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Blank Children's Hospital

Thomas

No parent likes to think about the possibility of his or her child suffering a traumatic injury, but if the unthinkable does occur, you can turn to Blank Children's Hospital for expert pediatric trauma care and rehabilitation.

Thomas and his family know how quickly traumas can occur, and they also know the value of receiving lifesaving care in a professional, comforting environment. On July 1, 2008, 9-year old Thomas mounted the starting block at swim practice at the Des Moines Golf and Country Club pool in West Des Moines. When his relay teammate touched the edge of the pool beneath him, Thomas, a West Des Moines Elementary student, dove too deep into the pool and hit his head on the bottom.

"I don't know what went wrong," says Thomas. "I've been swimming relays for a few years."

Coaches brought Thomas-still conscious and able to communicate-to the surface and kept him stabilized using a backboard until an emergency medical services (EMS) team arrived.

"Thomas was breathing fine, but he couldn't move his limbs for several minutes," says Cyndi, Thomas' mother. "It was very frightening, but we were fortunate to be surrounded by kind, helpful people."

Rapid Response

Thomas was taken by ambulance to Blank Children's Hospital, where physicians and nurses in the Emergency Department (ED) follow a strict protocol whenever they receive word that a pediatric trauma patient is on the way.

"Our team begins mobilizing when we receive a call from EMS," says James Swegle, MD, trauma medical director for Iowa Methodist and Blank Children's Hospital. "We have a list of criteria for severely injured patients that warrant a trauma activation. If a patient meets certain criteria, such as a neurological injury or dangerously low blood pressure, we gather various resources and physicians from other hospital departments and go to the ED to be on hand when the patient arrives."

A trauma team may include trauma surgeons, a pediatric emergency medicine physician, pediatric nurses, ED technicians, X-ray technicians, a respiratory therapist, surgery residents and a Child Life specialist, who is specially-trained in comforting injured and ill children. After several tests, including computed tomography (CT) scans and magnetic resonance imaging (MRI) scans, physicians determined that Thomas had fractured the fifth and sixth vertebrae in his neck. Thomas was admitted to the Pediatric Intensive Care Unit (PICU) at Blank Children's Hospital, where he was placed in a halo vest - a piece of equipment that keeps the head and neck immobile.

"We were all very scared and nervous when the halo was attached," Cyndi says. "The Child Life staff at Blank Children's Hospital was helpful in keeping Thomas calm and informed."

Road to Recovery

The placement of Thomas' halo marked the beginning of an intensive rehabilitation period,  as specially-trained pediatric physical and occupational therapists worked with him to regain strength and balance, particularly since the halo vest added considerable weight to his upper body.

"We learned that we use our heads for balance to walk upright," says Ken, Thomas' father. "Thomas was unable to move his head due to the halo, so he had to learn to adjust his upper body from the waist to balance."

Therapists continued to work with Thomas on relearning how to perform simple actions of daily life, such as eating or scratching his nose, until he was discharged on August 6, 2008.

"My son's level of care at Blank Children's Hospital was incredible," Cyndi says. "From the moment Thomas arrived until the day he went home, he and our entire family were treated professionally and compassionately."

Returning to the Water

Thomas wore his halo for nine weeks and a neck brace for an additional two months, and he continues to perform rehabilitation exercises at Blank Children's Hospital and at home. Though he must avoid contact sports for now, Thomas is back in school, and most exciting for him, back in the pool. He began practicing with his team in October, and though he's swimming only the backstroke at the moment, he proudly boasts, "I can do flip turns!"