July 17, 2012

A Canadian family was on vacation, passing through West Virginia when something went wrong.

"He sneezed and lost feeling in his feet," said Debbie Toney, RN, CNRN. "The sneeze broke his back."
The 16-year-old boy had Ewing’s Sarcoma of the spine (a form of cancer). He was taken to the nearest hospital and then transferred to CAMC.

After Dr. Robert Crow reconstructed and stabilized his spine, the boy went into cardiac arrest (his heart suddenly stopped working properly).

Pediatric cardiac arrests are rarely seen at CAMC, and it didn’t look good for the teenager.

"We nearly lost him," said Sande Egnor, RN, CCRN, nurse manager for the neurosciences ICU. "Then someone spoke up and said, ‘what if it’s just blood clots in his lungs? What about trying tPA?’"

So the care team tried something no one else had attempted – using tPA on a pediatric patient in cardiac arrest.

Now, the boy is alive and well and the doctors and nurses who provided the life-saving care are the talk of the medical world.

Egnor and Toney, along with Dr. Ron Biswas and Dr. Robert Crow, submitted a case study abstract to the Ninth Annual New York Neuro-emergencies and Neuro Critical Care Symposium.

CAMC’s case was one of four selected to be presented in the category of "Cheating Death," which asked presenters to review a case in which teamwork, innovation and ingenuity saved a patient’s life against all odds.

The presentations were judged by the symposium faculty. The NSICU presentation won first place.

"The thing that makes this case a rarity in the medical world is the presentation of his cancer (back) and rarity of the way it was treated," Toney said. "This is such a remarkable recovery. He should have died, but returned to life with no deficits beyond the original diagnosis."

Egnor and her team now want to know if this type of care can be used more widely. The case study calls for further research.

"We were excited and honored to know that the care we provided here was recognized nationally," Egnor said. "We attend conferences annually… this year we were the ones with the audience."

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