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Saving Sydney

Published in the Spring 2012 Issue of ProHealth Magazine.

Sydney
After suffering severe injuries when a semi-truck landed on her car last year, Sydney Waitz-Kudla is completing her freshman year of college. Sydney’s story is one of determination on her part and skill on the part of the highly trained and synchronized trauma team at MVH.
March 15, 2011, began as just an average school day for Sydney Waitz-Kudla. But in an instant, her life changed dramatically.

“I don’t remember the accident at all, and I’m glad,” says Sydney, who was 16 at the time. “I was driving south on I-75, and, as witnesses later told me, the driver of a northbound semi-truck lost control. The truck jumped the concrete median and landed on the front of my car, crushing my legs under the dashboard and steering wheel. The airbag deployed, somehow forcing the back of my seat to recline so that my upper body was lying flat. The cab of the truck stopped where my head would have been.”

Traffic halted in both directions, and another driver rushed to Sydney’s side while someone else called 911. Sydney, still conscious but disoriented, was trying frantically to free her legs. It was no use. Fire and emergency medical crews from Middletown Fire Department would need a crane and the jaws of life to pull her out. An hour and a half after the crash, Sydney was finally loaded onto a CareFlight helicopter and rushed to Miami Valley Hospital, the region’s only Level I trauma center.

Sydney’s life was now in the hands of two critical-care-trained CareFlight nurses. While one worked to keep her stable, the other contacted the CareFlight Air and Mobile Services dispatch center to report her vital signs, describe her injuries and give an estimated time of arrival. The dispatcher relayed the information to MVH, and about 35 members of the hospital’s trauma team were paged and put on alert. This included physicians and nurses from multiple specialties – orthopedics, neurology, surgery and respiratory care, among others.

At the Ready

When the CareFlight helicopter landed on the MVH helipad, the trauma team was assembled in the emergency department. Surgeon Mary McCarthy, MD, took the lead. “On a scale of one to five, five being the worst, Sydney’s condition was at least a four,” says Dr. McCarthy, who is chair of the Department of Surgery and a professor at Wright State University Boonshoft School of Medicine. “She had sustained a concussion and multiple leg and arm fractures, and had inhaled glass shards when the windshield of her car shattered. But our immediate concern was that Sydney had lost a lot of blood and was in shock, meaning that her blood pressure was dangerously low. This was putting her major organ systems at risk.”

The team knew that, in order to save Sydney’s badly damaged right leg, she would need surgery that day in the hospital’s dedicated trauma operating room. “Sydney’s orthopedic injuries were extensive,” says Shelli Powell, MD, an orthopedic surgeon and adjunct professor at WSU Boonshoft School of Medicine. “Her right ankle had almost been severed in the crash. In addition, she had open fractures of her left femur (thigh) and humerus (arm) and a closed fracture of her right femur; and the nerves in her upper left arm had been crushed by bone fragments. But, because Sydney was still in critical  condition, we couldn’t keep her in surgery long. So we stabilized the fractured limbs with the plan of coming back later to do reconstructive surgery. She returned to the operating room a few days later for further repairs.”

Afterward, Sydney was transferred to the hospital’s intensive care unit, where she would remain for the next 10 days.

“Sydney was in critical condition when she arrived at MVH and stable by the time we got her to the ICU,” says Dr. McCarthy, who was instrumental in establishing the trauma program at MVH in 1991 and served as its director for almost 20 years. “This was possible only because we had a whole team of highly trained medical personnel working together.”

First Steps Toward Recovery

With Sydney out of immediate danger, her mother Krista could finally breathe a small sigh of relief. “I was home when the accident happened, but the police didn’t notify me right away because we’d recently moved to Oakwood from Cincinnati and they didn’t have my contact information,” says Krista. “By the time I arrived at Miami Valley, doctors were already working to stabilize Sydney. I couldn’t see her right away, but the CareFlight nurse found me and was very reassuring. As a parent, it hurt that I couldn’t be there when Sydney was taken to the hospital, but it meant a lot that someone who cared was with her.”

Dr. Ekeh HS
A. Peter Ekeh, MD
Dr. McCarthy HS
Mary McCarthy, MD
Dr. Powell HS
Shelli Powell, MD
Dr. Peters HS
Tim Peters, DO
Dr. Larsen HS
Beth Larsen, RN
Mother and daughter would continue to experience that kind of caring and compassion in the days ahead as the extent of Sydney’s orthopedic injuries became clear. Dr. Powell worked with Tim Peters, DO, a surgeon who is trained in orthopedic trauma surgery, to plan and perform reconstructive surgeries on Sydney’s right ankle. The ankle was particularly problematic.

“The bones in Sydney’s right ankle were so badly damaged that we knew it would be a very difficult reconstruction,” says Dr. Peters, who is also an adjunct professor at WSU Boonshoft School of Medicine. “I performed two surgeries that involved fixing the bones around the ankle with plates and screws. Sydney is young, and that gave her an advantage. She also was determined to walk again."

