Melissa Campbell, a transport nurse for Texas Children’s Kangaroo Crew, shares the critical role of our transport team and how their training, passion and shared commitment to patient safety helps keep them strong no matter what challenges they face along the way. Read more
When people tell stories about the care Texas Children’s provides, they often use the same word: miraculous. With the heroic actions of our Kangaroo Crew in two recent cases, it’s easy to see why.
The first story took place on August 7. The team in Texas Children’s Mission Control received a frantic call from a surgery center north of Houston.
“There was a very panicked voice on the other end,” said ETM dispatcher Amber Lieberman. “She said, ‘We need your team, we need blood and we need you now.’”
A 6-year-old patient had suffered a lacerated carotid artery during a routine outpatient procedure. The surgical team had applied pressure to stop the bleeding, but the patient had lost too much blood and there was no emergency blood on hand. Without immediate assistance, the child might die.
Mission Control immediately sprang into action. A Kangaroo Crew team at Texas Children’s Hospital The Woodlands was dispatched to the patient. On the scene, the team swiftly assessed the situation and began preparing the patient for transport, taking special care to keep the patient as secure as possible since the team at the community surgery center was still applying pressure on the artery. One wrong move could mean disaster.
Meanwhile, Mission Control also dispatched the Kangaroo Crew from Texas Children’s medical center campus to take the emergency release blood to The Woodlands team. In a stunning display of coordination, Mission Control and the two teams orchestrated a hand-off of the blood just off Interstate 45 between The Woodlands and Houston. They planned down to the exact moment when each vehicle would arrive and also on which side of the highway they would meet. In the parking lot of an abandoned restaurant, the two teams connected almost simultaneously and the blood was handed off.
Once the patient was stable, the medical center campus Kangaroo Crew followed The Woodlands Kangaroo Crew to the Texas Medical Center in case support was needed during the drive. Mission Control constantly tracked the movements of each vehicle and coordinated our teams in the emergency center (EC) and operating room and interventional radiology (IR), providing constant updates on the patient’s condition and ETA.
When they arrived at the EC, Kangaroo Crew team members assisted the emergency staff until the patient was taken to IR. This is a story that could have had a much different ending.
“Because of the seamless coordination with Mission Control, it’s amazing what we can accomplish,” said Kangaroo Crew transport nurse Roma Frier. “It wouldn’t have happened like it did without the transfer center and the way it operates.”
Just over a week later, on August 16, the Kangaroo Crew was transporting a patient from another hospital in the Texas Medical Center to Texas Children’s neonatal intensive care unit (NICU). As they passed the Jan and Dan Duncan Neurological Research Institute, Michael Johnson, the EMT on the team, saw something startling at a nearby bus stop.
“There was an individual giving chest compressions to a man,” Johnson said. “I turned and yelled to the back, ‘We need to stop, I don’t think this guy’s breathing.’”
The Kangaroo Crew immediately stopped to assist. Members of the team sprinted to help and began CPR while another crew member stayed with the stabilized patient on board and contacted Mission Control, who alerted paramedics. Less than three minutes later, the Houston Fire Department (HFD) arrived on the scene and a unified command was initiated. HFD, assisted by the Kangaroo Crew, began administering advanced cardiac life support.
Within moments, the patient was revived.
As HFD and EMS prepared the cardiac arrest patient for transport to an adult hospital, the Kangaroo Crew proceeded to Texas Children’s NICU with our patient, who had been stabilized and monitored throughout the rescue.
This is another story that could have ended in tragedy. However, both the NICU patient and the gentleman are alive today, and the prognoses are excellent.
“This is a story that deserves celebration,” said Texas Children’s President and CEO Mark Wallace. “The heroes in the Kangaroo Crew and Mission Control are such a big part of this one amazing team. They are always running toward the problem, and they make such a huge difference here at Texas Children’s.”
Also awed by the heroic actions of the Kangaroo Crew that day was Craig Moreau, HFD captain and paramedic from Fire Station 33.
“I am convinced that the early decisive actions of the members of the Kangaroo Crew gave this patient the best possible chance for survival,” Moreau said. “If in the unfortunate event something drastic is to occur to me or any members of my family, I hope the Kangaroo Crew is nearby to assist. Their efforts went above and beyond the call of duty.”
