Teamwork, Quick Thinking Saves Seven-Month-Old Baby

NEW  HYDE PARK, NY -- It’s every parent’s worst nightmare – your infant child falls on the floor and hits his or her head. Seven-month-old Amara Felder tumbled off of a couch and, though her parents, Nova Felder and Jvonne Dickson, didn’t see any bruises on their daughter, they decided to take her to the hospital just in case.

They drove Amara from their friend’s home in Brooklyn to Franklin Hospital in Valley Stream, NY, presuming that, at the very worst, the baby might have a concussion. After a computer tomography (CT) scan was performed, the parents received a much graver diagnosis: Amara had an epidural hematoma, or bleeding near her brain, along with a skull fracture. The pressure needed to be relieved quickly. After Joseph Zito, MD, an emergency medicine physician at Franklin Hospital, discovered the brain bleed, he called the transfer center, inserted a breathing tube and kept the infant stable until the ambulance could take her to Cohen Children’s Medical Center of New York in New Hyde Park, NY, so she could receive the life-saving care she needed.

Time was of the essence. A Nassau County police officer had just driven an ambulance to Franklin and saw this little girl needed immediate help. He and a team blocked off all of the side streets from Franklin to Cohen, and the ambulance got Amara to the children’s hospital in 12 minutes.
“The police officer said that New Hyde Park Road would be faster,” said Fiore Mastroianni, an emergency medical technician and second-year student at Hofstra North Shore-LIJ School of Medicine, who drove the ambulance. “I took him at his word. This wasn’t the time for a debate.”

Joseph Falco, DO, a pediatric critical care fellow; Lillian Hope, RN, a transport nurse; Thomas McCarthy, a paramedic; and Phoebe Yuen, a respiratory therapist, were in the back of the ambulance, trying to keep Amara stable during the frantic ride to Cohen.

Mark Mittler, MD, Cohen’s co-chief of pediatric neurosurgery, already had an operating room prepped for the child’s operation. Dr. Mittler said he knew going into the surgery that “this is as critical as it gets.” Had more time elapsed before the pressure on Amara’s brain was relieved, this would have been a very different story, he said later. Within about 10 minutes of Amara’s arrival, the blood clot in her brain was removed, Dr. Mittler said. This speed was achieved, in part, because Dr. Mittler was able to bypass the hospital’s emergency department and have the surgical team prepped.

As a result of all of the collective efforts of so many medical professionals and the police, Mr. Felder’s and Ms. Dickson’s baby is back to her normal, smiling self in their home in Laurelton.
“It meant all the world to us going to Cohen Children’s Medical Center,” Mr. Felder said. “It was critical care that they gave to Amara. They knew what to do with no confusion. It seemed so streamlined.”

Mr. Felder said he decided to take his daughter to Franklin instead of a Brooklyn hospital because he previously received quality care at the hospital. On what he described as “the hardest day of my life,” Mr. Felder said he wanted his only child to receive the best care.

Though Franklin could not provide the full range of services that Amara needed, a speedy transfer to another North Shore-LIJ Health System hospital saved her life.

“This was a good picture of how services came together well,” Mr. Mastroianni said. “Everyone was on the same page. It was very good to have everyone involved. When I practice later, I’ll appreciate what had to happen to get this patient to the care she needed.”

Dr. Mark Mittler said, “This child’s story really exemplifies everything that the North Shore-LIJ Health System is about. From the community hospital that identified the problem to specialized emergency room physicians that were able to stabilize the child to a multidisciplinary transport team in constant communication with the neurosurgical service to an operating room that was ready with a board-certified pediatric anesthesiologist -- everything worked. And it’s supposed to work. And this is a great example of how things do work.”

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