Sydney underwent a total of five orthopedic surgeries while at MVH. By the time she was transferred from the hospital’s ICU to its inpatient trauma unit, she was fully engaged in the recovery process. Physical and occupational therapists came to her bedside for therapy, and she learned how to use a wheelchair and other assistive devices.

“The MVH trauma unit is a nursing unit for patients who are in stable condition but still need advanced care,” explains Beth Larsen, RN, nurse manager of the unit. “Very few hospitals have anything like it. Before the unit opened in 2007, MVH trauma patients and trauma specialists were scattered throughout the hospital. Now, with everyone in the same location, team members can collaborate and communicate more effectively. As a result, patients receive the care they need when they need it from the hospital’s amazing network of resources.”

People Make the Difference

Beth Larsen describes a spirit of camaraderie and teamwork among staff on the 40-bed unit. “Everyone is accessible and available. If a nurse sees that a patient needs wound care or is dealing with a lot of pain, he or she can request a consult very quickly,” she explains. “Another positive is that our doctors spend a lot of time educating our staff, patients and family members. And we trust one another, which makes for great patient care.”

Many patients in the MVH trauma unit are recovering from orthopedic injuries, while others are healing from a traumatic brain injury, spinal cord damage or gunshot wound. The goal is to prepare them for the next stage of their recovery. For some, this next step means going to the hospital’s rehabilitation unit; others are discharged to a skilled nursing facility or home.

Patients spend anywhere from one day to several months in the trauma unit, and often develop strong relationships with the staff. That was certainly the case for Sydney – and her mother. “The nurses were very loving and caring,” Krista says. “They put themselves in Sydney’s shoes, doing things for her that they knew would make her feel better, like brushing her hair and bathing her when she couldn’t do it herself. That was typical of the care she received at MVH.”

After 10 days in the trauma unit, Sydney was transferred to the hospital’s rehabilitation unit, where therapists focused on helping her regain mobility in her legs and left hand, which had sustained extensive nerve damage. “My nurses and rehab specialists were so fun to be around, and they helped me stay positive,” Sydney says. “The recreational therapist even had me play my guitar as part of my recovery, and one of the occupational therapists would sometimes stop by to hear me play.”

Back to Life

Sydney returned home a month after the accident and spent the rest of the school year going to outpatient therapy, studying for Advanced Placement exams and participating in as many senior-year activities as possible. Prom was a special milestone. “It was the first time I’d gotten dressed up for anything since the accident,” Sydney says. “Eight boys asked me to dance, and I was out on the dance floor a lot in my wheelchair. It was really fun.”

Sydney graduated from high school in June and received a standing ovation from her classmates as she accepted her diploma. Today, the National Merit Scholar is a freshman at Vanderbilt University, majoring in English and psychology with hopes of becoming a forensic psychologist.

She continues to work hard at her recovery and has regained all of the mobility in her left hand and left leg. The range of motion in her right ankle is about 15 percent. Sydney walks with a slight limp, requiring a cane or wheelchair only for long distances. She enjoys swimming and hopes to return to two other favorite activities some day: dancing and horseback riding.

Sydney and Mom
With the worst of her ordeal behind her, Sydney can focus on the years ahead. But, she and her mom Krista (left) will always remember the care and compassion Sydney received at MVH.
“The accident disrupted my life but didn’t ruin it,” Sydney says today. “I’ve learned a lot about what I’m capable of doing. Now, my goal is to find ways to help others. I wouldn’t want anyone to go through something as difficult as I did and feel they are alone. I was lucky. A lot of people were in my corner, helping me believe.”

What Sets the Region’s Only Level I Trauma Center Apart?

Many people associate the term “trauma center” with a hospital’s emergency department. In fact, a trauma center refers to the entire hospital and the resources it has available to care for patients with traumatic injuries.

In order for a hospital to function as a fully verified trauma center in Ohio, it must be visited by the American College of Surgeons every three years. During each visit, the ACS confirms that the hospital has the resources necessary to be verified as a Level I (the highest), II or III trauma center.

MVH, which is the region’s only Level I trauma center, has been verified for 20 years. It treats the most seriously injured patients in southwest Ohio and east Indiana, 24 hours a day, seven days a week. In 2011, approximately 3,300 trauma cases were treated at MVH, making it one of the busiest and most experienced trauma centers in the state.

“Miami Valley Hospital offers trauma patients the full continuum of care, from emergency services to complex operations to rehabilitation therapy,” says A. Peter Ekeh, MD, medical director of the MVH trauma program and an associate professor at WSU Boonshoft School of Medicine. “In the event of a traumatic injury, residents of the community can be confident that at MVH they will receive the best care available in the area.”

In addition to reacting to trauma, MVH is proactive. As part of its community outreach, the hospital cultivates close working relationships with emergency medical teams in  many surrounding counties, providing educational courses to help first responders hone their clinical skills. The hospital also sponsors a number of injury-prevention initiatives to help lower the incidence of car crashes involving teen drivers, reduce the risk of falls in the elderly and more. And trauma team members participate in the latest research to improve patient outcomes.

It adds up to a significant commitment of time, energy and resources, all with the goal of providing optimal care for patients and their families.

Learn more about the services provided at MVH’s Level I Trauma Center.