The heroes on August 7 were:
Mission Control
Mona McPherson, Pediatric Medical Control
Amber Lieberman, Dispatch
Gloria White, Charge Nurse
Kangaroo Crew Transport Team 991 from The Woodlands
Adrian Gonzales, EMT
Shawnaka Holland, RN
Ryan Seaholm, RRT
Jacob Willits Martinez, Orientee
Kangaroo Crew Transport Team 992 from Main Campus
Ray Estlinbaum, RRT
Roma Frier, RN
Kim Karn, RN and Orientee
Michael Johnson, EMT
The heroes on August 16 were:
Kangaroo Crew Transport Team
Ashley Griffin, Orientee
Michael Johnson, EMT
Kristine Knight, RRT
Jennifer Rinaldo, RN
Click here to learn more about the Kangaroo Crew.
Click here to learn more about Mission Control.
Texas Children’s Kangaroo Crew recently received the Texas Department of State Health Services Texas Emergency Medical Services Air Medical Service Award. The award is given annually to an air medical service team in Texas that demonstrates the highest standards in providing patient care and leads the way in innovation and commitment to advancing that care every day.
The Kangaroo Crew demonstrated this resilient commitment at their annual safety training at Hobby Airport. Team members participated in simulated emergencies that may occur in the field.
“We don’t like to talk about it, but it’s something we have to train for and discuss in case of an emergency,” said Kangaroo Crew Education Coordinator Jennifer Bee.
Texas Children’s created the Kangaroo Crew over 30 years ago to transport critically ill babies and children to Texas Children’s Hospital from all over the nation and Central America for high level care. The team’s annual safety training focuses on extensive preparation activities that allow them to agilely care for patients on and off of the ground. The Kangaroo Crew partners with Hobby Airport, Seven Bar Aviation, and Wilson Air to stage the event, which highlights Federal Aviation Administration (FAA) regulations, and tactics for responding during aircraft and ambulance transports.
Texas Children’s Mission Control plays a major role in the Kangaroo Crew’s swift transportation process. The initial call for a transport comes through Mission Control to the dispatchers. A charge nurse and physician help assess the need, and a transport team is dispatched immediately. Prior to the creation of Mission Control last year, the transport process averaged about 50-60 minutes.
“Now that Mission Control is part of that process, we’ve decreased our transport time by almost 50 percent,” Bee said. “We’re down to like less than 30 minutes, which is a significant change for our team. We’re getting out the door to the patients much faster.”
Efficiency is an important part of the process when dealing with critically ill patients. However, it is also imperative to perform each step precisely to avoid mistakes. Hence, the annual training.
“You want to stay calm and collected so that way you’re not tripping over stuff,” said Seven Bar Aviation Captain Kyle Neill. “Being more methodical about it versus just trying to get out as soon as possible, is a better practice. That way you can get the patient, unhook their lines and get out the door safely.”
Despite the immense pressure of the job, the goal of the intense training is to educate and strengthen the team. Bee said she makes sure the training is also a bonding experience.
“I try to throw a team building activity in there, which helps because we are constantly on the go when we are here at the hospital,” she said. “It’s kind of a small family. Everybody understands the importance of everyone’s role.”
The Kangaroo Crew employs nearly a hundred employees with a wide range of backgrounds.
“It is imperative that we train as a multi-disciplinary team – with pilots, transport team members and simulated patients – for high-risk-low-frequency events and prepare for every situation,” said Dr. Jeanine Graf, Kangaroo Crew Medical Director. “I am proud to be associated with a consistently high performing team that prioritizes safety in our simulation training.”
Texas Children’s Kangaroo Crew is the only pediatric intensive care transport service in the region that offers such a high level of expertise on each transport.
“As we look forward to the opening of Legacy Tower, we will be ready to provide access to all of our critically ill patients who call on us for service,” Graf said.
Click here or more information about the Kangaroo Crew.
Texas Children’s continues to deliver on its mission of providing quality and safe care to our patients. As part of the expansion of the Maternal Fetal Medicine services at the Pavilion for Women, the obstetrics service has partnered with the Texas Children’s Kangaroo Crew to create the Maternal Transport Service.
The Kangaroo Crew transport team has decades of experience in critical care transport. To ensure expertise in high risk obstetrics care, the Kangaroo Crew and the Pavilion for Women labor and delivery (L&D) nursing staff have combined their specialized experience to create a program that supports critically ill obstetrics and gynecology patients. The team consisting of a Kangaroo Crew nurse, L&D nurse, respiratory therapist and EMT can provide specialty care not only to newborns and children, but now to mothers while enroute to the Pavilion for Women.
