Pediatric Calls Proving Challenging for Responders

Aug. 03--SOUTH BEND -- It's a scenario a paramedic could face at any moment: A baby girl rendered lifeless by a severe head injury, or a little boy crumpled in the street, surrounded by wailing family members, after being hit by stray gunfire.

South Bend has seen several high-profile deaths of children in the past year -- perhaps an uptick, according to some medical personnel -- and these cases can take a special toll on the first responders tasked with saving mortally wounded kids.

After 4-month-old Halo Stutzman died from head injuries last month in a case of alleged neglect by her father, South Bend Fire Department EMS Chief Andrew Myer devoted the department's monthly medical training to pediatric emergencies.

"It just seemed to me we did have a few of these cases out here recently," Myer said. "The guys are exposed to (injured) kids a lot. I'm not saying they're all fatal calls, but we get a lot of pediatric calls -- a lot more than people would realize."

In April, 2-year-old John Swoveland Jr. was struck and killed by a stray bullet as he played along Campeau Street after an apparent fight between rival gangs escalated to gunfire a few blocks away.

In another recent example, Shirley Mundia, 6, was stabbed to death by her father in June 2013 in an attack that stemmed from a violent domestic dispute at an Irish Hills apartment.

"It comes in waves, and right now it seems like we're in the middle of one of those waves," said Lt. Jamie Borders, a paramedic and 15-year veteran of the fire department.

In a given year, Memorial Hospital treats about 100 serious, traumatic injuries to children 15 and younger, spokeswoman Maggie Scroope said. She added that those statistics do not reflect children who are brought to the emergency room with minor injuries, including those that stem from abuse.

The South Bend Fire Department's policy requires medics to take children to Memorial for serious injuries.

Not all cases of abuse or accidental injuries to children make headlines, but almost every paramedic has responded to 911 calls for badly hurt or sick children, and those cases often stand out from routine medical emergencies.

From a medical standpoint, injuries to children can demand even more urgency than a typical case because a child's body is not as resilient as an adult's, said Capt. Gerard Ellis, a spokesman with the fire department. A child's body is smaller, carries less blood and can deteriorate more quickly.

"If you look at a child losing a tremendous amount of blood, they can decompensate much faster," he said.

Medics who treat children also must keep other details in mind, such as the fact that a child's heart rate is faster than an adult's -- an important fact when reading vital signs, Ellis said.

While medical personnel provide the same level of care in every emergency, seeing a wounded child only increases the stress, especially for responders who have kids of their own, Borders said.

As parents, Borders said, it can be difficult for paramedics to maintain emotional separation between themselves and badly injured or dead children.

"Next thing you know, you're seeing your own child's face laying there," he said. "It's hard to get that out of your brain, and you're kind of forced to have to."

In high-profile cases, the stress level rises even more, as first responders often encounter a chaotic mix of sights and sounds, from police lights to throngs of bystanders and hysterical family members. Adding another layer of stress and uncertainty, paramedics sometimes arrive before police have had a chance to secure a potentially dangerous crime scene.

"Sometimes you get there too quick. You get there and don't know what you're walking into sometimes," said Noel Hamilton, a lead paramedic with the fire department.

Paramedics found themselves in that situation when John Swoveland, the 2-year-old boy, was shot in April. A nearby ambulance quickly responded after clearing another call, arriving at the Campeau Street shooting scene before authorities could assess exactly what was going on.

In a cell phone video captured by a bystander, a paramedic can be seen sprinting to John, scooping him up and disappearing into the ambulance within seconds, even as voices curse and wail in horror.

South Bend EMS officials know exposure to children's trauma can deal a mental and emotional blow to first responders, so the department makes counseling services, known as "critical incident stress debriefing," available to any employee who is struggling to deal with the stress.

Some responders take advantage of the counseling services and some don't, but they all have their own ways of coping with the stress, Borders said, even simple acts such as calling their spouses or hugging their children.

Others confide in their ambulance partners, replaying the most recent incidents in their minds, but questions often linger.

"I always just re-analyze if there's anything I would have done differently," Hamilton said. "Most of the time, I'm pretty confident in what I did. There's nothing I did or didn't do that's gonna reverse the situation."

CSheckler@SBTinfo.com

574-235-6480

Twitter: @jcsheckler

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