When we think of neonatal intensive care units, we think of Rockford Memorial Hospital. But did you also know that the Children’s Medical Center is one of just 10 state-certified pediatric intensive care units in the state?
The Rev. Caleb and Melanie Schauer were far from their Union, Ill., home last July when they got a call no parent wants to receive. Their 15-year-old son, Malachi, had been shot.
“My son and his 13-year-old brother were on a farm when they found some guns and played with them,” Schauer says. “Malachi was accidently shot in the abdomen. In cases where gunshot wounds are to the head or abdomen, a REACT helicopter is called. He was airlifted to Rockford Memorial Hospital [RMH] Children’s Medical Center.”
Malachi spent only a moment or two in the emergency room before he was rushed into surgery. There, Dr. Spyro C. Analitis, a general surgeon, opened him up and traced the bullet’s pathway.
“The bullet had pierced Malachi’s stomach but it appeared that no other damage had been done to major organs,” Schauer recalls. “They left him open on the operating table for 15 to 20 minutes to ensure he was not bleeding internally anywhere.”
Certain that Malachi was not in danger of bleeding out, the attending surgeon closed the incision. Malachi was transferred to RMH’s pediatric intensive care unit (PICU). But about 90 minutes later, Malachi’s blood pressure dropped to nearly zero and he was rushed back into surgery; doctors couldn’t find any obvious bleeding.
“The doctor once again traced the pathway of the bullet,” Schauer says. “As he touched the major descending aorta, a pinhole wound appeared. The doctor said that this was weird because about three liters of blood course through the aorta and it should have gushed blood. He searched the area and pulled out a blood clot. Immediately, the doctor pinched the aorta shut and called for an additional surgeon.”
The surgeons found that not only had Malachi’s aorta been nicked, but his ascending vena cava vein that returns blood to the heart also had a wound and blood clot.
“That vein can’t be pinched shut because it brings blood back to the heart,” Schauer says. “The surgeon stitched Malachi’s blood vessels and once again, they waited 15 to 20 minutes, watching for any signs of bleeding.”
Malachi was returned to the PICU, where a nurse named Brad sat by his bedside all night long, monitoring his vital signs.
“He was amazing,” Schauer says of the nurse. “Meanwhile, we had flown home to Chicago and arrived at RMH around 10:45 p.m. Dr. Analitis was still there, waiting for us. He told us what had happened with Malachi so far, then emphasized just how lucky our son had been.”
Schauer was told that, if any pressure at all is applied to the puncture area, in a situation like this, a patient is likely to bleed to death within three to four minutes. What saved Malachi was the fact that his blood clotted, which is somewhat unusual in those particular blood vessels.
“The next day, when my wife and I were a bit more clear-headed, Dr. Analitis spent about 45 minutes describing what had been done surgically to save Malachi’s life,” says Schauer. “Meanwhile, Malachi was receiving excellent care from RMH’s PICU. It wasn’t just the doctors and nurses. All of the support staff, including the housekeeping personnel, was encouraging and sympathetic. I had a lot of really good conversations with them.”
Malachi remained in the PICU for nearly a full week before transferring to a regular pediatric room for another week. During that time, Schauer says, Dr. Analitis went on vacation.
“He called us from the airport to make sure Malachi was still all right,” Schauer says. “Everyone told us Malachi should have been in the hospital for at least a month, but with God’s miracles and the outstanding medical treatment he received, he was able to come home much sooner.”
And while Schauer wouldn’t wish this kind of situation on anyone, he says he feels his family has been truly blessed by the care shown by RMH’s highly dedicated pediatric specialists. In a letter of appreciation, the Schauers stated to RMH president and CEO Gary E. Kaatz: “…Additionally, the nurses and doctors in the PICU and the regular pediatric floor, as well as the Family Life Specialists, were very much a blessing to us. We were overwhelmed with the care and compassion that they showed to us. They were ALL very professional, personable, friendly and pleasant to work with, and every one of them exceeded any expectations that we may have had.
“We thank God for the wisdom and skill that He gave the medical team. They were top notch and very proficient. God has blessed us with the gift of our son’s life, through the hands of the team at Rockford Memorial Hospital.”
