[telephone ringing] Hi, this is Kris in Loma Linda Children's Hospital, Peds Critical Care Transport Line, can I help you?

Okay... You're calling from Inland Valley?

And you said you have a five-year-old near-drowning.

Okay.

Okay, team, um, we have a five-year-old um, who was found underneath the water at a party.

Uh, parents pulled the kid out.

Two things that you want to look out for on this transport, um, you want to watch the airway very closely, make sure that he, the patient hasn't aspirated.

It sounds like the patient's doing okay with the GCS-15, but you also want to monitor the neurostatus very closely.

We just got a call from Mercy Air; they'll be here in 10 minutes.

I'll grab your helmets and your gurney, and we'll get your stuff loaded so you guys can be on flight for pick-up.

All right.

Have a safe trip.

[thunderous whiring] [narrator] This is the Pediatric ICU Transport Team.

They airlift the sickest patients from hospitals around California to Loma Linda University Children's Hospital, the only Level One Trauma Center for a quarter of the state of California.

[voice on radio] General emergency 2-5 [indiscernable chatter] [whiring intensifies] [hopeful theme music] [hopeful theme music] Come on, Tom.

Help me unload.

I just love um, coaching baseball.

It's something that I grew up with, with my family, and my dad and my brothers.

And it, it's really cool to actually give back to the kids and give back to my son um, something that I grew up with.

You got this!

Nice run!

Keegan, run!

Oh my gosh, that's a, a nice hard swing.

Okay.

You got this.

Okay?

Get that elbow up.

Okay.

Go.

You know, I wanted to be a nurse because I, I felt like, when I was growing up, I wanted to do something to help people, and in my second year of college, my, my dad was diagnosed with cancer, and I saw him through that whole process, and it was because of that it, it really spurred an interest in helping others and helping people when they're hurting, and, and especially in children.

I think it's my calling in life.

When my pager does go off, while I'm coaching, then I have to stop everything I'm doing and I have to go.

I do miss out a lot on my son's games or practices, but they're very understanding and they're forgiving, and they're very loving and supportive.

They know that when that pager goes off, there's a critical child at the end, end of that transport call.

[kids together] One-Two-Three Pizza!

Yay!

[sound of helicoptor rotors] [omnious music] [narrator] The transport team is en route to pick up a drowning victim from Murrieta in Southern California.

Five-year-old Zander Dolan was found unresponsive at the bottom of a pool during a back-to-school function.

Drowning is the second-leading cause of death of in children under the age of 14.

[sound of rotors] [speaking off screen] Zander's at the bottom of a pool and like.

Okay, then what?

And then I jumped in the pool and then the, the other mom jumped in the pool [indiscernible].

She took him out, and then there was another mom that did the compressions and then finally-- it seemed like forever, but--he started vomiting.

Is, this, probably about a minute?

Yeah.

Yeah.

At least a minute.

This is a five-year-old uh, 23-kilo uh, near drowner, came in this afternoon, was submerged for about a minute.

When they pulled him out, he was unresponsive to stated CPR for about a minute and he vomited.

Uh, they did do chest x-ray.

It does look a little bit hazy.

Uh, we just loaded up, so we'll be there in about 20, 25 minutes.

[sound of rotors] Theresa Duran and Victor Bannis lead a team of highly specialized transport nurses and respiratory therapists-- a job requiring years of experience and dedication.

Our pediatric ICU transport team is on call 24/7.

In a moment's notice, we're ready for anything.

We work at a Level-1 Trauma Center and children's hospital.

Uh, Level-1 Trauma Center means that we essentially bring the ICU to the patient at the referral hospital, with all of our equipment; specialized equipment specifically for pediatric patients.

It's the only Level-1 that we have in this area that serves 1.2 million children.

We cover like 70 different hospitals, so our range is probably like 500 miles, and we do cover a wide area.

We go to Imperial County all the way south to the Mexican border.

East, all the way to Blythe.

All the way as far north as Nevada/Las Vegas, up to Central California to the Sierras.

So our biggest challenge is the weather.

I've driven up to um, Mammoth for transports, and that's a six-hour drive each way, because we can't fly because of snow.

Pediatric patients can be one-day-old all the way to 18-year-olds, so there's a huge variety.

Traumas, near drowning, any type of disease, it's very important to bring them back, and be taken care of by specialists.

[dramatic tones] Five-year-old Zander was pulled out of a pool not breathing.

He's fortunate that CPR was performed almost immediately.

Although initial chest x-rays look positive, doctors are concerned that fluid could continue to build up in his lungs, an event commonly referred to as dry drowning.

[off screen] I'm so thankful for those mamas, like I said, jumping in, did the, did everything they -- Yeah.

I know, baby.

I know.

You feeling all right?

