When the CHKD transport team arrived, they found 13-year-old Bryce Callaway struggling for breath from a severe asthma attack. The team had been called to the hospital near Bryce's home to transport him to CHKD.
"I knew there was a chance he might not survive," CHKD paramedic Roger Vaughan recalls. "But our team was ready. We tried to improve his ventilation, but it was extremely difficult. We had to rethink our normal therapies just to keep him alive. We had to get him to CHKD fast."
The boy's father, Evan Callaway, also recalls his panic. "Bryce was blue and gasping," he said. "I thought he was gone."
But his stepmother, Karen Nash, happens to be a nurse on the CHKD transport team, so she felt something different: Relief at the sight of her team members.
"When I saw our transport team come through that ER door, it was like my knights in shining armor had arrived," Karen said. Nash had started her day on the job at CHKD and raced to the hospital where her son was after her shift.
She knew the team on this shift – paramedics Vaughan and Andy Gary, nurse Lisa Hawkins and respiratory therapist Diana Rath. And she had worked on many transports in her year with the team. But she'd never been on the other side of a call before, so the feeling of relief in the midst of her personal trauma took even a seasoned veteran by surprise. "I was so relieved to see them. I knew that everything would be OK now."
Bryce's medical emergency started rather uneventfully. He had spent that cold Sunday afternoon in February playing football, wrestling and shooting hoops with his stepbrothers Zachary, 12, and Jared, 15.
The cold air gave Bryce some trouble with his breathing. Jared warned him to take it easy and to take his asthma medicine. But Bryce hadn't let his parents know that he was out of his medicine. Boys being boys, he kept right on playing then went indoors to eat chili.
The next activity on this busy day was to wash the family puppy, but Zach noticed that Bryce's breathing was getting worse. The combination of cold weather, exercise and missing his medicine had taken a toll. So Bryce went into his room to use his nebulizer, an asthma inhaler used to reverse more severe asthma symptoms by spraying a fine mist of medication to loosen mucus and open airways.
Minutes later, Zach found Bryce unconscious and turning blue. He shouted for his father, who called 911 and then held his son in his arms until emergency personnel arrived.
At the nearby hospital emergency room, Bryce's condition worsened. The undigested chili had aspirated into his struggling lungs. It was clear that Bryce needed the expertise of the pediatric specialists at Children's Hospital, so CHKD's rolling intensive care unit was called to make the transport.
During the race to CHKD with their patient, the transport team was in constant touch with the intensive care physician in CHKD's Pediatric Intensive Care Unit to prepare for Bryce's arrival.
"The coordination between the hospital and transport team when en route with a severely ill child is critical," pediatric intensivist Chie Shih said. "In Bryce's case, as with all of our patients, we were ready to begin care as soon as the team arrived."
At CHKD, Bryce was admitted with acute respiratory failure. Dr. Shih began treatment to suction the aspirated material from the boy's lungs and support his breathing. Bryce remained on a ventilator for the next 10 days as he recuperated from the prolonged compromise of his airways.
When Bryce was able to breathe without the ventilator, he was moved from the PICU to the general care unit, where he received rehabilitation for 10 days as he recuperated.
His dad looks back on Bryce's near-fatal asthma attack and the days that followed with amazement.
"It's a miracle he's alive. Everything came together the way it needed to. The transport team did exactly what they needed to do to save Bryce. And the PICU doctors and staff were wonderful. He was surrounded by angels at CHKD. It's amazing what they do at that hospital," he said. "The nurses were especially great and he loved them."
Karen, who has been a nurse at CHKD for nine years with the past year on the transport team, says Bryce's story is a dramatic one with an important message about maintaining an asthma treatment plan. "Children need to know how important it is to take their medications and avoid asthma triggers," she said. "And as we discovered the hard way, everyone in the family needs to stay on top of that treatment plan."
Evan says there's also a message for children with asthma. "Bryce has always been physically active, playing football and basketball, lifting weights and doing anything he wants. He can still do that, just as long as he follows his asthma treatment plan.
"It's important for kids with asthma to know that they can be active and athletic."
Dr. Shih practices with Children's Specialty Group PLLC at CHKD.