Straight Talk - “Thirty minutes to live”

August 11, 2011

Dear Friends and Colleagues,
The message was chilling but the tone was calm. “Thirty minutes to live,” said neurosurgeon Dr. Mark Gerber to Chief Nursing Officer Michele Thoman, on a Saturday afternoon two weeks ago, concerning a seven-month old infant with a head injury. With the baby’s life hanging in the balance, NCH teamwork would never be more important.

I won’t keep you in suspense. Now two weeks later, the child is well and at home, doing what any normal seven-month-old does, except for the temporary physical and occupational therapy for the next few months at an NCH outpatient facility. North Naples Hospital ER Coordinator RN Jill Zollar picks up this miraculous story.

Emergency Medical Services entered the waiting room with a mother, cradling the vomiting infant. ER RN Jessica Walsh quickly called the mother into the triage room, where the mother pointed to a fist-sized hematoma (bruise) on the baby’s head. The baby was pale, lethargic and had a low heart rate. Jessica immediately involved Dr. John Lewis, on-duty ER physician (and also co-Chairman of our ER physicians, Chairman of the Board Quality Committee, and an NCH Board member). ER RN Julie Stoner quickly executed Dr. Lewis’ orders for oxygen, an IV, and a CT scan of the head, which showed a large blood clot on the brain (an epidural hematoma). Pediatric intensivist Dr. Debbie Lopez and Registered Respiratory Therapist Beverly Ward then arrived and never left the baby’s side thereafter.

Together, Drs. Lewis and Lopez called Dr. Gerber, one of our five neurosurgeons on call all the time. Dr. Gerber, in his car that Saturday afternoon, pulled over, got out his iPad and viewed the CT results. (NCH is among the 200 top IT hospitals in the country; we can view radiology results anywhere with Internet access.) Dr. Gerber’s instant conclusion: The baby would be too ill to transfer out of town. Dr. Gerber had all the necessary neurosurgical instruments at the NCH downtown campus, where we do the majority of brain surgery. Dr. Lewis arranged for emergency transport there.

Anesthesiologist Dr. Rob Statfeld had already finished his Saturday morning surgery schedule and had just arrived home. Earlier in the week, he graciously agreed to cover on Saturday afternoon for a colleague who had another engagement. Dr. Statfeld has had extensive experience with pediatric trauma in his former practice and as he drove back to the hospital, he considered plans for anesthesia and the equipment he would need for an infant. Fortunately, Dr. Lopez keeps a pediatric cart full of equipment in the downtown ER, just in case it’s needed. It was. Sarah Holton, Assistant North Naples OR Director who recently joined NCH after five years of pediatric surgical experience at Nemours Alfred I dupont Hospital for children, also headed in to assist OR staff Rose Echols, Lily Mangovski, Cheryl Marshall, and Matt Roberts.

The baby was successfully resuscitated with blood, emergently cross-matched at NCH North Naples lab, by Peter Kubetschek and transported downtown. Then Dr. Statfeld, with Dr. Lopez in the OR as well, administered the anesthetic, and Dr. Gerber performed successful neurosurgery. All stayed for most of the afternoon, as the patient was cared for by RNs Linda Yerger and Kelly Whitfield. Finally, as the baby emerged from anesthesia and one of his pupils started to react to light, a second CT scan showed stabilization and the child was transferred to the McDonald Seacarium where RNs Brittany Cassan, Patty Devarenne, and Jenna Randall continued the care. The baby was saved.

A miracle? Certainly. But it was a miracle because of teamwork at its best among highly-trained professionals. It is a privilege to work with such dedicated and talented caregivers.

Allen S. Weiss, M.D., President and CEO
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