Acts of Expertise & Compassion in the Emergency Department

Jillian had exactly one thing on her mind that spring evening in 2016 — it was going to be the best summer ever.

Her sophomore year of high school had just ended on a high note. She won best lead actress as Elizabeth Bennett in her school’s production of Pride and Prejudice and top honors at the Ohio statewide drama competition — something she had worked toward since she first set her foot on a stage in fifth grade.

She was 15, ready to take on the world, laughing with her friends, when it happened.

They were goofing off as they waited for some latecomers to join them before they headed out to dinner. They were making plans for their summer freedom — amusement parks, pools and joy in the sun.

It was just an instant. The car turned suddenly. She fell. The back of her head met the pavement first. And everything went dark.

“At first, it didn’t hurt, which I thought was strange,” Jillian said. “But then my friends helped me sit up, the pain came hard, and I felt really sick.”

Soon, Jillian started vomiting. Her pain spiked. Something was seriously wrong.

“That’s when her friend’s mom called me,” Jenn, Jillian’s mom, remembers. “They were taking her to the emergency room, and I should meet them there.”

Always Ready

A career veteran of pediatric emergency medicine, Stephen Porter, MD, is used to being in the thick of it. And, as our Director of Emergency Medicine, he helms one of the busiest emergency departments (ED) in the nation.

“The ED is the hospital’s open door to the community,” he says, smiling. “We have to be prepared for anything from relatively straightforward illnesses to devastating, life-threatening injuries.”

Dr. Porter and his team field more than 61,000 visits each year at our Burnet Campus ED. As the only Level I Pediatric Trauma Center in more than a 100-mile radius, we receive patients from all over who are in dire need of the best emergency care possible. Every second matters in these complex life-and-death situations, and they often require the expertise of many — sometimes up to 10 care providers at a time.

However, the sheer diversity of patients and conditions coming to the ED doesn’t just mean that the care team must be ready for anything — it also means the physical space of the department must be flexible, well-equipped and able to accommodate all patients, their families and the care teams.

That’s why a new emergency department will be one of the major cores of our new Critical Care Building (CCB).

Hope in the Darkness

“A small brain bleed. Strained spinal ligaments. Traumatic brain injury.” The words sank straight from Jenn’s ears to the pit of her stomach, as the team of doctors surrounded Jillian.

Jillian began to cry. It was just a bump on her head. It was just an accident.

Her best summer ever was beginning in a bright, noisy, bustling emergency room — exactly the opposite of the dark, quiet space Jillian would need to recover.

Unlike many visitors transferred or discharged from the ED in a relatively short time, Jillian and Jenn had to stay there overnight.

“We arrived at around 11 pm and we were there until about noon the next day, before a hospital room was available,” Jenn says, then pauses. “For 13 hours, all I had was a plastic chair and a counter to lean on.”

Jillian jumps in. “While the space wasn’t ideal, the care was. One of the nurses braided my hair because it was getting so tangled. I never felt like another thing on their to-do list. They genuinely cared about me.”

Making the Best Better

For patients like Jillian, who needed multiple teams to coordinate her care in the ED, the space can be challenging.

“Our current ED has four curtained bays for resuscitation teams to work on a child who is, for example, severely injured in a car accident,” Dr. Porter says. “These areas are big enough to do what we need them to do, but if we have patients and their care teams in all four areas, it gets very crowded.”

Families also find the ED’s current configuration difficult. “I had complete faith in our care team,” says Jenn, “but I was beyond exhausted and needed somewhere I could close my eyes for a few minutes and decompress.”

Dr. Porter nods. “Right now, we provide unmatched care in a space that needs updating to accommodate growing needs. The new ED will allow our work to grow stronger, showing that even the best can get better.”

Every inch of the new ED is purposefully designed for optimal care — including the family’s experience.

When it’s completed, it will be three times larger than our current space, with 60 treatment rooms. There also will be 15 smaller observation areas for children who need more time in the unit before discharge. Each space will have more comfortable places for families.

Learning a New Normal

Jillian spent the summer of 2016 learning what her new normal would be. She did exercises to help her short-term memory and made lifestyle changes to ease brutal migraines.

“I think her memory issues scared her the most—because she couldn’t return to acting if she couldn’t remember lines,” Jenn says. “The hardest thing about her injury is that the best medicine is time. Her doctors told her it could be up to five years before she fully recovered.”

But Jillian persisted. Every day she worked hard to hone her memory.

Now, two years later, she’s a freshman at Ohio University, having graduated high school with the best grades of her life, and still was able to do what she loves — acting.

Jenn beams. “I admire her so much for tackling a lead role in her senior year. Memorizing lines and conveying them with the emotion she did was so much harder for her because of her brain injury. The fact that she did it, won Best Actress in her school and then state — it’s a feat bigger than anyone could understand.”

The Science of Emergency Care

At Cincinnati Children’s, we believe that great research leads to great care, and scientific discovery drives everything we do. Emergency care is no exception.

Our emergency medicine program is internationally recognized for innovation—which is why we are a leading recipient of pediatric NIH funding. In fact, many of today’s best practices, such as the head trauma and CT scan protocol, were established through research completed right here at Cincinnati Children’s.

Our new ED will have embedded research labs that will include an area for specimen processing and storage. There will also be clinical trial space — setting us apart from all other pediatric medical centers.

“We purposefully designed research space into the new ED to investigate the science of everyday care,” Dr. Porter says, smiling. “And, because the department will be open 24-hours, year-round, I anticipate that our research area will be a fulcrum of discovery for the entire Critical Care Building.”

We will also be able to continue to lead many multi-center studies and collaborations with colleagues from across the country and around the world, so we can improve care for children everywhere.

To support our emergency care and research, contact Lauren Bosse at 513-803-0639 or email: lauren.bosse@cchmc.org.