When kids suffer trauma, Aaron Puntarelli and the Riley team are there to help the patients and their parents through it.
By Maureen Gilmer, IU Health senior writer, mgilmer1@iuhealth.org
As a charge nurse in the emergency department at Riley Hospital for Children, Aaron Puntarelli sees more than his share of trauma.
Car accidents, falls, shootings, stabbings, burns, drownings. And the most horrifying of all – child abuse – or what he and his team refer to as nonaccidental trauma.
No day is the same, he says, and that keeps him on his toes.
“Nursing is just what I want to do.”
His career path wasn’t always that clear. The multi-sport athlete, who grew up on the south side of Indianapolis, was in pre-med at the University of Indianapolis but changed course after graduation.
He went into teaching and coaching back in his old stomping grounds before the pull of medicine brought him back.
There was something about nursing – and taking care of kids – that sucked him back in, he said.
He returned to school, earning his nursing degree from Marian University. During that time, he did his clinical rotations at another hospital, but when it came time to choose the place where he would launch his career, there was no question that it would be Riley.
It helps that Puntarelli’s wife, Sarah Johnson Puntarelli, works at Riley as rehab services supervisor, but there was something else.
“GIVES YOU CHILLS”
“There is just something different when you walk into this hospital,” Puntarelli said. “It kind of gives you chills when you think about it, but you walk in those doors and there’s a different aura here.”
It extends from the physicians, nurses and clinical staff to support staff and administrators, he said.
“I can’t explain it,” he said. “We here in the emergency department call it the Riley miracle.”
Nettie Wilson and Amy Knowles, clinical managers for the ED, say Puntarelli is part of that miracle. They describe him as “a fabulous trauma nurse” and someone who wants to learn as much as he can to better care for patients.
“We have known him in the role of a student PCA to new graduate nurse to now an experienced nurse, and he has thrived in all roles,” Wilson said. “Aaron is an efficient and reliable charge nurse and an expert in his field.”
Puntarelli started as a tech in the ED six years ago before being hired on as a nurse.
“I love kids … and it’s rewarding to treat them and see them get better,” he said.
TRAUMA TEAM IS READY
Depending on the severity of their illness or accident, he doesn’t always get to see them beyond the 30 minutes or so that they are in the ED.
“It’s hard in the ED, after you stabilize a critically ill patient, you don’t get to follow them into surgery or go up onto the floor when they’re admitted,” he said.
As the state’s only Level 1 pediatric trauma center verified by the American College of Surgeons, Riley receives trauma patients from all over Indiana.
“If there is a stabbing up in northern Indiana or a horrible pile-up down south, they fly them here,” Puntarelli said. “We’ve seen some bad things.”
The team immediately springs into action no matter the time of day or night. Pediatric trauma surgeons, as well as specialists in emergency medicine, critical care, radiology and anesthesia, are available in the hospital at all times.
And in Riley’s family-centered care model, it’s not just the patients who are treated.
“A lot of our treatment involves the parents,” Puntarelli said. “No parent wants to see their child hurt or sick like that. Part of our job is to console them, give them information and just be with them. I can’t imagine what it would be like to have your kid in a situation like that.”
BABY ON THE WAY
Parenthood is on his mind a lot these days, as he and his wife prepare for the birth of their first child – a little boy – in July. The joy and anticipation are written on his face.
The couple married nearly four years ago under the bright lights of a baseball stadium. They exchanged vows on home plate at Victory Field in Downtown Indianapolis, shared cocktails with guests in the concourse area and held their reception on the Corona Patio.
Outside of work, Puntarelli likes to do CrossFit at the gym, attend his nieces’ and nephews’ ballgames and spend time with his wife and family.
“Come July, I’ll have a different sense of what life is like outside work,” he said with a laugh.
SAFE SLEEP WARNING
With a baby on the way, he has a message he wants to send to all parents of little ones.
He has seen heartbreak too many times in the ED when a child is brought in after suffocating as a result of unsafe sleep practices.
Number 1: Do not sleep with your baby, he says, no matter how tempting it might be after a middle-of-the-night feeding. Number 2: Place the infant on his or her back when it’s time to sleep. Number 3: Keep blankets, pillows, bumper pads and soft toys out of the baby’s bed.
These practices can help lower the risk of accidental suffocation, sudden infant death syndrome and deaths from unknown causes, according to the Centers for Disease Control.
“It’s heartbreaking every time,” Puntarelli said, when an unresponsive infant, who appears otherwise healthy, is brought into the ED.
That and child abuse are among the worst things he sees in his job, sometimes even harder than motor vehicle accidents.
“We live in the world we live in, and it’s a hard place sometimes. We choose to work here, but sometimes we have to step away for a bit, let someone else take over.”
CARE EXTENDS TO TEAM
After every major trauma case, the care team debriefs for a few minutes to go over what went right, what went wrong and how they can do better. But caring for the team members themselves is also key.
“Our team here is awesome,” Puntarelli said. “We can talk to each other, pick each other up.”
A hospital chaplain is always available to console families and team members, and the employee assistance plan is another vital resource.
As charge nurse, Puntarelli is responsible for coordinating care for patients and attending to parents’ needs while his team is actively treating the child.
Wilson has seen him in action, describing him as a strong leader in his role as charge nurse and in trauma evaluations.
“He strongly exhibits our value of team in his interactions with his peers and colleagues,” she said. “He is always willing to do what is necessary for the unit and for our patients.”
That means jumping in to care for the child when appropriate, but he takes seriously his obligation to parents and other caregivers in the moment.
“I’m trying to keep them informed, whether it’s a resuscitation situation, or if their child is being intubated or headed to surgery. I’m letting them know we’re doing all we can.”
Adult minds can wander, he said, so keeping them informed is the best thing he can do.
“That’s what they want – to know we are working our hardest to help save their kid.”
Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org