Red toy wagons, used to help caretakers to transport ill children to and from treatments and appointments, are a staple in the hallways of Children's Healthcare of Atlanta. The pediatric patients' IV poles have always had to be pulled awkwardly behind the wagons — until a grandfather and his son decided that needed to change.
Roger Leggett's granddaughter, Felicity, was diagnosed with a brain tumor at the age of 4 in 2011. While visiting the young girl during her treatment at Children's Healthcare of Atlanta (CHOA), Leggett and his son, Chad, saw a mother pulling her child in a wagon, struggling to also drag his IV behind. "Chad looked at me and said: 'There's gotta be a better way to do that,'" Leggett told NBC affiliate WXIA.
Chad tragically died of heat stroke just a few weeks later, but Leggett remembered that moment, which inspired him to create the not-for-profit, Chad's Bracket, which is dedicated to connecting IV poles to patients' red wagons, according to the organization's Facebook page. With help from students at Chattahoochee Technical College, Leggett has affixed IV poles to more than 100 wagons at CHOA, and is hoping to fill requests from hospitals around the country, according to WXIA. His workshop is currently based in the bed of his late son's pickup truck.
Felicity received news recently that she is in remission, and Leggett is humbled by the support his efforts have garnered. "I don't feel I deserve the praise. I'm just trying to make the time a child and parents spend at CHOA easier and safer," Leggett said.
Seattle Children's Hospital hallways erupted in cheers and applause this weekend as the Seattle Seahawks played a nail-biter of a game against the Green Bay Packers and officially locked down their spot in Super Bowl XLIX.
And 8-year-old Maria Moore's room was no exception. The recovering leukemia patient watched the game while wearing her Seahawks hat and clutching her signed football. On the table next to her, she propped up a photo of herself with Seahawks quarterback Russell Wilson, who visited her at the hospital in November.
At one point, Maria was so bummed that her team appeared to be losing, she shed a little tear, her dad told ABC News. He told her not to worry, that Wilson and the Seahawks would come back. And they did.
"We were just totally shouting and applauding and hollering and giving high fives to each other," Thomas Moore told ABC News. "It was an amazing gave to watch. She was super excited."
Marie was diagnosed with acute lymphoblastic leukemia in September and initially didn't respond to chemotherapy, but the doctors at Seattle Children's and Fred Hutchinson Cancer Research Center helped get her treatment "recipe" just right, he said. Marie underwent a cord blood transplant on Jan. 2, and is in remission, but should be at the hospital a few more weeks, he said.
"We’ll probably be watching [the Super Bowl] from the hospital, but that's OK," he said. "As long as she's doing well, that’s fine by me."
Nearly every Tuesday, the team's star quarterback, Russell Wilson, visits Seattle Children's Hospital to meet with patients, said hospital spokeswoman Kathryn Bluher. So the team holds an extra special place in the hearts of patients and their families.
Wilson visited Maria the day after flying back from an East Coast game in November, and she was "all smiles," Moore said.
"It makes a bigger fan out of me. I really can't say enough," Moore said. "[Wilson] is a down to earth, really nice guy. He takes time talk to the kids, do pictures, sign some things."
After Sunday's win, patients at Seattle Children's Hospital took photos with "Congratulations" signs from their hospital beds to show their support.
"It takes their mind of things," Moore said. "It gives them something fun to think about."
Not all children with severe brain injuries need to be monitored for subclinical seizures, researchers said here, which means that resources can be focused on those at the highest risk.
Victims of abuse, those younger than 2, and those with bleeding within the brain rather than only in the epidural compartment are the pediatric ICU patients most likely to show significant seizure activity that should be detected and treated, said Rajsekar Rajaraman, MD, of the University of California Los Angeles (UCLA).
A separate study by many of the same investigators also found that, in a broader range of pediatric brain injury cases, risk of seizures could be predicted with "fair-to-good" accuracy on the basis of clinical characteristics that would be recorded routinely at admission.
