Wings for Marcus
Comprehensive trauma care saves a child’s life
On a hot July day, Michelle Marks reflected on the anniversary of her youngest son’s accident – July 28, 2011 – the day baby Marcus, who was 6 months old at the time, was airlifted to Ministry Saint Joseph’s Children's Hospital in Marshfield.
She watches her spirited toddler run up and down the driveway between his older siblings, Meaghan and Michael, at their house in Wild Rose, Wisconsin. Marcus hears a small plane fly overhead. He points up at the sky, pacifier in his mouth, pausing only for a few seconds before running in the direction of the plane.
“Isn’t that something?” Michelle says, grinning at the curious boy.
A year ago last summer, the mother-of-five was preparing for a camping trip on the Wisconsin / Michigan border. Leaving before sunrise on a Thursday morning, Michelle and her children followed another family north and made a pit stop at a local store in Rhinelander. After shopping, Michelle returned to her SUV with the kids.
While waiting for the others, Michelle was holding Marcus outside the vehicle when Meaghan called out for her. She placed Marcus on the passenger-side seat and asked Malachi, her oldest son, to keep an eye on the baby while she ran around the truck to help Meaghan.
Malachi turned to help his youngest brother and before Michelle knew it, Marcus – having just learned to crawl earlier that week – had fallen out of the vehicle. Within seconds, Michelle had jumped over the hitch and was at the baby’s side.
“I suspect he had tried to flip over and in that split second ... he was on the ground,” she remembers. “I scooped him up and he had two little bumps on his head. He was crying and upset.”
After calming him down, they decided he was okay. Back on the road, he drank a whole bottle and fell asleep in his car seat.
When they arrived at the campsite about a half-hour north of Eagle River, Michelle noticed something wasn’t right. Marcus’ eyes wouldn’t focus and he started to vomit.
Right then, Michelle put the baby back in the car seat and they got back on the road.
Twenty-five minutes later, they pulled up to the emergency room at Ministry Eagle River Memorial Hospital. Marcus was limp, white as a ghost and fairly unresponsive.
Roderick Brodhead, MD, medical director of emergency services and an emergency department physician at Ministry Eagle River Memorial Hospital, treated Marcus at Ministry Eagle River Memorial. He immediately ordered a CT scan of Marcus’ head.
“I was fearful of one of the most serious, critical and dreaded diagnoses in emergency medicine,” Dr. Brodhead remembers.
The physician predicted Marcus had an epidural hematoma, which is a type of traumatic brain injury usually associated with a skull fracture in the temporoparietal area of the brain where the temporal and parietal lobes meet.
When the skull is fractured in this area, a large artery that runs through that area can also become fractured. This causes significant bleeding between the skull and the surface of the brain.
The CT scan confirmed Dr. Brodhead’s prognosis
“There aren’t many things in emergency medicine other than heart attack or stroke that hinge on minutes,” said Dr. Brodhead. “It is an incredibly time-sensitive condition. Once the pressure on the brain has become irreversible, it’s an unsurvivable injury.”
Dr. Brodhead recognized the situation and charged the team to “get the bird in the air.”
He was referring to Ministry’s Spirit Air 2 a helicopter air transport to Ministry Saint Joseph’s Children's Hospital. It was the only chance Marcus had to survive.
Matter of life and death
The only treatment option for Marcus was the surgical removal of the collection of blood.
Dr. Brodhead called his emergency medicine associate at Ministry Saint Joseph’s in Marshfield, who conferred with Sanjay Rao, MD, a Marshfield Clinic pediatric neurosurgeon on staff at Ministry Saint Joseph’s Children’s. The three doctors discussed the CT scan.
Just 20 minutes after Marcus’ arrival at Ministry Eagle River Memorial, the Spirit Air 2 crew arrived to assist the emergency department team. The helicopter crew first gave Marcus medicine intravenously to ensure he slept throughout the procedure, then inserted a breathing tube. He also was given medication to relieve the pressure on his brain. Dr. Brodhead credits a large part of Marcus’ survival to this.
“I accompanied the baby in the ambulance from the hospital to the helipad (at Eagle River Airport),” Dr. Brodhead recounts, choking up. “I turned to the pilot and said, ‘If you ever made this a quick trip, do it now.’”
Spirit Air 2 arrived in Marshfield just 47 minutes later, a full 15 minutes earlier than normal.