Uh-hmm.

You chilly?

I'm calm.

I need to talk to the doctor.

Okay.

The things that I'm gonna be most looking out for are gonna be, um, his lungs.

We're gonna check x-ray Okay.

to make sure that um, there's no inflammation or something like that.

Uh-hmm.

Um, at this point you know his lungs sound pretty good.

The most important thing for you guys is to see how he's doing.

Right.

Okay.

Try not to worry about the numbers, it's just gonna be beeping and stuff.

That's, that's our job.

We'll worry about the numbers.

Right.

You guys be there f or him.

Okay.

That's gonna be the most important thing for him.

Okay.

[people talking in background] I'm always, always on my boys like, Stay with me.

Stay with me.

Stay with me.

I don't want anything bad to happen to you, you gotta stay with me.

We started swim lessons, like he, literally yesterday was his third swim lesson.

This can't happen again.

I don't want any of my ba-- any more of my babies gone.

For--our daughter, Hannah, with Type 1, it was like she was here, and then within a moment something just happened, and she was brain dead.

[music] Muster up all these memories.

Um, cords and, just poking and checking and, I mean it's just, I feel good that this is gonna be a better outcome.

I believe it's gonna be a better outcome.

[music] This is a child that was a five-year-old found down under the pool.

Uh, family pulled the patient out and started CPR at the scene.

It looks like it's gonna be a very good outcome because they started CPR.

He's very fortunate uh, to have the parents doing CPR immediately, getting him out of the pool so quickly.

That's so important.

We used to get 20 to 30 drownings a year.

Pool safety is, is so important, and it can happen to anybody.

But the key thing is to recognize that the child did fall in the water; get them out as quickly as possible, and start the CPR immediately so that we have the good outcome, uh, as we do for this child.

I'm glad he's doing well.

Well, I, I've always wanted to uh, help people.

So wherever I am, I try to touch someone's life.

If I'm not at work, I'll pick up donation bread for my church, and then they feed the homeless.

And, this gives me a lot of uh, satisfaction because it's benefitting people who really need it.

[soft piano music] This is the bread.

Usually there is uh, six in a box.

This one was probably just too small, but it's very healthy it's good bread.

There's nothing with it.

My friends ask me, "Do you go to the gym?"

And I said, "I don't go to the gym.

This is my exercise."

I was uh, walking and there was a young lady that says, "Hey, I know you from somewhere."

And I said, "You do?"

She goes, "Yeah.

You're the guy at the church.

I know you as the bread man."

A lot of people know me as the bread man.

And she said, "Yeah, times where I don't have any food and I come to church, and you are there with bread and pastries, and this is how sometimes I survive."

And she said, "I just want, I just want to say thank you for what you do?

When I feel discouraged, I remember that story.

I have a, a very good saying on my, on my desk at work.

It says "By helping someone, you heal yourself."

So for me, this, this is, this is therapy.

[music] The transport team has received another call from a local hospital in the Coachella Valley.

A young girl is in serious condition after suffering a stroke.

Three-year-old who was found unconscious, is currently intubated and on the ventilator.

We go into every transport, even if it's a patient who's on one-liter nasal cannula.

They could start seizing on us and stop breathing.

It can change by the moment.

You could be sitting there in the helicopter with helmet on and, communicating, and the vital signs are stable, and then all of a sudden the heart rate drops to 40.

And at that moment, interventions need to be done quickly.

For sure, 2-5.

Roger.

[music] When we got there, she was not very responsive but was starting to wake up a little bit from the sedation.

Moving a little bit more than we expected her to be moving.

Um, which is good.

Did well on the transport as well.

All her vital signs stayed looking good and, hopefully she'll keep doing okay.

[narrator] Three-year-old Emery Ramos was found unresponsive on the floor of her bedroom.

Her parents rushed her to the emergency room, where doctors ordered CT scans of her head.

Initial images showed some sort of mass in her brain.

Those images along with low levels of hemoglobin in her blood point to leukemia.

Do you know when they got the call from the outside facility, they weren't sure, when they got the first scan, was it a, was it a bleed, was it a tumor.

That's why we flew her over here.

Um, because if there was a bleed, you know, you have to be concerned if you have to do emergency surgery to make sure that she doesn'’t have damage to her brain.

There's like no swelling or anything on her head, right?

Just that bruise on her left eye, sort of to the right.

But, the temporal area?

Yeah.

Neurosurgery's on their way.

[dramatic music] So, previously healthy-- She was sleeping in Mom's bed.

At 5 a.m., Mom transferred her, her to her um, own bed, and then couple hours later, about two hours later, found her down on the floor; had some vomit around her, and then came over to Eisenhower ED.

Um, they ended up giving her some hypertonic saline.

CT shows some sort of hemorrhage.

