Critically ill kids at Corewell now use PANDA One’s ‘ICU on wheels’
Hailey Hillier was pregnant with her first baby and a week overdue when she went to Corewell Health Beaumont Grosse Pointe Hospital on Sept. 4 to be induced.
Hillier, who is 31 and lives in Detroit’s East English Village neighborhood, was eager to see her daughter’s face, to hold her for the first time and to have all the experiences most new parents long to have.
It didn’t go as planned, however, and two days after the induction began, Hillier and her baby were in distress.
Doctors used a vacuum extraction device to speed along the delivery because they were concerned the baby was stuck in the birth canal. They tried once without success, and then a second time. The third attempt finally delivered 7-pound, 8-ounce Amelia Scheiderer into the world.
Hillier expected to hear her newborn cry, but she was met with silence. Amelia was completely unresponsive.
“I think initially, I was in shock because I was pushing for three hours and I had a fever, so I was a little delirious towards the end,” Hillier said. “It was really intense. Just not hearing her cry, and not getting the expected Golden Hour, and all the things that you anticipate happening after you deliver a baby, obviously, did not happen.”
Instead, Amelia was whisked away so the medical team could resuscitate her and perform CPR.
“Then she had to be intubated immediately,” Hillier said. She didn’t even get to see her baby girl’s face.
Doctors determined that Amelia had gone for too long without oxygen while she was stuck in the birth canal. It caused a condition called hypoxic-ischemic encephalopathy, also known as HIE, which can lead to neurological damage, seizures, difficulty breathing and feeding, a slow heart rate, hearing deficits, muscle and reflex problems, developmental delays, cerebral palsy, as well as organ failure.
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Research has shown that when full-term newborns with moderate or severe HIE are cooled through a medically induced therapeutic hypothermia within six hours of delivery, it can improve rates of survival and reduce the severity of disabilities and long-term health effects.
Amelia needed cooling and intensive medical care for the next 72 hours, but the Grosse Pointe hospital where she was born doesn’t have a neonatal intensive care unit. She would need to be transferred to Corewell Health Willam Beaumont University Hospital in Royal Oak to get the support she needed.
“They were concerned about her liver, kidneys and brain because of the amount of lactic acid in her body caused by the lack of oxygen,” Hillier said, adding that Amelia also was having seizures.
The Corewell medical team tried something new. They called PANDA One, the Pediatric and Neonatal Dedicated Ambulance Service owned and operated by Children’s Hospital of Michigan in Detroit, to help.
“We are essentially an ICU (intensive care unit) on wheels,” said Sally Piwko, manager of patient care services for the PANDA One team.
It is the only staffed and dedicated pediatric ambulance transport team in the state. It includes two ambulances brightly painted with a smiling panda on the sides, each with a crew of pediatric critical care nurses who can provide the most advanced level of care for infants and children while en route from one hospital to the next.
PANDA One was an option in Amelia’s case because of a new partnership between Corewell Health East and Children’s Hospital of Michigan, which aims to provide a safer, smoother journey to babies and children in metro Detroit with life-threatening health conditions like Amelia’s.
The partnership allows critically ill children treated at five Corewell Health hospitals in metro Detroit that don’t have on-site pediatric intensive specialty care — Trenton, Taylor, Wayne, Farmington Hills and Grosse Pointe — and at its three emergency centers in Lenox, Canton and Livonia to use PANDA One when they are transported to Corewell’s pediatric hospitals in Royal Oak, Troy and Dearborn or to Children’s Hospital of Michigan in Detroit.
That includes infants like Amelia who need treatment in a neonatal intensive care unit.
“We have 1.2 million children in southeast Michigan, and they get hurt and injured and sick, and we need to make sure that we can very quickly get them to whatever hospital they need to get to — whether it’s within Corewell or the DMC (Detroit Medical Center) or wherever. And so that’s what this is,” said Dr. Matthew Denenberg, chief of pediatrics at the Royal Oak hospital, at a news conference Wednesday announcing the partnership.
PANDA One is equipped to transfer the tiniest babies to older kids who need critical care — whether they have been injured in a traumatic accident, have been severely burned or are in need of life support or resuscitation.
Each of the ambulances is outfitted with an isolette, which gives the medical team the ability to warm or cool infants while they’re being taken from one hospital to the other, said registered nurse Danielle Tupancy, who is part of the PANDA One intensive care transport team.
When PANDA One arrived to pick up Amelia, Hillier said the nurses immediately started working to cool her body. They also made sure Hillier got to see her little girl before they took Amelia to Royal Oak.
“The team made it a point to bring her over once they had her all hooked up … and I was able to see her,” Hillier said. “They also gave me a really cute panda stuffed animal … which was really sweet.
“She was one of the first pediatric cases that had been transferred with this new program.”
Archie Drake, CEO of Children’s Hospital of Michigan, said there was no exchange of money as part of the agreement between Corewell Health and Children’s Hospital of Michigan, which is part of the for-profit Detroit Medical Center, owned by Texas-based Tenet Healthcare.
“The whole benefit is care for children,” Drake said. “Altruistically, that is the benefit. We have an asset that is in demand, and so it truly is about using that asset. And when you talk about the financial side, we have these ambulances, 24/7 fully staffed, times two crews around the clock. So there is no increased cost. There’s nothing like that. Neither health system will get a benefit or disadvantage from this collaboration financially.”
Although Corewell and the DMC are competitors within the same health care market, Drake said they are united in improving health outcomes for kids throughout the region.
“There is enough work to do in this region for all the health systems,” he said, “and that’s a true statement. So it really was thinking about: How do we better the care of pediatric patients?”
Before the partnership began, PANDA One was already handling ambulance transport for about 1,000 kids per year who needed a higher level of care from hospitals and doctor’s offices in Michigan, northwest Ohio and Windsor, Ontario. With Corewell’s hospitals added to its caseload, the team has transported about 50 patients among Corewell Health’s hospitals since Sept. 1, Denenberg said.
“A lot of them have been neonatal, which is great,” he said. “Those are the riskiest transports.”
The additon of Corewell’s hospitals could drive the expansion of PANDA One services in the region, said Drake.
“We’ve been thinking about that,” Drake said. “I’m going to let the demand drive the supply. We pride ourselves on fast response because that’s what really matters. … We can track that every single day, every single month. If we start to see some elongating of our response times and transport times, we would then be ready to add additional assets to the program.”
Drake did not say specifically what those assets would be — whether another PANDA One ambulance and crew would be the next addition or whether a helicopter and crew could be added.
Eight days after little Amelia Scheiderer was born, she was discharged from the hospital, Hillier said.
It could be several years before doctors can fully assess the effects of HIE, but now, at 11 weeks old, she is so far hitting all the developmental milestones.
“The results that followed the cooling treatment and NICU care are showing that it’s looking very, very good,” Hillier said. Amelia hasn’t had any seizures since she left the hospital and is no longer taking anti-seizure medication.
“It’s looking like pretty much she’s in the best-case scenario as of right now,” Hillier said. “And the hospital set me up with resources. There’s an Early On Program that she’s been referred to and accepted in, so she’ll have speech, occupational and physical therapy that will assess her closely, and obviously, if they notice anything, they will focus on that.
“She’s home with us, and is a very happy baby.
Contact Kristen Shamus: [email protected]. Subscribe to the Free Press.
This story was updated to correct the number of PANDA One ambulance transports that have been made since the program was expanded to add Corewell Health East.
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