Below is a detailed account of event's that took place on 12/19/2014 with links to medical definition's and such, The first day of many this beautiful young miracle girl did and will continue to fight through.
- On December 19th 2014 Sabrina Lee collapsed at home, Her Mother rushed her to the E.R. at Logan Regional Hospital as fast as she could, She explained what had happened and told them Sabrina's history of stomach issue's, Upon arrival Sabrina had a very cachectic, ill, pasty appearance and was unresponsive, Her oxygen saturation was good on room air at 90+, Heart rate about 135, blood pressure was initially difficult and unable to achieve as she was so thin and pale, At this point resuscitation measures where initiated, IV's where attempted bilaterally on her upper extremities, While attempting these IV's Sabrina had a noted bradycardia, Her heart rate went from the 130's down to 50's, At this point the ER team did begin CPR and pulses where initially noted, They then lost pulses and CPR was initiated again, The E.R. team could not intubate Sabrina as her teeth where fairly clenched and so they ambu bagged Sabrina gently until her interosseous lines where achieved and succinylcholine was then initiated, They put in an endotracheal tube and an Nasogastric tube At this point, They gave her multiple rounds of epinephrine and atropine, After about the 4th round of epinephrine her heart rate picked back up to the 130 range, They also gave her boluses of fluid and loaded her up on Dopamine drip, Epinephrine drip and Norepinephrine drip, Sabrina was also a bit hypothermic in the 90-92 area and was in a bair hugger throughout the resuscitation, After drawing lab's,Getting chest x-rays, Giving Sabrina some blood and a dose of bicarb and somewhat stabilizing her, They contacted P.I.C.U. made arrangements with the life flight team and prepared Sabrina for the Life flight to Primary Children's Hospital in Salt lake city, UT.
- Life flight arrived at the P.I.C.U. with Sabrina at approximately 14:00 hours in very critical condition post PEA cardiac arrest, The P.I.C.U. team started high doses of inotropic support and fluid support, They ran blood, Urine and respiratory cultures and adjusted the ventilator settings accordingly, Sabrina needed to have a Central Venous Catheter put in so the surgical team prepped her and placed one in her right subclavian vein (upper right chest) The catheter was then sutured into place, Even though her acidosis was improving the continued increase in her already high and toxic level of inotropic support led to an elective ECMO ("extracorporeal membrane oxygenation") by the team, They discussed this with General surgery , One of the surgeon's (A true hero) spoke up and said : Going on ecmo right now would be a mistake, We wont be able to do anything else surgically without great risk of bleeding, This surgeon explained Sabrina is a 15yr old female who currently weighs 23kg. (50.7 lbs) She initially was presented today to Logan Regional Hospital with severe abdominal pain and in septic shock, She arrested and was brought back, Then transported here to PCH/PICU where she has continued with severe systemic inflammatory response and has been doing relatively poorly and a decision to initiate ECMO is being put in place; However, Given the high likelihood of the abdomen as her septic source surgery has elected to not cannulate, But rather continue to resuscitate, Go in and surgically explore the abdomen, Sabrina was moved from P.I.C.U. to the O.R. where the surgeon made a mid-line incision dissected way down through the ileocecal junction where there was an area of massive inflammation and dense narrowing causing an obstruction of the distal ileum, The ileum proximal was massively dilated, The cecum also appeared grossly abnormal, The surgeon then decompressed the small bowel and resected the area of obstruction, Then placed staple loads across both the distal ileum and the ascending colon, Returned the small bowel to her abdominal cavity, Washed out her abdomen put a wound vac in place, Then put a damage control dressing on, She was then moved back to her room in P.I.C.U.
- To put this surgery in perspective what the surgeon did is made an 8 inch vertical incision down the center of Sabrina's abdomen area went in and found obstruction's in her small intestines were they meet the large intestines, and cut them out, There were blood vessels wrapped around parts of the obstruction specimen's composed of a terminal ileum, cecum with appendix, and proximal ascending colon and the larger piece that was cut out resembled dark dried wood, The ileocecectomy specimen measured 15 cm in length 8 cm in diameter and 13.5 cm in linear circumference it was rather large,
- This was the cause of Sabrina's severe stomach aches,Diarrhea,nutritional and growth problems over the past while, Thanks to a very intelligent, wise and seasoned surgeon, The cause was found and specimen's cut out were sent to a lab for testing which a week later would confirm Sabrina was suffering from crohn's disease. (Continue to next page)