8-year-old survives traumatic injury
Helping father on family farm
Cole Heiden was helping his father, Allen Heiden, with the evening chores on the family's dairy farm near Whitehall, Wis., when the unthinkable happened. The tractor fender that Cole was sitting on snapped off, throwing the 8-year-old to the ground. Before Allen Heiden could stop, Cole had been run over by the tractor and the feed wagon behind it.
"Cole was awake and talking, but I could tell by the way he was breathing that he was really hurt," says Cole's mom, Julie Heiden. "I've been on a farm my whole life and have seen accidents. I knew this one was bad."
Mayo One helicopter
Kimberly Arndorfer, flight nurse on the Mayo One helicopter team, was equally concerned. The staff, medical equipment and medications on board Mayo One make it a mobile emergency room equipped to handle nearly any patient with serious trauma. But Arndorfer says, "In my ten years of experience, Cole was one of the most critically injured pediatric patients I have cared for."
Collapsed lung, serious injuries
Of most concern was Cole's labored breathing, which indicated that he had a collapsed lung and would need to have a tube inserted into his chest to re-expand it.
Arndorfer and her Mayo One partner, Jeff Stearns, knew that if they performed the procedure on the farm, they risked exposing Cole to a dangerous infection. They determined it was best to take him to the hospital, where the chest tube could be inserted under sterile conditions.
At Mayo Clinic Health System in Eau Claire, Wis., the trauma staff stabilized Cole and inserted a chest tube. They then began a series of imaging exams to determine the full impact of his injuries. What they saw prompted a call to Cole's parents, Julie and Allen Heiden, who had not yet reached the hospital.
"They told us Cole's injuries were very serious," says Julie Heiden. "I felt like my heart was breaking. I didn't think he'd make it. I prayed that he would."
Heavy internal bleeding
Imaging tests had revealed that Cole's liver was nearly severed from his body, causing heavy internal bleeding. Medical staff in Eau Claire began giving Cole blood to replace what he was losing, treatment that Arndorfer and Stearns continued during the 35-minute flight to Saint Marys Hospital in Rochester, Minn., a Level I pediatric trauma center.
By the time Mayo One landed, a pediatric trauma team was assembled and waiting for Cole. The group included trauma surgeons, pediatric emergency medicine physicians, critical care specialists and nurses. After listening silently to the Mayo One flight team's report, Christopher Moir, M.D., a pediatric surgeon and director of the Mayo Clinic Children's Center, directed the trauma team to an operating room. Cole's only hope for survival lay in stopping his blood loss.
When the trauma team viewed images of Cole's liver, even the most experienced members of the group were taken aback.
"Blood was pouring out of his liver faster than I've ever seen," says Ian McPhail, M.D., a cardiologist/interventional radiologist. To stop the bleeding, Dr. McPhail would need to plug Cole's hepatic artery with a wire coil. The procedure, called embolization, is only available at major medical centers such as Mayo Clinic.
With the eyes of his colleagues upon him, and with the full knowledge that he held a child's life in his hands, Dr. McPhail began his work. Initially, he was concerned he might not be able to save the 8-year-old boy on the table.
"There was a very critical 15 minutes when I wasn't sure I'd be able to plug the artery," says Dr. McPhail. "And I knew that would make or break things for Cole."
Fortunately, Dr. McPhail was able to stop the bleeding and save Cole's life — for the time being.
Lungs, intestines, kidneys at risk
Cole was temporarily stable, but his fate was still far from certain.
"After that much trauma, the body often shuts down and that's what began happening to Cole," says Dr. Moir. "His lungs didn't work, his intestines didn't work, his kidneys were at risk of shutting down."
Fortunately, Cole had dozens of Mayo Clinic medical professionals committed to fighting each insult to his small body.
"The Mayo system is set up for us to work miracles together," says Dr. Moir. "We're a team of teams: First, the Eau Claire team and Mayo One transport team saved Cole. Then the ER pediatric trauma team stabilized him, and then the OR team put him back together. Finally, the pediatric ICU team shepherded him through a month of critical illnesses."
Walking, talking, eating, playing again
After that month, Cole slowly began to improve. He left the ICU and began breathing on his own. Mayo physical and occupational therapists joined his team of caregivers, working with Cole to help him walk, talk, eat and play again. And on Nov. 2, 2011, just a little over two months after the accident, Cole left the hospital and returned home to a joyous welcome from his eight brothers and sisters, dozens of friends, supporters and his dog, Missy.
"All and all, he's almost back to his old self," says Julie Heiden. "Considering where he was, I am amazed. To have a child almost taken away, and then given back — it's like a second birth."
"Mayo saved his life. Without the doctors and their knowledge, he wouldn't be here," she says. "Mayo gave Cole back to us. It's the best gift a parent can have."