Both studies were reported at the American Epilepsy Society's annual meeting here.
A senior author on both studies, Nicholas Abend, MD, of Children's Hospital of Philadelphia, said at an AES press briefing that identifying and treating seizures is important in the pediatric ICU. When seizures are extremely frequent or long-lasting -- and these can easily go without detection in hospitalized children who are unconscious or lethargic -- they significantly increase the likelihood of poor short- and long-term outcomes.
Such seizures can only be detected via continuous EEG monitoring, Abend explained, which also requires interpretation from trained electroneurologists.
Another investigator in the studies, UCLA's Jason Lerner, MD, noted that children may appear to be napping peacefully while actually undergoing continuous seizures.
Although it would be desirable to perform intense monitoring on all pediatric cases involving head trauma, that is not feasible at most centers, Abend said. He said the field could benefit from risk-stratification models that would allow the care team to track only those patients at the highest risk for damaging subclinical seizures.
Such models, he added, could be tailored to meet the needs of individual centers on the basis of their patient mix, staffing, and other factors.
In a platform session at AES, Rajaraman described one approach to developing such a model. He and colleagues collected data on 135 consecutive pediatric patients (ranging in age from infant to late adolescent) with traumatic brain injury who were treated in ICUs at UCLA and at Children's Hospital of Colorado in Denver. These children had continuous EEG monitoring for detecting subclinical seizures.
They found that all such seizures occurred in children younger than 2 and in those with intradural bleeding, and that the vast majority also involved abusive head trauma. Rajaraman and colleagues then sought to validate these associations in a separate cohort of 44 pediatric ICU patients with head injuries treated at Children's Hospital of Philadelphia. The same patterns were seen.
Across both cohorts, 81% of those with subclinical seizures were determined to have been victims of abusive head trauma, whereas the prevalence of such trauma in all the patients was 25%. Abend said it was uncertain why abusive trauma should be such a strong predictor of these seizures, but speculated that "shaken baby syndrome" -- the most common form of abuse of infants and toddlers -- may produce fundamentally different injuries in the brain compared with falls and car accidents.
Also, such abuse is often chronic, such that the episode that brings a child to the hospital is only the latest in a series of abusive incidents.
The other study, led by Abend, was aimed at producing a predictive model yielding a risk index score that pediatric centers could use to identify critically ill children who could benefit the most from continuous EEG monitoring. It was based on clinical information to which the attending neurologist would have ready access: age, seizure etiology, presence of clinical seizures prior to beginning continuous EEG, initial EEG background category, and interictal discharge category.
Data to design the model were drawn from a database of 336 patients from 11 centers, and then tested against a separate validation dataset of 222 patients treated at Children's Hospital of Philadelphia.
Normalized scores in the model could range from 0 to 1.0, and Abend and colleagues examined the sensitivity and specificity of various cutoffs. When set at 0.10 in the validation cohort, sensitivity was 86% but sensitivity was only 58% -- the high sensitivity meant that 43% of patients would be identified as candidates for continuous monitoring. At the other end, a cutoff of 0.45 reversed the sensitivity and specificity percentages to 19% and 97%, respectively, such that only 5% of patients would be assigned to monitoring.
Abend said the beauty of this approach is that an individual center could choose its own optimal cutoff depending on the resources it has available to monitor multiple patients at one time. A well-equipped and staffed ICU could thus opt for high sensitivity whereas one with more limited resources could be more restrictive.
From Tampa to Pittsburgh, Chicago to Memphis, comic superheroes are being spotted all over the country -- and they are fighting grime.
On windows, that is.
In their off-hours, Spider-Man, Captain America, and Batman, to name a few, are washing windows at children's hospitals. Their mission? To bring happiness to the youngest of patients.
