I graduated from nursing school in 1993 and went directly into a critical care fellowship at our local hospital. (It was 3 months of additional training to work in the ICU at the hospital.) I worked one year in the ICU and the critical care float pool. I started in the emergency room in 1995 and was a midnight charge nurse within 8 months of starting in the ER. My entire 18 years as a nurse has been in critical care.
In 1996 I became a father for the first time with the birth of my daughter Peyton. In February 2000, I remarried a beautiful lady who, at the time, was also an RN in the ER. In April 2001 we had our Daughter Mattison (Mattie).
Within those six years in the ER, I had contact with flight teams as they would occasionally come into our ER to transport patients to specialty hospitals. Usually, these were pediatric and trauma patients. The flight crews would show up in their cool flight suits with all their whistles and gadgets. They would swoop in, get their patient and disappear as quickly as they came. I, like every other ER nurse, thought this had to be the coolest job a nurse could do. It was the pinnacle of ER nursing in my eyes, but I never thought I would have the chance to do it. Flight nursing jobs were few and far between, besides these had to be the smartest of the smart, very selective, top notch.
In late March of 2004, Mattie developed a high fever, a strange body-wide rash, swelling to her hands and what appeared as bilateral pink eye. She was started on oral antibiotics by her pediatrician. After two days, Mattie went back to her pediatrician. Her symptoms were getting worse and her fever reached 104 degrees even though she was being treated with antibiotics plus OTC meds for her fever. During her re-check at her pediatrician’s office, Mattie’s grandmother came in with a newspaper clipping from the local newspaper, The Ashland Daily Independent. The paper has a small medical advice column that’s called “Ask Dr. Donahue”.
In this particular “Ask Dr. Donahue”, someone asked about Kawasaki’s Disease. Dr. Donahue explained that it was a rare, pediatric illness that primarily occurs in the spring, usually in Orientals, mostly in males. It is diagnosed by particular symptoms that include a “sandpaper rash”, high fever, bilateral eye redness, and a “strawberry looking tongue.” Mattie’s tongue was indeed bright red and bumpy.
Mattie’s pediatrician wanted to do some blood work, so he sent Mattie over to the hospital to have her blood drawn. While waiting for her results, we took Mattie down to the ER to have a friend of ours who was a physician in our ER, take a look at her. Just to see what he thought. We asked him if he thought it could be Kawasaki’s disease. He said he didn’t think so because Mattie didn’t fit the typical patient profile for the illness, and it was very rare.
Mattie’s lab work came back with findings consistent for Kawasaki’s. There is no true lab test for Kawasaki’s, but diagnosis is based upon symptoms and particular irregular lab findings. Mattie’s sed rate was greater than 100, and her liver enzymes were elevated. She was admitted to the hospital with Kawasaki’s, and started on IV fluids, steroids, high dose aspirin and an infusion of human immunoglobulin. (Immunoglobulin is a blood product. It takes 1000 blood donations to extract enough immunoglobulin for one infusion.)
Mattie seemed to be improving over the next day. Her fever came down and she was scheduled for an echo-cardiogram of her heart to see if any of her coronary arteries had developed aneurysms. Shortly after her echo, the cardiologist came in and said Mattie’s coronary arteries showed no aneurysms but they appeared enlarged. He was going to talk to her pediatrician. Meanwhile, Mattie’s fever had returned and she had started vomiting. Her pediatrician informed the pediatric charge nurse he wanted Mattie transported to Children’s Hospital in Cincinnati immediately by air.
The pediatric transport team from Children’s arrived at KDMC in a very short time. It was amazing how quickly they made it to Ashland. They were excellent with Mattie and took the time to explain to my wife and myself exactly what they were going to do. They said one of us could go with Mattie. She was going by plane to Cincinnati and there was room for a parent. They loaded Mattie up to all of their equipment. Secured her to their cot, and assured me my daughter and wife both would be fine. Then they left with two of the three most important people in my life, and one was very sick.
I was going to drive to Cincinnati. I knew they would get there much sooner than I. I was on the highway and hadn’t even made much more than an hour of traveling when my cell phone rang. It was my wife. They had arrived at the airport in Cincinnati and Mattie was being loaded into a waiting Children’s Hospital Ambulance, just as the flight crew had said back at KDMC, to complete the trip to the hospital. Mattie was doing better and loved the airplane ride.
I cannot explain the amount of relief I felt knowing my family was safe in Cincinnati, and my daughter was doing better. I will never forget it. I was able to continue my trip to Cincinnati knowing at least, these two things.
Mattie ended up getting another dose on immunoglobulin, her coronary arteries were fine, and she was discharged a few days later. A few days after coming home, the same local newspaper that had the unexplainable circumstantial article on Kawasaki’s Disease at just the right time, did an article on My Mattie.
The following year, I became a critical care transport nurse for an air medical service in Eastern Kentucky. I started out on the ground transport service, but after 2 months I had completed orientation for the flight program. I loved flying and was hooked.
On my first day out of orientation, on my own, wouldn’t you know, my first flight was a pediatric trauma patient, a three year old. He was involved in a head on collision. His mother died on scene, his father had severe fractures and was flown out earlier. Our little guy had a femur fracture, but was stable. He did fine on the flight. (And I did fine on the flight.)
I love my job! I was right, it is the pinnacle of nursing, and I am lucky to be able to do it. I want to do it as long as I can.
We have to remember, our patients are someone’s baby, or mother, or father. Chances are they are very important and very much loved by someone. That’s why I take a moment and talk to the family, and I try to get a number and call once we arrive with the patient. I know what it is like to be on the other end of that phone call.
A few years later, when Mattie’s class graduated from kindergarten, as they walked across the stage to get their diplomas they got to say into the microphone what they wanted to be when they grew up. Mattie said she wanted to be a flight nurse.
She is now doing great. This year she will be in the 5th grade and she only has to follow up with Children’s Hospital once a year, for a yearly echo.
The key to Kawasaki’s Disease is early diagnosis, early aggressive care, and rapid transportation to a specialty facility when needed. If Kawasaki’s Disease goes untreated, there is a high risk of aneurysm development in the large vessels. These develop after the acute, 5-day high fever stage when the child actually looks like they are improving. Clots can form in the aneurysm and the child can throw a clot. There are also possible long term effects on the vessels due to the aneurysms, and the disease effects on the circulatory system. Studies continue on long term effects of both treated and untreated Kawasaki’s Disease.
So, why did I become a flight nurse? Because of My Mattie.
Name:
Matthew Hale, RNFrom:
Kentucky
and men are not prevalent in the field.
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