On some days, working in an emergency department can really wear you down because the truly emotionally tough cases rarely have a happy ending. October 4, 2014 could have been one of those days for Dr. Lauren Donnelly, Emergency Department physician at Temecula Valley Hospital. She was informed of a doctor’s worse moment, a pediatric code coming in from an electrocution.
The day for Elijah Belden started off great; he was celebrating his 10th birthday with a few friends from school and some players from his baseball team. Something went terribly wrong when Elijah wrapped his arms around an awning pole just after posing for a photo his mom had taken. Suddenly he collapsed; he had been electrocuted. His mother was the first to reach him, but was unable to break him free, because he shocked her as well. As she screamed for help, Elijah’s baseball coach was just a few feet away, and when he reached to help, Elijah shocked him as well. Realizing what was going on Coach Scott Baker did the only thing he knew to do and that was to tackle him to break the current. Just a few weeks prior to the incident Elijah’s mother had been certified in CPR and knew from her training that the most important thing to do was to get his heart beating followed by his breathing. His coach, an Orange County Sherriff, went into cop mode, and the two of them began CPR.
Emergency Medical Services was on the scene in five minutes. They defibrillated him, restarted his heart, and transported him to Temecula Valley Hospital where emergency staff confirmed his pulse and blood pressure. However, he was not waking or taking good breathes on his own, so the team intubated him, cleared his airway so he could get oxygen, and put him on a ventilator. Since Temecula Valley Hospital does not have a pediatric unit, the emergency team was in contact with Rady Children’s Hospital Trauma Team and Critical Care Team who mobilized a helicopter. It was decided to initiate therapeutic hypothermia.
Therapeutic hypothermia can improve a heart attack patient’s chances of full recovery. The therapy is for those who have been quickly and successfully resuscitated following cardiac arrest. In this situation, Elijah had regained his pulse and blood pressure, but was still unresponsive. Therapeutic hypothermia decreases the release of chemicals that cause injury to the brain and the consumption of oxygen by the brain. It also reduces the amount of acid in the brain, allowing neurons to stabilize, helping to preserve brain function.
The team induced the medical hypothermia, cooling him, started him on medication to stay in the coma, and began medication to prevent shivering which is the body’s way of staying warm. Elijah was then airlifted to Rady Children’s.
Two days later, Mr. Belden received a call from Dr. Donnelly to check on Elijah. “I realized at that moment that my son wasn’t just a patient with a wristband, he was a real person that had captured her heart, and she wanted nothing but the best for him. I informed her that the team at Rady Children’s was cautiously optimistic, and she let me know that if we needed anything to please feel free to call even if it was just to have a listening ear.”
The night he woke up, Dad texted a picture to Dr. Donnelly after they pulled out the endotracheal tube she had put in eight days before. She began receiving daily updates from the Belden’s showing the amazing recovery Elijah was making. According to Dr. Donnelly, “As an emergency department physician, you sometimes wonder if you make a difference. Something like this gives you hope.”
Elijah was fortunate.
He was fortunate he had a mom and coach who knew and performed CPR.
He was fortunate that the ambulance arrived and administered life-saving procedures quickly.
He was fortunate to be so close to a cardiac specialty hospital that allowed the time the 911 call came in to the time the ambulance arrived at the ER bay to be less than 15 minutes.
He was fortunate to have skilled emergency personnel treat him quickly and effectively.
“This time of year there is lots of discussion and reflection about blessings and things to be thankful for, and for us, Dr. Donnelly, Joanna Hosta and the others at Temecula Valley Hospital rank right up there on our list,” according to Tony Belden.