Saving Katarina

On December 13, the day before her sixth birthday, Katarina Parsons was helping her mother and sister pack the car for a trip to the beach when two Belgian Malanois, family pets with no history of aggression, streaked across the driveway.

They attacked Kat, gripping her by the neck and leg and dragging her across the front lawn.

Katarina ParsonsKat’s mom, Sandy, raced to her aid and threw herself without thinking into the melee. Kat’s sister, Justice, ran for help. For the next several minutes, Sandy fought the dogs with every ounce of strength she had. She was finally able to scoop her daughter into her arms and take refuge in her car while a neighbor kept the dogs at bay with a shovel.

“It was terrifying. Katarina was bleeding and crying,” says Sandy, who had injured her foot and was also covered with bites. “I was physically and emotionally exhausted.”

Emergency medical technicians arrived and called for an air ambulance to take Katarina to CHKD for trauma care.

The CHKD trauma team is ready 24/7 to respond to a complex pediatric trauma emergency. In the past year, the team treated close to 600 trauma patients suffering from injuries including internal injuries, complex fractures, burns, head trauma and spinal cord injuries.

“Our trauma team consists of a dozen different individuals, starting with the emergency room attending physician and a surgeon, who are at the hospital around the clock,” says Dr. M. Ann Kuhn, a pediatric surgeon and medical director of trauma services at CHKD. “When we are alerted about an incoming trauma patient, we immediately assemble a team consisting of a pediatric anesthesiologist, a surgical resident, an emergency room resident, at least three nurses, a pharmacist, a radiologist, a representative from the operating room and a social worker and chaplain to support the family.”

This team was ready for Katarina when she arrived. As the medical team sprang into action to assess Katarina’s injuries, Sandy also received some special care from a nurse on the team. “I was just standing there, numb from it all, and suddenly a nurse started picking dried leaves from my hair and wiping the blood from my face,” Sandy says. “I thought little of it then, but I think a lot about it now. It was just the first of many ways CHKD cared for all of us.”

Dr. Frazier Frantz, CHKD’s chief of pediatric surgery, was the surgeon on call for trauma that day. As he removed Katarina’s neck brace to examine her wounds, he saw that the bites had exposed her jugular vein.

While tests ultimately showed that Kat’s jugular was intact, her other injuries were extensive. She had deep, rough tears across her chest, shoulder and neck where she was missing tissue. She also had bites on her thigh and pelvis. “They were the worst injuries I’d ever seen from a dog attack,” says Dr. Frantz.

In surgery, Dr. Frantz and his team worked quickly to stabilize Katarina. They spent hours and used more than 200 stitches to close her wounds. Meanwhile, Sandy waited for her husband, Kurt, and their two other daughters, who were rushing to CHKD from Maryland. The Parsonses, who are from the Annapolis area, were visiting close friends in Chesapeake when the attack occurred.

Other members of Katarina’s care team at CHKD were also responding, including child life specialists, nurses, social workers and chaplains. Kristi Beers, a CHKD social worker, explained procedures, helped with paperwork and immediately went to work to find a lace for the Parsonses to spend the night nearby. Mary-Katherine “Kit” Tate, a chaplain at CHKD, was also at Sandy’s side, holding her hand for many hours that night as they waited for news from the operating room. And Lisa Hand, a CHKD child life specialist, prepared to help Kat through a difficult birthday the following day. “There were so many people working so hard to help Katarina,” says Sandy.

“Even though we were far from home, we never felt alone.”

Celebrating a birthday after such a traumatic event is difficult, but CHKD’s child life specialists understand that acknowledging the special day can help provide a distraction and normalize a patient’s experience. The morning after the accident, Lisa delivered a special birthday gift: a doll that looked just like Kat with long hair and brown eyes.

“If the patient gets a cast, the doll gets a cast,” Lisa says. “If the patient gets an IV, we’ll give the doll an IV. It helps the child focus on something other than her own discomfort.”

As Kat’s swelling began to subside, Dr. Frantz called Dr. John Birknes, a pediatric neurosurgeon at CHKD, to take a closer look at the injury to Kat’s arm.

“When I examined Kat, it became evident she had no feeling in her left arm,” says Dr. Birknes. An MRI revealed that one of the dog’s teeth had penetrated Kat’s dural sheath, the tough exterior membrane that surrounds and protects the spinal cord. The puncture caused a leak of fluid from her spine, and nerves leading to her left arm had been ripped.

“There are five nerve roots that go from the spine to a ball of nerves that moves the arm,” Dr. Birknes says. “At least two of Kat’s nerve roots had been severed during the attack.” Dr. Birknes explained that Kat would need months of healing before surgeons could attempt to repair the nerves and restore movement to her arm.

Still, Kat’s physical therapy team needed ways to get her moving around, a key element to her recovery. With the holidays drawing near, Sandy described a tradition based on the book, “The Elf on the Shelf” – a holiday elf hidden each night and discovered by Kat and her sisters each morning.

Kristi hurried down to CHKD’s gift shop, where shop manager Mary-Claire Darden was able to find one last smiling elf for Kat. “The elf changed positions while Kat slept,” says Dr. Frantz. “It was Kat’s job to go find him. And it worked. It got Kat engaged and out of bed for her physical therapy.”

CHKD chaplain Kit also found a clever way to engage Kat. She arrived one day with a special candy bar that helped them bond: a Kit-Kat bar. “From that point on, Kat was looking forward to Kit’s arrival each day,” Sandy says.

In the following days, Kat’s condition stabilized, and plans were made to move her to a hospital closer to home. While Sandy was simply grateful that her daughter was alive, she knew this holiday would be a tough one. “It was just a few days before Christmas. I had no gifts to give my kids. That’s when the child life specialists took me to Santa’s workshop.”

Each year, CHKD’s child life department turns a hospital conference room into a makeshift toy store, and child life specialists help parents of hospitalized children select brand-new gifts donated throughout the year for patients. The Parsonses were able to hand-select gifts for each daughter. For Kat, Sandy chose a few books, a craft kit and a Barbie doll.

Eleven days after the traumatic attack, Katarina Parsons headed back home to Maryland, where doctors continued her care.

Katarina and her mother returned to the hospital three months later to thank the trauma team at CHKD that saved her life.

“CHKD surrounded us with amazing care during one of the most difficult times in our family’s life, and we feel a connection here,” says Sandy. “There were so many people who helped us. It is obvious that everyone who works here is dedicated to helping children heal, and we will forever be grateful for CHKD.”

“The rapid response and integration of all elements of our trauma team give patients the best chance of survival and full recovery,” says Dr. Frantz. “CHKD is uniquely equipped to meet the full spectrum of physical and emotional needs of injured children and their families. Caring for Katarina and her loving family was a true privilege. Seeing her skipping through the halls of the hospital after her wounds had healed was very gratifying and helped to validate our commitment to providing quality trauma care.”