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A Flight to Therapy for Babies Born Too Soon

By Alice Reid
Friday, December 7, 2007

Jessica Carman knows about small. She can do CPR on a baby's chest no bigger than a lemon, using only her fingers. She can insert a tube no wider than a strand of spaghetti into a premature infant's trachea.

And she can manage nearly all of it on a helicopter or in an ambulance as it races a sick baby to Children's Hospital in Northwest Washington.

Carman, a nurse, is a member of the hospital's neonatal transport team -- the group whose job it is to move babies, usually born much too early and with many problems, from the hospital where they were delivered to Children's. There, the medical staff offers the most advanced infant care in the hospital's neonatal intensive care unit, or NICU.

Last month, the team brought 75 babies to the NICU. Fifteen of them arrived in the hospital's shiny white helicopter, known as Sky Bear.

A love of babies drew Carman to the field. The challenge has kept her there.

As a transport team nurse, "you never know what kind of situation you'll walk into," she said during one of her seven-hour shifts. "It can definitely be scary."

Most of the babies she and her colleagues ferry to the hospital have been delivered at community hospitals in the area. With underdeveloped organs not ready for life outside their mothers, they require more help than most community hospitals can muster.

Usually, calls for help come with no warning, as one did late last month from Southern Maryland.

The case was fairly typical. The baby had arrived after 25 weeks in his mother's womb, well short of the 38 weeks of a normal pregnancy. His weight was just over a pound, and he was struggling to live.

The call set in motion a complex series of steps needed to get any such child safely to Children's. First, vital statistics were collected from Maryland: heart rate, blood pressure, blood-oxygen levels. Then a Children's doctor and Carman conferred about how to care for the infant on the trip.

Finally, dressed in a red and black flight suit and a white helmet, Carman headed to the hospital's roof, where she joined pilot Allen Bennett, paramedic Dan Rice and respiratory therapist Victor Lopez for a 21-minute Sky Bear flight to Southern Maryland. Along with the three staffers, about $140,000 in equipment rode in the copter's cramped cabin: a red canvas bag bulging with the hardware and medications needed to treat a preemie, and a specially equipped incubator, its heat elements already running.

"As soon as a call comes in, the first thing we do is turn on the heat in the isolette," Carman said. "Cold is a very real danger to these babies."

Less than 2 1/2 hours after the call came in, the team had returned, and the infant was safely inside a sophisticated incubator that is about as close to a uterus as anything mechanical can be.

Most of the time was spent not in the air but at the Southern Maryland hospital, where Carman and her colleagues stabilized the child and took the baby to see his parents. It's an important step, Carman said, for the bonding that goes on, regardless of the circumstances of a baby's birth.

"We realize this is a baby born to a family," she said. "And the family is important to the baby."

With the help of modern medicine and the devotion of the Children's Hospital staff, many premature babies manage to continue the miraculous process that has been interrupted and go on to thrive.

Carman says that's another thing that keeps her coming to work.

"It's great when a really sick baby grows, and leaves, and then comes back to see us. You know you've contributed to that family and made a difference," she said.

How to Help

Sky Bear is available to any area child, of any age, who needs it. That's why we've launched this effort to raise $500,000 for Children's Hospital between now and Jan. 18 -- to help the hospital cover the cost of that generosity.

To donate, send a check or money order payable to Children's Hospital to Washington Post Campaign, P.O. Box 17390, Baltimore, Md. 21297-1390. That's the post office box of our bank, Chevy Chase. All funds go to Children's Hospital.

To contribute by phone using Visa or MasterCard, call 202-334-5100 and follow the instructions. All gifts are tax-deductible as allowed by law.

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