RMH’s unique PICU unit is one element in a comprehensive pediatric program unlike any other in the Rockford region. Courtney Anderson, the program’s nurse manager, says Malachi was treated in a seven-bed unit certified by the Illinois Department of Public Health as one of only 10 pediatric intensive care centers in the entire state.
“As a Pediatric Intensive Care Center, we have four pediatric intensivists who specialize in taking care of critically ill pediatric patients, ages birth to 18 years old,” Anderson says. “We treat patients with acute illness and injury, as well as patients with chronic illness. We sometimes take care of patients older than 18 who are chronically ill and severely developmentally delayed. Many of these patient come to us from Walter Lawson Children’s Home.”
While treating the various illnesses and traumas suffered by youths, RMH’s pediatric department also takes care of the developmental and emotional needs of young patients. Anderson says RMH’s Child Life program focuses on helping children and their families to cope with the anxieties that come with any hospitalization.
“Four employees are specifically trained to provide developmental care and support, and to make the hospital experience as stress-free as possible,” Anderson says. “It’s an unfamiliar situation for most. One of the things our Child Life staff does is lead a tour of the hospital before scheduled surgeries. We’78 e discovered that this helps to familiarize them with the hospital and equipment that they may never have seen before. This decreases anxiety and assures the best outcomes and experiences for the patient and family.”
Child Life Services works with nursing staff, therapists, pharmacists and case managers, coordinating the best care plan for each child, including follow-up for when the child is ready to go home. The interdisciplinary team includes physicians, nurses, therapists, case managers, Child Life Specialists, nutritionists, nurse managers and pediatric clinical nurse specialists.
“This time of year, we’re particularly concerned with respiratory diseases including syncytial virus,” Anderson says.
Human respiratory syncytial virus (RSV) causes lower respiratory tract infections and is a major cause of hospitalization for infants and young children. According to the Mayo Clinic, 60 percent of infants are infected during their first year, and nearly all children will become infected by the age of 3. Fortunately, only 2 to 3 percent develop bronchiolitis as a result. Some infants can become symptomatically infected more than once in a season.
“Adults are not normally harmed, but with children, this causes a lot of trouble,” Anderson says. “Babies who are born prematurely are especially vulnerable to the illness.”
Anderson says RMH also treats chronic gastrointestinal diseases in children, such as Crohn’s disease and metabolic disorders like Types I and II diabetes.
“Many children come to us in crisis because of the onset of diabetes,” Anderson says. “They didn’t know this was happening until the child developed unmistakable symptoms. It’s harder to treat children with diabetes. Once we get them stabilized, there are so many adjustments that will have to be made at home. Treating children with diabetes is especially challenging.”
Many pediatric patients return because of lingering health issues after premature birth, Anderson says.
“They were born here and survived, but because of their premature birth, they often have respiratory or other health problems that need to be treated,” Anderson says. “Some require nebulizer treatments and stay a few days using the protocols we have put in place. We treat severe asthma in children again and again. Sickle cell anemia is another chronic disease that brings children back to RMH for further treatments.”
During the course of treatment, no one at RMH loses sight of the fact that these are children, says Anderson. Rooms are available through the hospital’s social workers, where family from faraway communities or with extremely ill children can stay close.
“Parents can sleep on the pediatric unit, and in most cases the PICU,” Anderson says. “The kids are scared, and it eases their anxieties to have their parents close by.”
Through the Child Life program, children are provided with games, puzzles, video games and movies that help them to feel like the kids that they are. There’s a playroom in the pediatrics unit where children can visit and play with other children, if they’re not contagious or too vulnerable to infection.
“We offer craft projects and lots of interactive games,” Anderson adds. “And we have celebrity visitors such as the IceHogs and NASCAR driver James Buescher. And of course, Santa Claus brings toys to the children, donated during our annual toy drive.”
Halloween is another holiday celebrated in style at RMH, with children parading in the hallways, trick-or-treating on the unit. Anderson says the entire staff strives to keep life as close to normal as possible for its young patients.
Recognized as its own “Center of Excellence,” RMH’s Children’s Medical Center is the go-to medical center for children with crisis-level health issues. Through its highly trained nurses, neonatologists, hospitalists and intensivists, the center provides the finest possible care. Working with local pediatricians, the center strives to bring children back to the full wellness they deserve, by focusing not only on injury and illness, but also the child’s emotional, educational and developmental needs.