[pensive music] Looks like some sort of mass in her brain, at first, they were talking about maybe a bleed.

The neurosurgeon just told us that she'd looked at the imaging and doesn't think that it's actually blood, we'll have to continue to do more labs.

Um, some of her initial labs were a little bit concerning, her hemoglobin being really low, and so little abnormalities here and there, so we'll have to do a workup like a malignancy versus something else going on.

Uh, so, just looking at the uh, CT scan of the head that was just done for the patient, it's not really clear right now what exactly this, this area is.

There is an area of abnormality though.

Um, we need to get an MRI to better, better elucidate what's going on.

[dramatic music] If it's a tumor, then they have to figure out, what kind of treatments are they gonna need.

Are they gonna need to do surgery and/or chemotherapy or radiation; those kind of things.

And that's what they're gonna have to figure out the next uh, you know, few hours.

But a lot of it will be driven by what the MRI shows.

[music] I'm very sympathetic to parents, when they're in the hospital, because I don't know how I could handle the situation like you do, as a dad whose, whose daughter had an asthmatic attack.

I transported this child over, and I know the outcome was, was very poor, and I, one day I just went and gave him a big hug, and I said, "I am so sorry."

And I, I started crying.

And, there's this dad who is supposed to be emotionally a wreck and I am the one actually crying, because I'm sympathizing with him.

So, for, for me, I wanted to comfort him, but he's comforting me, saying, "It's okay."

"Everything will be okay."

And even when the, the child passed, I wanted to go to the funeral um, because, for me, I connected with that dad and I just wanted to make sure that he knows that we did everything we could at this hospital to make sure that your daughter was okay, but unfortunately, it's not.

But we're here to comfort you through the time of sorrow.

That's probably the hardest part of my job.

My family sacrificed, we all take it in stride.

I've done this so many years.

But the death and dying part, that's probably the hardest part.

[Victor] I would say for like an hour or two hours, we were trying to stabilize that patient.

We finally bring them here, but eventually sometimes they pass.

And uh, for us, that's like, man, I did everything I could, but it didn't help.

[Theresa] We're very gentle, very sincere, and very supportive of families through the worst moments of their lives.

Sometimes the parents, agree to organ donation, and with one patient's death, nine people can survive.

So even exponentially, that one horrific, terrible event, that child's spirit can live on through other people as well.

[gentle piano chords] Do you want to talk to brother?

[on phone] Hi, brother!

Hi!

I went on a...

I went on a helicopter.

Okay!

Did you hear, did you hear him, [indiscernible]?

Brother went on a helicopter ride.

Yeah.

[on phone] He went to the chiropractor?

No, not the chiro-, not the chiropractor, a helicopter.

[on phone] Oh yeah, is, is he standing now?

Yeah, he can stand.

He can sit up.

Oh boy, either I got yellow apple juice and I gave you the popsicle, here.

I have a perfil IV with D-5 and S.47 cc an hour.

Currently starting clear liquids.

Uh, he's alert, oriented, um, doing well.

No issues as far as vitals.

Press down to clear?

Uh, once he's off oxygen and he's eating well, he can go home.

I think a day or two.

Okay.

Yeah, he's a lucky boy.

Yeah, totally.

For sure.

[narrator] Just a few rooms down the hallway, Emery Ramos has received her MRI results.

Good morning, Emery.

You're gonna have a good day today.

Waiting for the MRI is just uh, nerve-wracking.

When they finally came in though, it was uh better results than we were expecting.

Just glad it wasn't bad news.

[quiet and slow piano music] While the MRI results show no tumor in her brain, Emery's life is not left unchanged by the stroke.

Emery is now blind in both eyes.

Doctors are still unsure what caused the stroke, or if it will happen again, Because of the complexity of Emery's case, doctors from several specialties have called a meeting to discuss her plan of care.

Very hard to give a prognosis.

I know that prior to this, you know, we were, like, we need to find and observe why we did this before we go, but I just don't think that's a reasonable, I don't think we will be able to actually get the answer before we actually have her go through rehab.

The answer of like, underlying-- Yeah.

The why wasn't their main concern, I don't think.

I think their concern was her clinical improvement and how she's moving now, how she's talking now, stuff like that.

And especially if she can do rehab, I think that would be, I think that would be very-- --'Cause that was my question.

Can we get her into rehab?

'Cause that's what she needs right now.

And then I would just want to repeat the head imaging in a month.

I did tell the family that we were gonna talk first, and then we were gonna go grab them, just so, you know, we can just kinda touch base with them and, just kinda see where they are.

So, she came in basically with a, a stroke.

That's how she actually presented.

And when you have a stroke, especially in children, there are certain things that we kinda go one by one to kinda figure out why we had a stroke.