Road to Recovery
Michelle, along with her daughter and family friend, were in the car just in time to see the helicopter take off.
“Every time I hear or see a helicopter now, my heart skips a beat,” she says. “It was just a normal day, and then suddenly someone is telling you your child is dying.”
Within minutes after the helicopter landed, baby Marcus was rushed into the operating room that was ready for him at Ministry Saint Joseph’s in Marshfield. After his surgery, Marcus was moved to Ministry Saint Joseph’s Children’s Hospital’s Pediatric Intensive Care Unit (PICU) – the highest level PICU in northern and central Wisconsin – where he spent just 4 days (Thursday through Sunday).
Day by day, the toddler made significant improvements while being carefully monitored by the staff at Ministry Saint Joseph’s Children’s.
Marcus was moved to the pediatrics floor on Monday, and, after a few brief setbacks, the family was given the green light to take Marcus home on Tuesday.
Dr. Brodhead explains that, because of his young age, Marcus had a soft spot in his skull (called a fontanel) that provided some room for the brain to expand. The medication the baby was given before he arrived at Ministry Saint Joseph’s also helped keep him alive.
Dr. Brodhead credits the work of everyone involved, including the expertise and speed of the Spirit crew – “some kind of record,” Dr. Brodhead adds. “I certainly think the 15 minutes saved his life.”
“I had very serious doubts that child would survive the flight, much less make it through surgery,” says Dr. Brodhead. “Even if he did all of that, I worried that the amount of pressure on his brain would cause him not to wake up.”
When asked to describe Marcus’ situation, he takes time to think before answering, “I think of two words: Thank God.”
“The hospital staff, flight crew – all did their best,” Michelle says. “Whether they realized it or not, they left it in God’s hands. It wasn’t time for Marcus to go. He’s meant to be here to do more work!”
Work for bright-eyed Marcus today means running, never walking; taking turns with his siblings going down the slide; awing mom and dad with his endless curiosity for the outdoors; and listening for the next airplane to fly overhead.
The flight that saved Marcus’ life
When Dr. Brodhead called Ministry Spirit Medical Transportation services, he knew that Marcus would be in good hands.
For over 18 years, Ministry Spirit Medical Transportation has provided regional emergency medical ground and air transportation for adult, pediatric, neonatal and high-risk obstetrical critical care patients requiring advanced life support.
Ministry Spirit Medical Transportation is not a 9-1-1 service, but an emergency medical transportation network based in Marshfield at Ministry Saint Joseph’s Hospital, central and northern Wisconsin’s first verified Level II Trauma Center.
Ministry Spirit Medical Transportation helicopters are in service 24 hours a day – one based in Marshfield and the other based in Rhinelander.
Ministry Spirit Medical Transportation performs a wide variety of missions, including inter-hospital transport, providing air transportation to trauma patients at the scene of an accident, and education outreach to the EMS community and area schools.
A communication center can dispatch the appropriate vehicle, collect and relay patient history and condition information and track the location and status of each emergency transport vehicle in the field. This communication is vital for patients in life-threatening situations.
With dedicated intercept locations in Marshfield, Weston and Rhinelander, Ministry Spirit Medical Transportation services can also dispatch paramedics to the scene of an accident within a 25-mile radius of each location.
Ministry Spirit Medical Transportation is capable of transporting high-risk newborns from northern and central Wisconsin to Ministry Saint Joseph’s Children’s Level III Neonatal Intensive Care Unit.
The paramedics are well trained in critical care, have advanced skills, an average of more than 10 years in emergency medical services and more than 200 hours of critical care / emergency transport orientation and certifications. When not on transports, the nurses and paramedics assist in the care of critically ill patients at Ministry hospitals where Ministry Spirit Medical Transportation bases are located.
“Our goal is to have the patient to the trauma center in under an hour,” said Charlie Kotke, northern region manager of Ministry Spirit Medical Transportation. “Decreased response times benefit the patient and save lives.”
“Time is critical in the treatment of trauma, heart attack and stroke,” said Stewart Watson, MD, president and CEO of Ministry Medical Group. “Ministry Spirit Medical Transportation dramatically reduces the time it takes to transport patients to the closest hospital providing the needed level of care.”
Spirit Air 2, the second in the fleet, is based at Ministry’s Saint Mary’s Hospital in Rhinelander. It had only been operational for 2 months before Marcus’ accident.