care was called to Three Rivers Health Emergency Department for a tiny 20-day-old female in respiratory distress.  What follows is her mother’s testimonial of events and the story of her flight with Air Care.

The Little Bundle Comes Home
Little Ally Pritchard was born slightly past term on November 11, 2009 with *meconium-stained amniotic fluid.  Her mother, Angela Pritchard, was thankful that her course progressed normally to discharge home without further complication except minor “nostril inflammation”.  During the following weeks, Ally and her family settled in a comfortable routine punctuated only by an episode of bacterial conjunctivitis.

A Mother’s Intuition
On December 12, Angela thought Ally was working too hard to breathe and was growing concerned.  Luckily, Ally’s father, Walter Pritchard, arrived home early that day.  Angela asked Walter to watch their other young daughter, Emmy, and took Ally to Three Rivers Health Urgent Care.  Karan Thomas, NP, immediately sensed Ally’s distress and agreed with her mother’s assessment. 

Angela recalls, “Karan looked at Ally and told me, ‘You need to go next door to the Emergency Room.’”  Ally was quickly moved to the E.R. and none too soon, according to her mother. “Within two minutes after (Dr. Theresa Kordish) walked in there, Ally totally crashed.” 

“Just do whatever you need to do.”
As the staff of Three Rivers Health supported Ally’s breathing and Dr. Kordish proceeded with endotracheal intubation, Bronson Methodist Hospital was quickly notified and West Michigan Air Care was activated.  The flight team included flight nurses Nick Wright and Dawn Johnston, Bronson pediatric transport nurse Dorothy Mack, and pilot Krystian Zygowiec.
Just minutes prior to Air Care’s arrival Ally had a restless episode in which her endotracheal tube became dislodged.  The E.R. staff of Three Rivers Health continued to effectively manage Ally’s airway with a bag-valve-mask as the Air Care team arrived and assumed care.  The E.R. staff remained in assistance as Ally was reintubated.  Wary of another restless episode, the Air Care crew kept Ally sedated and used a neuromuscular blocker after intubation.  Since Ally’s chest x-ray indicated pneumonia, the crew retrieved antibiotic therapy from the E.R. staff to begin in transport.  As Ally was prepared for transport, Dorothy quickly called Bronson PICU to provide an update and estimated time of arrival.
Swaddled in blankets and a pediatric immobilization device, Ally received good-bye kisses from her family and the Air Care crew received orders from Angela: “Just do whatever you need to do.”

Rapid Critical Care Transport
During the 10-minute flight, the medical crew continued to manage Ally’s airway and carefully monitor her condition as they administered needed medications.  The medical crew called a radio alert to Bronson E.R. to request helipad assistance and provide a report of Ally’s condition.  
Upon landing at Bronson Methodist Hospital, Ally was transferred to the Pediatric Intensive Care Unit (PICU) and then carefully moved to a specialty crib.  Nursing and respiratory therapy staff assisted Dr. Tammy Drew in Ally’s care. 

Bronson’s Pediatric Specialty Services
Angela lost track of day and night as 4 days went by in the PICU.  She greatly appreciated the Bronson staff’s support during this time. 

“Nurses do not get the credit they deserve.  I could ask the same question 20 times and they didn’t mind,” Angela said.  “I didn’t know how they could come in every day being happy… they cared for Ally like she was their own child.”  
Slowly Ally began to improve and was extubated.  She was moved to the pediatric general floor.  On day 6 she was discharged home with her family.

“Everyone at Bronson was so wonderful,” said Angela, who asked that RNs Angela Kinnell and Keri Wiersma be given special recognition.

A System That “Rocks”
Angela and her family are also grateful for Air Care’s critical care transport system that connects Southwest Michigan’s hospitals and provided the needed bridge of care for Ally.  This is the advantage Air Care brings to regional hospitals by acting as an extension of their resources when the need is urgent.

“The system rocks, obviously,” said Angela. “People just don’t realize it.  The whole system worked out great for us that night.  When Ally wakes up every morning, I know how lucky we are.  There are no words that I can say.”

*Meconium is normally stored in the infant’s intestines until after birth, but sometimes (often in response to fetal distress) it is expelled into the amniotic fluid prior to birth, or during labor. If the baby then inhales the contaminated fluid, respiratory problems may occur.

By Dawn Johnston,
Flight Nurse
West Michigan Air Care