On December 8, 2017, Texas Children’s had its first maternal fetal transport case where a high-risk pregnant patient was transported to the Pavilion for Women from an outside hospital. The transfer call came in to Texas Children’s Mission Control, the hospital’s state-of-the-art communications hub that houses representatives from the departments of Room Management, Transport Services and Critical Care.
When a transfer call comes into the center, teams across the system work together to assure an efficient transfer occurs that provides the highest quality and safest care possible for high risk maternal patients.
“Whenever safe to do so, transporting a pregnant patient to the appropriate facility before an emergency happens is safest,” said Dr. Karin Fox, medical director of Maternal Transport. ”There is not an incubator yet made that can support an unborn baby and the mother, provided she is stable and a true emergency has not yet occurred.”
Prior to the maternal transport, meticulous collaboration took place before coordinating the patient’s successful transfer to the Pavilion for Women.
“We collaborated with our Maternal-Fetal Medicine and subspecialist teams to determine if this patient would benefit from maternal transport,” said Elizabeth Bolds, assistant clinical director at the Pavilion for Women. ”Intake assessment revealed this would be an ideal candidate for our Maternal Transport program and as such we coordinated the patient’s transfer to the Pavilion for maternal ICU care.”
The Kangaroo Crew staff – Shannon Frost RN, Heidi Allen, RRT, Nathan Martinez, EMT, along with maternal transport nurse, Khanh Nguyen, comprised the pioneering team that transported our first maternal transport.
According to Deb D’Ambrosio, RN, director of Transport Services and Mission Control, and Dr. Jeanine Graf, medical director of the Kangaroo Crew, “we had six successful transports in the first few weeks of starting the program. We anticipated this would be the volume for one month.”
By extending this transfer service beyond the hospital’s pediatric and neonatal populations to our high-risk expecting mothers, the Pavilion for Women continues to bolster its reputation as a primary referral site for patients with high-risk pregnancies.
“When the Pavilion for Women opened five years ago, it was created to care for the most complicated pregnancies and critically ill newborns, as well as serve thousands of normal deliveries each year,” said Cris Daskevich, senior vice president at the Pavilion for Women. “By working with our Kangaroo Crew and Mission Control partners, this transport service allows us to help our partners in the community transport their really sick patients to us where we can improve outcomes for mothers and babies.”
Click here to learn more about high-risk pregnancy care at Texas Children’s Pavilion for Women. Click here to learn more about our Kangaroo Crew transport team.
May 15 was International Kangaroo Care Awareness Day. At Texas Children’s Newborn Center, our physicians and neonatal nurses are strong believers in the benefits of kangaroo care, which promotes parental bonding with a new baby from the earliest moments of life.
Kangaroo Care is a method of holding babies skin to skin with a parent. The infant wears a diaper and is placed on the parent’s bare chest and covered with a blanket for warmth, much in the same way a kangaroo cares for its baby in the pouch.
The benefits for the infant include improved feeding, temperature stability, stabilized heart rate and respiratory status, improved oxygenation and decreased length of hospitalization. Skin-to-skin contact also improves the bonding between parents and baby, and stimulates breast milk production for new mothers.
Texas Children’s neonatal nurse practitioner and mom Jennifer Gallegos shares her and her husband’s unforgettable bonding experience with their son, Bennett, moments after his birth.
“Kangaroo Care has always been a passion of mine as a bedside nurse and as a nurse practitioner. It took on new meaning when our second child, Bennett, was born at 34 weeks. The time spent with Bennett in skin to skin was memorable, and is treasured by both my husband and I to this day.
The first time my husband, Greg, held Bennett, our son was still on CPAP. For me, it was no big deal, but Greg was terrified of all the “wires and machines.” A little encouragement from Bennett’s nurse persuaded him to try it. The photo to the right is their first of several sessions. Greg became a believer, and he would use their special time to give Bennett “pep talks” on breathing so he could come off the CPAP. While I enjoyed holding Bennett skin to skin, it was just as special watching a father bond with his baby in this way as well.”
To learn more about the benefits of Kangaroo Care at Texas Children’s Newborn Center, click here.