http://waterowl.livejournal.com/184474.html . I would have
posted it as a comment, but it's too long to be a comment.]
Since Thida doesn't feel that the details are hers to tell,
as the father of the little girl involved I will tell
them. (I don't normally blog, and have created this
account solely so I can tell what happened. It helps me to
tell.)
I'll tell the story (almost) chronologically, even though I
was not a first-person witness until I arrived at the
hospital. Details prior to that point come from things my
wife and Thida's family have told me. (I also have a copy
of the fire department's report. I'm waiting for the
police report and the ambulance report.) Of course, I
might be misremembering what they've told me, so I hope
Thida will correct anything I write that's not correct.
My five-year-old daughter Little S is a friend of Thida's
Special K. They are in gymnastics together on Tuesday
afternoons. This particular Tuesday my wife L brought
Little S home after class, then brought her to Special K's
house to play while L went to run errands. This is a
standard pattern.
Around 6pm Little S and Special K were in an upstairs
office/bedroom. There's a couch of some kind (futon?) that
folds down into a bed. It is right next to a window that
overlooks the driveway. The window is one of those
double-hung kinds where the bottom lifts up (I think the
top is fixed), with a screen on the outside. At the time
the couch was in the bed position, and the window was
open. The screen was present, but may not have been fully
in place (not that it would have made any difference).
Little S and Special K were were apparently jumping on the
bed. They apparently heard or saw L drive up, returning
from her errands. Special K may have said "Hide!", which
is a game they apparently play whenever my wife returns to
pick up Little S. In any event, L says she heard laughter
coming from the upstairs window, and then she heard, but
did not see, Little S hit the driveway. (I've been told
that Special K had the thought "Little S, don't go out the
window" or "I should tell Little S not to go out the
window", but I don't know if she had that thought before,
while, or after Little S went out the window. But that
doesn't really matter.)
There is a short roof below the window that apparently
broke her fall a bit. (There are actually two, at right
angles to each other; which one she hit would depend on
whether she went out the left side or the right side of the
window.) The FD report estimates that she fell about 12
feet to the concrete driveway. The screen popped out when
she hit it.
My wife got out of her car, picked Little S up (she knows
she shouldn't have done so, but wasn't thinking at the
time; I've suggested we both take a Red Cross first aid
class so we'll know what to do in emergencies), yelled for
Thida to call 911 (which she did; the call was logged at
18:03:43), and put her down in the hallway just inside the
door.
The fire department arrived at 18:06:57. At 18:07 they had
her strapped to a pedi board (L says Little S tried to
fight them off). I'm not sure when the ambulance or police
arrived, but at 18:14 the ambulance was enroute to Stanford
University Hospital (SUH) with lights and siren with Little
S inside. (My wife told them that we have Kaiser, but they
said they were going to SUH because it has the best trauma
unit in the area. Kaiser covered everything. I know some
people have problems with Kaiser, but I think they're
great.)
The ambulance arrived at SUH at 18:30, and they turned
Little S over the the Emergency Room (ER) staff at 18:32.
Here is the narrative from the fire department report [I'll
put my commentary in brackets]:
ME1 [Medic Engine 1] and R1 [Rescue 1] arrived on
scene to find young girl in hallway of home being
attended to by her mother [L] and family friend
[Thida, I presume]. ME1 medic performed medical
evaluation (see PCR [Patient Care Report] for
further [sic]). AMR [American Medical Response,
the ambulance company contracted with by the
county] ambulance crew arrived and provided
assistance. Patient [Little S] was loaded into
ambulance and transported to local hospital. R1
firefighter rode along in ambulance to hospital
and was retrieved by R1 after call.
Here is the narrative from the Patient Care Report [again,
my comments are in brackets]:
R1 arrived on scene and found pt [patient; Little
S] lying in doorway with snoring respirations
[Little S snores when she sleeps, so this is
normal] after falling out of a second floor
window. per [sic] mother pt was found in the
driveway with eyes open and not making any
sounds. UNK [Unknown] down time. Mother feels
pt fell out of window, rolled onto the garage and
dropped to the ground. Approx 12 feet fall to
concrete. Mother picked up child and carried her
into the house. Placed pt in c-spine precautions
[they put a collar around her neck that held her
head in a fixed position] by R1 personnel and pt
woke up and rolled onto her back and started to
moan. Pt placed in pedi-bed and moved to
ambulance. Pt transported C-3 [lights and siren]
to SUH [Stanford University Hospital] with ALS
[Advanced Life Support; they placed a
non-rebreather (whatever that means) oxygen mask
over her face, ran an IV in case they had to give
her any drugs (which they didn't), and put her on
an ECG to monitor her heart] done by AMR medic
enroute. secondary [sic] eval done by AMR medic
with no abnormality found. While enroute pt
would wake up and moan and then go unconscious.
