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Trauma central

By Dawn Brazell
Public Relations

Accidents happen. All the time. No one knows that better than the two blue-suited flight nurses in front of me describing the pediatric emergency calls they respond to daily by boarding an aircraft or "rolling out."

Craig Duncan and Mark
                                        DaniellCraig Duncan and Mark Daniell, both registered nurses and part of MUSC's Pediatric Critical Care Transport Team, have seen it all. They and their fellow crew members train constantly, including surviving a simulation of being dunked upside down in a water tank. The drills make sure they're ready to administer emergency care anywhere, trained so well they can function on auto-pilot, and in cramped spaces.

One of their typical treatment areas is inside the tight cockpit of the new EC 135 helicopter they describe as their "flying ICU." Their faces light up when they talk about it – the Night Vision Goggle (NVG) technology and terrain avoidance and forward projection radar. They do anywhere from 50 to 75 missions a month, 20 to 30 of those airborne.

Generally I focus well during an interview, but today I find my mind drifting.

I wonder if either of them were on board 16 years ago when my son was medevaced from Walterboro to MUSC after being mauled by a dog. His blood coated my shirt. He had a collapsed lung lining and seven broken ribs, though I didn't know that at the time. Rushing him to the Walterboro hospital, I braced myself to be able to do CPR if needed. Arriving in the emergency department, I handed him to nurses and requested a call for an airlift to MUSC. For the life of me, I can't remember why I didn't wait for their recommendation. I acted on pure, raw fear.

Duncan and Daniell, both fathers, note the job requires extensive medical training but more than that – a gifted ability to communicate. The patient for them isn't just the child injured, but also the parents who have been traumatized. Many of the extensive clinical skillsrequired for emergency pediatric care can be taught, but not that one. Duncan shakes his head. The team members just have to have it – that ability to empathize and impart trust - or they don't get selected.

I nod. I get that. Though I was so focused on my son that I can't remember the name of the flight nurse who took him, I'll never forget the look. In the pre-flight rush of bundling off my one-year-old toddler, we paused. He came to a complete stop, our eyes locking. I remember thinking, should my son die en route, will this man's face be the last he sees. In seconds, an eternity passed between us.

They talk about the golden hour – that magical period of time right after patients are injured or fall ill – a period if they receive prompt medical care and can be stabilized they may see their survival chances triple. When the critical care team arrives on a scene, often there can be much confusion. Duncan said everyone on the team knows how and will make decisions fast. It's what they do.

It's what I intuitively knew that awful afternoon so long ago. I let my son go because I knew he had more of a chance making it with them than with me. It would take me an hour to get to Charleston. They could be there in minutes. It would be the longest car ride of my life.

The crew now gets a cell number from parents. Duncan said they take time to call the parents after they arrive at the hospital and get the child or baby settled, so that the parents know how the patient fared during the flight. Duncan has five young children and Daniell keeps up with three boys, so they understand the bond parents have and how fast accidents can happen. Their rewards are the good endings. Daniell describes the rush of being able to treat a baby born too soon, administering the life-saving medicaton that will open up the baby's lungs and revive sluggish life signs. Duncan recalls the gratification of being able to revive children who suffer near drownings.

"You can relate to your own children – how easy it is to happen in an instant."

When they aren't able to save patients, they've learned how to cope. Daniell spends time in the well-baby nursery holding babies and helping out. Duncan remembers all the faces that have passed his way, children he has been able to help. He also gets recharged spending time with his own children. "You go home at night, and you can kiss these babies good night."

I smile at that – these macho flight nurses with such soft hearts. I can go home to kiss my 17-year-old, 6-foot-2 'baby' because of the type of training they and all the other members of the trauma team get. They think they know who it was on the team who was there for me in my golden hour. They promise to send me his name. Part of me doesn't want to know. That's odd, I think. But, how do I even begin to say thanks? All I can say is if our journeys had to cross, I was glad he was the one there.

Taking Flight
Meducare's new
                                          EC135 The Meducare adult flight team has four experienced pilots, four flight nurses who are registered nurses with critical care experience and four critical care paramedics

The Meducare pediatric and neonatal team has eight pediatric flight nurses and five pediatric flight respiratory therapists with extensive knowledge about the critical care of pediatric and neonatal patients.



Friday, Sept. 2, 2011

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