A Team Effort

Teen recovers from traumatic injury

Pedaling his way back to his family’s beach house last summer, Conrad Lehmkuhler could do nothing to steer his bike from the oncoming car, driven by a drunk driver. The impact tossed the 14-year-old onto the hood of the car and then to the ground.

“All I could see was pavement and it felt really hot,” Conrad says. “My left leg flopped around under me.”

Emergency responders on the scene that summer afternoon in Virginia Beach assessed Conrad’s injuries. The bone in his left upper thigh appeared badly broken and displaced, which could result in a life-threatening loss of blood. They were also concerned that the force of the impact may have caused serious internal injuries. It was quickly determined that he needed to be taken to Children’s Hospital of The King’s Daughters – which had recently become the region’s only Level 1 pediatric trauma center.

Conrad’s family lives in Alexandria and had never heard of CHKD. A rescue worker explained to his mother, Amy, that Conrad would receive specialized pediatric care at CHKD.

“He said it with such authority,” Amy says. “I didn’t question it.”

While the ambulance carried Conrad and his mom to CHKD, a trauma team at the hospital quickly assembled, including a pediatric trauma surgeon, emergency medicine specialists, nurses, child life specialists, social workers, and a chaplain. Everyone on the team has a specific role and is ready to provide expert care for the patient and support for the family.

Over the next 24 hours, Conrad would be treated by numerous pediatric subspecialties, including cardiology and orthopedics, before having surgery to place a rod in his left leg where the collision broke his femur.

Conrad’s journey illustrates the level of teamwork, collaboration, and highly specialized care that pediatric trauma patients receive at CHKD. “It takes a village to take care of these patients,” says Dr. Ann Kuhn, a pediatric trauma surgeon and CHKD’s medical director of trauma services.

One of the reasons CHKD became a Level I pediatric trauma center was to help prevent delays in care for critically injured children, Kuhn says.

“We’re so thankful we came to CHKD’s trauma center,” Amy says. “That’s where Conrad needed to be.”

Every second counts when you’re treating trauma patients. Medical professionals call the first 60 minutes after an accident “the golden hour.”

“The sooner you can treat a trauma patient’s injuries, the higher the likelihood they have for survival,” says Kuhn.

It’s especially critical for children. Unintentional injuries are the leading cause of death for children, according to federal health statistics. At CHKD, more than 400 children are admitted each year for traumatic injuries. Another 10,000 visits to the hospital’s emergency department and urgent care centers are for trauma-related injuries.

In the emergency department at CHKD, nurses put Conrad’s leg in traction, a painful but necessary process to help position his femur. X-rays confirmed he would need surgery but that would have to wait until a cardiologist could evaluate his irregular heartbeat. The trauma team wanted to make sure he didn’t have a bruise on his heart from the impact of the accident.

“I was more in shock than I was in pain,” Conrad says, “but I knew everyone around me knew what they were doing. I felt safe and knew I’d be fine in the end.”

His mom remembers how everyone treated Conrad with such respect. “One of the really important things for Conrad was that the nurses and doctors treated him like the young adult that he is,” Amy says. “Even though he was 14, I think they sensed his maturity. They did not speak down to him. They included him in some of the decisions, and they asked him questions directly.”

The morning after his accident, doctors cleared Conrad for surgery.

“It was a high-energy injury that snapped the femur in half, leaving shards where the break was,” says Dr. Carl St. Remy, a CHKD orthopedic surgeon, who put a rod in Conrad’s leg. The metal rod would help stabilize the bone until it healed. Conrad would need to start physical therapy and avoid putting any weight on his left leg for a while.

At this point, the Lehmkuhlers could have returned home to Alexandria for Conrad’s rehabilitation, but they decided to stay in Virginia Beach through the end of the summer so they could continue to work with CHKD.

“Why would we not continue to go to a place just for kids?” Amy asks. “Going to Landstown for physical therapy made sense because we could also see Dr. St. Remy there.”

When Conrad started physical therapy, he was still in a wheelchair, using crutches sparingly. He had lost a significant amount of muscle from his hip to his knee. As an athlete, he worried about his recovery.

T.J. Slowik, a CHKD physical therapist, could tell the teen was feeling a little down. As he worked with Conrad for the remainder of the summer, he found ways to encourage and motivate his patient. They used a lacrosse ball for balancing exercises. They celebrated every tiny step in Conrad’s recovery.

“T.J. completely gets Conrad,” Amy says. “He fine-tuned his physical therapy to his age and temperament.”

Conrad no longer needed crutches by mid-September, weeks ahead of schedule. In December, he started pre-season training for lacrosse again, completing sprints with the rest of the team.

Today, Conrad’s walk is so natural, you can’t tell he ever broke his leg, his mother says proudly. “His recovery has been amazing.”

This story was featured in the Winter 2019 edition of Kidstuff magazine, a quarterly publication from CHKD that features inspiring stories about patients, physicians and friends of CHKD.