No posturing noted enroute. [This is a good
sign. "Posturing", or moving the limbs into a
certain position, is an indication of some kinds
of brain damage.] Arrived at SUH and report by
AMR medic given to hospital staff.
They wouldn't let L ride in the ambulance with Little S,
and since L was in no condition to drive, a neighbor of
Thida's drove her to SUH, following the ambulance. On the
way, around 6:30pm, L called me at work to tell me what had
happened. I tried to reassure her (told her that moaning
was a good sign, that moving all her limbs was a good
sign), and said I'd be right there. I stopped what I was
doing, made one phone call to cancel an appointment I had
that evening, and drove to SUH. I met L in the ER waiting
room, where she told me they wouldn't let her see Little S
because they were doing some tests, including a CT scan.
This was the hardest part, waiting to see Little S, and not
knowing what condition she was in. Around 7:10pm (I took
notes; it gave me something to do) Dr. T came out to tell
us that Little S was moving all her limbs and going in and
out of consciousness.
At around 7:36pm I think they let us see her. I do know
that about that time they gave her some dilantin, which is
an anti-seizure medication; they thought that she might
have had a slight seizure while she was in the ER. She was
still in the collar. She had an abrasion on her left
cheek, her left elbow, and her left knee. She was in a
hospital gown. The paramedics had cut her shirt (which she
had borrowed from a friend) to take it off. I'm not sure
when the the rest of her clothes were removed, but at some
point L had them.
Anyway, at some point they let us see her. She was
unconscious, and on an ECG and an oxygen monitor. All of
her vital signs were strong. She would occasionally come
out of unconsciousness and moan or say a word or two and
then lapse back into unconsciousness. They were going to
transfer her to the PICU [pediatric intensive care unit] at
the Lucille Packard Children's Hospital [LCPH], which
connects with SUH; they were just waiting for a bed to open
up.
This was the second hardest part, with Little S
unconscious. Dr. G said that there was no way to know when
she'd wake up. He said that the CT scan was negative,
which was good. I asked him to show it to me. (Not that I
know how to read a CT scan, I just felt better seeing it
and having him explain it to me.) He pointed out some
brightness in one slice inside the back of her skull that
was probably an artifact (brightness like that could
indicate swelling; I'm guessing that actual swelling would
show up on more than one slice), but they'd do another CT
scan on Wednesday to make sure.
We stayed by Little S's side, talking to her, singing to
her (she hates it when I sing "You Are My Sunshine" to her
-- I guess I did it too much when she was an infant -- but
I sang it anyway), and waiting.
About 10:30pm a bed opened up in the PICU, and we followed
as they moved Little S up there. After we got there, or
perhaps on the way, Little S woke up (became fully alert)
and talked to us. She asked for a big hug, which L gave
her. I don't remember how long she stayed awake before she
went to sleep.
Little S had three teams of doctors taking care of her: the
neurosurgery team, the neurology team, and the pediatric
team. The neurosurgery team was in charge. They would all
assess her independently; having her move her eyes from
side to side and up and down, having her squeeze their
fingers with her hands, and having her lift her legs and
wiggle her toes. I think she got tired of doing the same
things over and over again (I know I would), but she
complied with every request without complaining. (Of
course, both SUH and LPCH are teaching hospitals, so this
was good practice for the various residents.)
Thida's C brought some things from L's car and our house (L
had left her keys with them) and some food to the
hospital. L gave me a list and I went home to get some
additional things for her. We both spent the night in the
PICU with Little S.
Also, the police arrived to ask some follow-up questions.
They have to treat incidents such as these as possible
child abuse or child neglect cases; I don't fault them for
that, as I know too many people who were abused as
children. They asked L to go over what happened, and
during her narrative L mentioned that she told Thida to
close the window as Little T might still be in the room;
this cleared up a mystery for them, as the window was
closed when they got there, yet everyone said that Little S
had fallen from it. They were satisfied that no abuse or
neglect was involved, and said the incident would be called
an accidental fall.
