A New Medical Protocol is Saving Lives in Polk County Bartow, Fla. (Dec 22, 2015 Source: Polk County Fire Rescue) – One of the scariest calls emergency responders face is a pediatric cardiac arrest and most are caused from drownings. Even for the most seasoned professional, these are high stress, high anxiety and high emotion calls.
Under the supervision of Medical Director Dr. Paul Banerjee, Polk County Fire Rescue (PCFR) continues to provide cutting edge prehospital emergency care, increasing the chances of survival for pediatric cardiac arrest patients.
In 2012 and 2013 PCFR had a 0% survival rate among pediatric cardiac arrest patients. But in in 2014, PCFR began treating these patients with a new protocol called the Handtevy method.
The Handtevy method simplifies the drug count. It takes the calculating away from the paramedic.
In 2014, PCFR had 21 pediatric cardiac arrest patients, 33% had return of spontaneous circulation (ROSC) and 71% (five patients) survived and the survival rate continues to increase even with an uptick in pediatric cardiac arrest calls.
January through October 2015, PCFR had 31 pediatric cardiac arrest calls, 29% had ROSC and 78% (seven patients) survived.
“We are changing how we approach pediatric care so our paramedics can stay calm and focus on the patient, that is exactly what this system does,” said Dr. Banerjee.
For three-year-old Landon, this method might be the difference between life and death.
March 22, 2015, was like so many other days. Friends were over, barbeque was on the grill and Landon had just finished swimming.
“He said he was done so I took his floaties off and said, ‘You can’t get back in because you can’t swim without your floaties on.’ He said, “Okay,” said Destiny Pitts, Landon’s Mother.
A short time later, Landon was nowhere to be found.
“It happened so fast,” she said. “We heard nothing.”
“When I pulled him up out of the pool, he was blue,” Pitts continued. “His lips were blue. He was limp. There were no signs of life at all. I thought he was gone.”
When paramedics arrived Landon was breathing again because bystanders immediately began CPR, but he wasn’t out of the woods yet. Secondary drowning issues like aspiration of water into the lungs, brain injury due to lack of oxygen, rib damage from CPR and pneumonia were still very real threats.
Pitts handed him over to emergency crews and they took him from there.
Using the Handtevy method, paramedics were able to calculate the dosage of drugs Landon would need while driving to the scene based on his age, saving precious minutes.
“Previously, our goal was to get the patient to the hospital as soon as possible,” said Banerjee. “Now, we immediately establish an airway, perform an intraosseous (drilling into the bone to administer drugs), administer epinephrine early, which helps get the heart get started again, and do compressions for at least two minutes before we leave the scene. This early, aggressive care on-scene has given Polk County Fire Rescue a survival rate significantly higher than the national average.”
“They were putting tubes down his throat and in his nose,” Pitts said. “They said that he didn’t even fight them or cry to put the IV in and that’s not a very good sign. I didn’t know what was going to happen. I didn’t know if he was going to make it still, even after he was awake.”
Crews finished prepping Landon for transport to the Bartow Airport where he would be flown by helicopter to St. Joseph’s Hospital in Tampa.
Pitts recalls the moment just before the helicopter took off.
“They let me kiss him, and from all the tubes in, there was blood running out of his nose and down to his ear. He just looked so awful,” she said holding back tears.
Pitts raced to the hospital. When she arrived, Landon was sleeping. The tubes were still in his nose and down his throat. The doctor explained that Landon’s brain wave tests came out normal and that they had some warming blankets on him to get his body temperature up.
After moving him to the pediatric intensive care unit, doctors removed the tubes, leaving only an IV.
“He was sitting up, and a little tired and groggy from the medicine, but he was back to being himself. He just wanted to watch cartoons.” Pitts recalled. “That was the sigh of relief.”
Landon was discharged the next day, less than 24 hours from the time of the incident.
“I have no doubt that Landon’s quick recovery was due in part to this new protocol for handling pediatric cardiac arrests,” said Dr. Banerjee. “The Handtevy method will continue to make a huge impact on people’s lives.”
“There is no kind of recognition or thing I can say to thank [the rescue crews] enough for saving my boy.” Pitts said.
Polk County Fire Rescue (PCFR) is a division of the Board of County Commissioners. PCFR provides fire and emergency medical services to residents in a 2000 square mile area, as well as provides mutual aid to surrounding cities and counties. PCFR has more than 525 full time employees throughout 48 stations, which run more than 80,000 calls each year. IMG_6977: A Unit Citation was awarded to the crews that ran Landon’s Drowning Call at PCFR’s annual award ceremony held on Dec. 8, 2015. – L to R: Battalion Medical Chief Audrey Pate, Engineer Michael Keiser, Destiny Pitts (mother), Landon Pitts (son, near drowning patient), Lt. Michael Martin, Kaylin Fehringer (daughter), Lt. Terry Stringer