Now, the other thing that we need to work up is, which we actually found was, that she actually has clots.

So, a lot of the times in kids we can actually have clots, and when you have clots, if it goes to the brain, then you can't have blood to the brain, and that's how you actually get a stroke in kids.

We actually got the neurologist involved, because the system that's actually most involved with a stroke to the head, so that's why we have um, Dr. Pichon.

Would you like to look at the images?

Yes.

The MRI from the 22nd, that's the area of the stroke.

You have to deal with this area, here.

Then this area.

Yeah.

It looks pretty much stable.

It hasn't worsened.

In our experiences with stroke with children is, I would say in general, a lot better than in adults, because the brain children is very plastic, so it continues to develop, and with the therapies, the child can actually recover faster.

But I cannot predict when it's going to happen, if it's going to happen again.

What has it truly affected within her body or her locations like, um, just like her eyesight, kind of more of those kind of events are more our concerns and questions from the stroke.

Um, in terms of the vision, we flashed a light in front of the child's eyes and then the signal would go, for a flashing light it's a signal, and it would go through the retina and then it would go through the visual pathways and go all the way to her back-- [father] where that stroke occured in the temporal lobe?

right - it's connected to the back, where the stroke was.

So, that was abnormal.

So what that tells me is, there is um, cortical visual impairment.

[father] Okay.

So basically-- [mother] --And that's both eyes?

--That signal traveling, yes.

Both eyes.

And then, in terms of the right leg-- --Mm-hmm-- --So, since the stroke was on the left side, so the right leg is affected We, it will be there.

We cannot change it, but with intensive therapy, we could treat.

We're working at a new baseline, but we are hoping for the best possible recovery.

And with children, that can be achieved.

Yeah.

In terms of the vision, is that something that can, can improve over time as well?

Is that fair to say?

It's very hard to say.

I, from my experience, once there is um, if the signal is not going through already and traveling, it's very hard.

It doesn't... come back.

'Cause I know that's a big concern for the-- --Yes.

--Yeah, absolutely.

Yeah, it's a fear not it's a-- Like I was telling her earlier, her other sister is deaf, so with that, that's very hard for us too because it's, one can't see the other sign, how can the other speak, you know, so, that's gonna be very difficult for us, so.

[somber music] That must be hard.

Just seem to, it's a new normal and-- --[indiscernible] --and, we don't know how much of an improvement we, but we all hope and pray that, that she makes the most recovery.

I can't imagine how difficult it must be for you guys right now.

But we're all here to support you and to, and to help you with that transition.

So, uh-- [contemplative piano chords] Just trying to figure out what's gonna be the whole new norm, and it's crazy to even imagine how it's going to be possible just with both of them, and, the disabilities between the two of them.

With a child that's deaf, you have to communicate with sign language.

If the other child can't see, how is she supposed to communicate with her other sister.

Nothing we can do to change it, but, anything we can do to make it better, and do the best about them.

It's good to see like a little bit of her old self again.

Yeah.

She's so like, I'm gonna tell you how it is.

She's really smart.

Always playing dress-up, always jumping on the couches.

It's good to like, watch her old videos so you don't forget like her little quirky habits and her little voice.

She's just a shell out of who she was before.

We hope to kind of break that shell apart and kinda get her, get her back to that goal of being that funny, silly little girl that she was.

So we've been definitely missing that, last couple days.

Missing the old Emery that we had, you know.

[Theresa] I feel like this is my mission in life, is to be there for the kids, especially the sick kids, and I've probably transported two thousand kids in my career.

[Victor] I, I truly care about people, and especially pediatric patients.

[Theresa] But it's challenging.

It's rewarding.

It's sacrificing.

But it's very, very worth it.

[Victor] We're humans, and we need each other.

The purpose of life is to touch others, and when my pager goes off and I have to go on a call, I get pretty excited because I know I can make an influence in someone's life.

[music] Victor, Theresa, and the rest of the team transport nearly a thousand children a year.

Their team is on call 24/7, ready to help the next child at a moment's notice.

After one month of intense therapy, Emery has made incredible progress and is finally able to go home.

Whee.

Ha ha ha.

Ah!

We're excited to take her home today.

It's release day.

So, we uh, we've been planning for this day for quite a while now.

Seven weeks and one day, so we are excited to go home and uh, get her to family and our friends and, we're excited.

We'll see, in, I'd say about a month or two and I think we will get her back walking, I'm pretty sure.

Yeah, we feel pretty confident with her, the way she's been progressing, it's been very well, very promising.

[playful laughter] One month after doctors said she would likely never see again, Emery has recovered 80 percent of her vision.

[hopeful guitar riff] [hopeful guitar riff] This program was made possible by the Ralph and Carolyn Thompson Charitable Foundation and Ed and Ann Zinke