Wednesday morning brought more visits from the three
teams. The nurse gave Little S some more dilantin per the
orders just as one of the doctors said it wouldn't be
necessary anymore. At about noon they scheduled the
follow-up CT scan. I think this was also about the time
they removed her collar; Little S was happy about that.
About 4pm (this is from memory; I didn't write down the
time) it was time for Little S's CT scan, so we all
followed as they rolled her bed down to the CT room. A
different Dr. G said it too was negative (I had him show it
to me, and saw that the brightness in the first scan wasn't
present in the second one), and that she could be
transferred to the regular pediatric unit.
L gave me a list of Little S's clothes to bring to the
hospital, and I went home to retrieve them. I also called
Kaiser, and they said I should get a copy of the CT scans
when Little S was discharged and bring them to her
pediatrician.
By the time I got back, Little S was in the regular
pediatric unit at LPCH. She was mostly sleeping, but woke
up around 8pm to complain that her head was dizzy (but it
didn't hurt). The nurse gave her some acetaminophen
(Tylenol). (The dizziness was to be expected.) L and I
spent Wednesday night in the hospital, too.
Thursday morning the three teams examined Little S, and
around 10am the doctor in charge said she could go home.
Of course, we had to wait for the discharge orders to be
written, which took about an hour. I obtained a copy of
her CT scans and a chest X-ray (they burned a DVD for me).
Little S changed into her street clothes.
The doctors said to call Little S's doctor or take her to
an ER if she has repetitive vomiting, or if she gets
headaches and they get worse or don't respond to
acetaminophen.
They also said she could resume normal activities, except
for gymnastics, which she could resume after about two
weeks of no headaches or dizziness. Her diagnosis is that
she had a concussion. I asked if this would be called a
mild, moderate, or severe concussion. Dr. A said it
wouldn't be mild, because she lost consciousness, and after
some hesitation said he'd call it a moderate concussion.
We went home around noon. I brought the DVD to Kaiser and
left it for Little S's pediatrician, and visited the police
and fire departments to request and/or obtain a copy of the
various reports. I met with the fire department battalion
chief so he could explain the jargon on their report to
me. Later that evening we went over to Thida's house, so
Special K could see that her friend was okay. (I don't
remember where they played, but the couch in the upstairs
room was in the couch position and the window was closed.)
Little S has an appointment with her pediatrician for this
Friday (tomorrow as I write this), and a follow-up visit
with the LPCH neurosurgery clinic in a few weeks. (If
Kaiser has a neurosurgery clinic we'll probably go there
instead, but if they don't I believe that they'll cover the
visit to the LPCH one.)
Since leaving the hospital, Little S has averaged about one
headache a day, usually at bedtime, but acetaminophen takes
care of them. (Sometimes I think she just says she has one
because we got bubblegum-flavored acetaminophen.) At first
she was sleeping more than usual (including naps during the
day; she gave up naps a long time ago), which is also to be
expected, but she seems to be back to her usual sleeping
pattern. And she is behaving like a normal five year old.
(In fact, I had to give her a timeout Friday morning, the
day after leaving the hospital, for misbehaving.)
Little S did come down with a cold that I think she caught
while in the hospital. Needless to say, I now have it.
---
There are certain things that are common with a
concussion. One, of course, is the headaches. Another is
the tiredness; after all, the brain is healing. A third is
retrograde amnesia; the inability to remember anything from
some time before the trauma. In Little S's case, the last
thing she remembers before waking up in the hospital is
getting into L's car to go over to Special K's house, about
an hour and a half before the accident. In some ways this
is good, as she doesn't remember the terror of falling.
But in some ways this is bad, because the object lesson of
"don't jump on a bed near an open window" is lost on her.
---
We are a very lucky family, and Little S is a very lucky
little girl. I appreciate the support that was given to us
during this time by Thida's family.
I have nothing but praise for the folks at SUH and LPCH.
They took excellent care of Little S and answered all of
our questions. In addition, I have nothing but praise for
Kaiser; they said it was an emergency, and keeping Little S
at LPCH was the right thing to do, so they will cover it
all.
Also, I do not hold Special K, Thida, or C responsible for
the accident. In some ways, this incident has been worse
on them than on us (especially Special K, who witnessed
it). I think they feel responsible for it, and I wish I
knew of some way of assuaging their feelings. Accidents
happen. Kids get hit by cars. They'll jump on beds; it's
in their nature.
All we can do is try to protect them, and also know that we
won't be able to protect them all the time.
--Father of Little S