"We donned the Spider-Man costumes and we rappelled down the side of the buildings," said Harold Connolly, president of Highrise Window Cleaning of Clearwater, Fla. "We knocked on the glass, waved hello – there were a lot of big smiles."
Connolly organized two superhero window-washing sessions at hospitals in Florida so far this year, and he isn't alone. Images of wide-eyed children in awe of their favorite superheroes washing windows have gone viral online, prompting hospitals and window washing companies nationwide to hop on board.
"Some of these poor kids, they don't get a lot of opportunities for anything fun there," Connolly says. "It cheered them up at least for the moment anyway."
Last week in Chicago, Captain America, Batman, and Spider-Man's mission for the day was surprising children into forgetting that they are in hospital beds at Ann & Robert H. Lurie Children's Hospital of Chicago.
Nolan Erickson, 6, has been spending a lot of time in the hospital with his 14-month-old brother Matthew.
Matthew was born with brain cancer and has undergone six surgeries and five rounds of chemotherapy; the family hasn't left his side.
"We have been in the hospital for 11 months out of the 14 that Matthew has been alive," mother Sue Erickson says. "Nolan has spent his last two birthdays here. Smiles come few and far between."
But on one day – for Nolan, Matthew and their 2-year-old sister Sophia, there was a break from all the sadness.
The three superheroes, window washers from Corporate Cleaning Services, were fighting grime as they rappelled down from the 23rd floor. The heroes circled all around the building, waving, giving a thumbs up and creating soap designs as they went.
"The superheroes' lines were hanging right in front of our window," Erickson says. "The kids just sat there waiting for 45 minutes to see which one it was. It was Spider-Man. When you see your kids excited and smiling – as a parent it was more than I could ever ask for."
Hundreds of kids, staff and families were mesmerized by the superheroes swinging around the building for hours.
"I have been here a lot of years but I have never seen anything like it — nothing can brighten a day like a superhero," says Kathleen Keenan, hospital spokesperson. "These three men truly became real-life superheroes when they were on that building and their ropes became their webs. It was magical."
Keenan added: "It was like each kid had their own superhero for a moment, it was like there was no glass between them."
The superhuman trend is spreading all over the country:
Le Bonheur Children's Hospital in Memphis, Tenn., has had two visits, one in October from the American National Skyline's superheroes and one in December from elves, says spokesperson Sara Burnett.
The youngsters at Ministry St. Joseph's Children's Hospital in Marshfield, Wis., got a big surprise in December when Spider-Man, Batman, and Captain America left the place smiling and squeaky clean, says Geoffrey Huys, hospital spokesperson.
In St. Petersburg, Fla., at least 40 or 50 inpatient children at All Children's Hospital caught a glimpse of Spiderman last month, says hospital spokesperson Roy Adams.
"We try all the time here to make it as fun as possible," Adams says. "We are trying to make kids forget that they are in the hospital and are going through these tough medical issues. We have celebrities come in, but this was a different kind of VIP visit because, well, they were coming down the side of the building."
Last July, Michelle Matuizek, office manager of Allegheny Window Cleaning, Inc., saw pictures of window washers in London dressed as Spiderman.
"I looked around and – at that point - no one had done it in the states," Matuizek says. "I thought why don't we do a character theme for our Children's hospital around Halloween."
So on October 22, the patients at Children's Hospital of Pittsburgh of UPMC had visit from Spider-Man, Batman, Captain American and Superman.
"The kids went wild. They were all over the windows, smiling and screaming – it was just magical," Matuizek says. "The nurses, the kids, the families it was a wonderful experience for everyone. We are going to do it again next October."
Both Allegheny Window Cleaning, Inc and Highrise Window Cleaning have plans to do more superhuman fly-bys in the future, and Connolly hopes the trend catches on.
"The kids—that the important thing," Connolly says. "We are hoping it spreads throughout the country and beyond. Other hospitals see this and then ask your window company if they will do it – I bet you they will. Who doesn't like making children happy?"