Mad dash to the ED saves little boy

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

Dr. Ben Petty sees a lot of things as an emergency department physician at IU Health West Hospital, but this was different.

Rushing toward him was a fellow doctor wearing a protective gown, mask and face shield and holding tight to a baby boy.

The child in his arms was cyanotic, Dr. Petty observed, pale and listless. His lips were blue. He was breathing, but clearly struggling.

“Honestly, I don’t think he could have been breathing on his own much longer,” Dr. Petty said. “He got here in the nick of time.”

Dr. Jason Cosgrove is a pediatrician with offices at IU Health West. When Kalina Chew brought her 1-year-old son in to see him that Tuesday morning last month, he knew immediately the child was in distress.

Chew had been watching her son closely since the previous night when he had a runny nose. By morning, he was worse. He had a well-child visit scheduled that day with Dr. Cosgrove, but she wondered if she should take Murphy directly to Riley Hospital for Children, where he had been seen a month earlier for a bronchial infection.

“RAN HIM TO THE ER”

Dr. Cosgrove was available to see her immediately, the pediatrician’s office told her, so rather than risk waiting in an emergency department, she drove her son to IU Health West, much closer to her Brownsburg home.

“That’s what I did, and I’m grateful for that,” Chew said. “Dr. Cosgrove was able to give him a steroid shot right then, and he scooped him up and ran him to the ER because his oxygen level was in the 60s.”

The entire visit in the pediatrician’s office took just a few minutes, Dr. Cosgrove said. He took one look at Murphy, had him swabbed for COVID and flu (both negative) and had a nurse check his oxygen saturation levels – twice. The first reading came back in the 70s, the next in the 60s. A normal oxygen level is 95 or higher.

The doctor gave him a shot of Decadron to help his breathing and had his nurses call down to the ED to let them know he was bringing a sick baby their way.

“He did not look good. I knew he was pretty sick,” Dr. Cosgrove said. “I just picked him up and headed down there. They met me on the way, and they were ready to roll.”

At a normal pace, the walk from his office on the west side of the hospital to the emergency department on the east side might take about 3 minutes. He went a lot faster this time.

“This was the first time I had walked a patient to the ER ever,” he said. “And they were well-prepared.”

TEAM JUMPED INTO ACTION

Dr. Petty estimates barely a minute passed between the time he got the call that a sick child was on his way and Dr. Cosgrove’s arrival with Murphy in his arms.

“That was the most notable thing – Dr. Cosgrove carrying the child down from his clinic to the emergency department,” Dr. Petty said. “I can’t recall ever seeing that happen.”

Meanwhile, Murphy’s mom was in a state of shock but took a photo of Dr. Cosgrove carrying her son to the ED because she wasn’t sure her husband, Tad, who was home with their older son, Clark, would believe what was happening in that moment.

She fought to stay calm.

“I knew not to panic yet, but when we got to the ER, I think at one point there were four physicians in the room and I don’t even know how many nurses. It felt like there was one nurse just for me, to keep me calm.”

Dr. Petty had readied his ED team and asked respiratory therapist Brenda Joyce to jump in. They put Murphy on high-flow oxygen through a nasal canula and prepared his mom for the possibility of him being intubated and put on a ventilator.

“The baby was lethargic and pale and his lips were blue,” said Joyce, who couldn’t help but flash back to the time her then 6-week-old grandson had a respiratory virus and had to be intubated. “She got him to the doctor just in time really. It could have been a lot worse.”

MUSIC CALMS HIM

At one point, Murphy’s mom asked if she could climb up next to her son and play a song on her phone that calms him. Murphy’s middle name is Joel, a nod to singer Billy Joel, whose 1977 tune “Scenes From an Italian Restaurant” later wafted through the emergency room.

“That doesn’t happen very often either,” Dr. Petty said, marveling at Chew’s level-headedness. “That was instrumental in allowing us to get an IV in and start him on oxygen.”

But talk of a ventilator scared the young mom.

“Of course, over the last couple years with COVID, you hear of someone going on a ventilator and not coming off, so that’s where my head went,” Chew said. “Thankfully, he responded well to the oxygen and albuterol.”

Dr. Petty said it is his job to prepare for the worst in the ED. He was grateful that it didn’t come to that.

“Everyone was so calm, worked so well together, got him on oxygen and stabilized him,” he said, before calling for Murphy to be transported to Riley via IU Health LifeLine.

“We were thrilled to see that he did really well,” Dr. Petty added. “I counsel parents to use their intuition because they know when something is off. Her mom instinct was right on that day.”

“PRAYING FOR THE BEST”

There was no room in the ambulance for Chew, so she followed in her car. That’s when she allowed herself to fall apart a little, realizing how close she came to losing her little boy.

“I had mentally prepared that our Lord was potentially calling our baby home, while accepting that I had done everything I could in that moment and praying for the best.”

Much of that morning was a blur to Chew, who said she finally caught her breath once they got to Riley and her baby’s oxygen levels stayed up.

The diagnosis of asthma that came later at Riley flooded Chew and her husband with relief, but she was also confused.

“I have asthma, but it’s very mild and I didn’t know I had it until college,” she said. “I don’t have to treat it, I just avoid triggers. But this is a learning curve for me because so many things could set off his asthma – carpet, pets, allergies, weather changes, a lot of things out of your control.”

Murphy, who now sees pulmonologist Dr. Evans Machogu with Riley Allergy and Asthma, was on the PICU at Riley for two days before being moved to the pulmonary unit. During that time, Chew attended asthma education classes and learned how to give her son breathing treatments.

“By then, he was doing so much better. It was about educating me to keep him healthy,” she said. “In the class, they said 10 people in the U.S. die every day from asthma. I just didn’t know it could be that serious.”

PARENTS: TRUST YOUR INSTINCTS

Chew said under normal circumstances she would not be sharing her family’s health scare publicly, but she felt this was too important to keep quiet.

“We are grateful to have a diagnosis so we can help him. Even if this helps one person, then good came from it.”

She encourages other parents to trust their instincts.

“If you feel something is wrong, don’t wait. And advocate for your child,” she said, as a happy, healthy Murphy squealed and babbled in the background.

“We had a great experience at Riley. I’m just so grateful,” she said. “I feel very fortunate that we have such an awesome children’s hospital within 30 minutes of us.”

Murphy, whose first name is a nod to the sports bar Murphy’s Bleachers across from Wrigley Field in Chicago, is smart, active and happy today, his mom said. He loves balls, Hot Wheels and salmon and likes to watch big brother Clark play baseball.

He has settled into a routine of twice-daily breathing treatments while listening to his favorite Billy Joel tune.

“We’re still learning what triggers it (an asthma attack) for him,” Chew said, “but we feel fortunate that we have access to such great care.”

Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org