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A Rescue in Bethesda
Comments () | Published August 1, 2009

On the way to Children’s, Walker kept talking to Coleson: “You’ll be okay, little guy. We’re taking you to the hospital. Keep fighting.”

Buc, Davis, and Lewis were offering similar encouragement to Aiden and Bricen. Halfway to the hospital, both boys stirred and began crying. Bricen thrashed so much that he pulled the IV line out of his left leg.

As they neared the hospital, both boys began breathing spontaneously and their pulses strengthened.

Coleson didn’t regain consciousness during his trip. When his ambulance pulled up to Children’s, he began trembling with a seizure.

Michael Petrucelli and firefighters Warfield and Klavon were taken in the same ambulance to the Washington Hospital Center burn unit. On the way, Michael overheard the two men refuse morphine—they wanted to have their wits about them. Klavon had suffered first-degree burns to his head and neck and second-degree burns to his ears. Warfield had first-degree burns on his face, neck, and shoulder and second-degree burns on his ears.

Michael listened as they talked on the phone. He thought of their families and all that the men had risked to try to rescue his.

Michael also had suffered first- and second-degree burns as well as severe smoke inhalation and cuts to his hands. As the ambulance wended its way through the city, he couldn’t stop torturing himself with what-ifs. What if he had run up the stairs to get the children out of the house when he first heard Rosa say there was a fire? What if he’d run to get them the moment he saw the heat shimmer from the kitchen window?

He thought of everything that was lost in the house. But all that mattered was his sons.

Michael heard someone in the front of the ambulance say, “Turn off the radio.” The driver turned it off, and Michael assumed that meant his children had died. As the ambulance neared the hospital, he couldn’t push from his mind the image of three small coffins.

“Trauma stat attending!” said the voice on the speaker system at Children’s Hospital after it was alerted by EMS about the impending arrival of the triplets. The word “attending” meant a senior surgeon was needed.

When Aiden’s ambulance arrived, paramedics and members of the trauma team rolled his cot to a trauma bay a few steps from the entrance, where an 18-member team of physicians, nurses, and medical technicians took over. Two other trauma teams were waiting for Bricen and Coleson.

Inhalation injuries get worse before they get better. The trauma team needed to gain control of Aiden’s airway before his trachea swelled and shut off air to his lungs, and they needed to do it fast.

They gave him an injection of rocuronium, a powerful muscle relaxant that effectively paralyzed him. Doctors then threaded the intubation tube through his mouth and down his narrow trachea. They turned on the ventilator to pump 100-percent oxygen into his lungs. While this was going on, nurses and technicians drew blood and checked his vital signs.

Doctors knew Aiden’s lungs had been injured by the heat and soot. Because he also had inhaled hydrogen cyanide, the trauma team gave him cyanocobalamin, a derivative of vitamin B-12. Cyanide’s effects are similar to carbon monoxide’s in that it competes for the oxygen-carrying blood cells. When it captures enough of them, the body doesn’t get enough oxygen to survive.

As the medication circulated in Aiden’s bloodstream, it bound itself to the hydrogen-cyanide molecules and rendered them harmless. It flushed them out of his body through his urine, causing it to turn purple.

Another team did the same things to Bricen, who arrived shortly after Aiden.

Coleson, still seizing, showed no sign of consciousness as the trauma team went through the procedures with him. All three boys underwent CT scans to rule out internal injuries.

The doctors drew blood to determine the triplets’ carboxyhemoglobin levels. Carboxyhemoglobin is formed when carbon monoxide combines with hemoglobin, the oxygen-carrying red blood cells. As it binds to hemoglobin, it diminishes the amount of oxygen the blood can deliver to the organs. No organ of the body needs oxygen more than the brain.

Under normal circumstances, carboxyhemoglobin levels should be zero. Bricen’s was 14.3 percent, Coleson’s was 16.3 percent, and Aiden, who had been closest to the bedroom door, had a level of 22.3 percent—all alarmingly high.

As she sped down I-95, Ami Susan kept phoning people. She learned from neighbors at the scene that the triplets had been taken by ambulance to Children’s Hospital, but no one could tell her more than that.

She prayed and tried to maintain an outward calm when she telephoned the hospital and was put through to the emergency department. A care coordinator walked with the phone to one the ER physicians, who told Ami Susan the boys were alive and being admitted for smoke inhalation. It was the first confirmation she’d had that her boys had survived.

Ventilated and stabilized, the triplets were taken to the intensive-care unit on the third floor an hour after they had arrived at Children’s Hospital.

X-rays and scans don’t always reflect current conditions, so the ICU team wanted the boys’ airways examined directly. Dr. Christiane Corriveau, a senior critical-care specialist, called in Dr. Holly Chaney, a pediatric pulmonologist at the hospital.

At Aiden’s bedside, Chaney threaded a slender fiber-optic tube through his ventilator tube down to the bronchi, the conduits for inhaling air into the lungs. The light at the tip of the device illuminated Aiden’s airway; as she looked through the instrument’s eyepiece, the evidence of smoke inhalation was unmistakable. 


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Posted at 12:00 AM/ET, 08/01/2009 RSS | Print | Permalink | Articles