THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Saturday, January 6, 1996 TAG: 9601060245
SECTION: LOCAL PAGE: B1 EDITION: FINAL
SOURCE: BY DEBRA GORDON, STAFF WRITER
LENGTH: Long : 159 lines
There won't be any balloons at Justin Lambert's birthday party later this month. Last week, a balloon nearly killed him.
Friday, thanks to a chain of events that put the right people in the right places at just the right time, Justin left Children's Hospital of The King's Daughters as jaunty as any normal 4-year-old.
Justin is remarkably lucky. Most children who inhale balloons the way he did are never even admitted to the hospital - they're usually dead by the time they arrive in the emergency room.
It happened to a 6-year-old Virginia Beach boy last summer, who choked on a piece of pink balloon.
But Justin beat the odds.
And so his mother, Terri Lambert of Chesapeake, wanted to tell her son's story. To warn other parents of the dangers of balloons, which she swears her son will never again touch.
It was three days after Christmas, and Justin, after a big chicken-filet dinner, was playing with an activity set he'd received for the holiday.
Terri had warned him not to play with the toy - which included crayons, balloons and other art supplies - without her supervision. But even though she was busy in the kitchen putting away groceries, her roommate's boyfriend was in the room with him, so Justin figured he was safe and pulled out the set.
Then he did as children will do. He put two uninflated balloons in his mouth, and chewed on them as he rocked on his hobby horse. Something made him laugh, and he took a deep breath, sucking the balloons into his throat.
There they draped over his vocal cords and windpipe like plastic wrap, shutting off his air supply. He grunted and turned blue. Then he threw up, a common occurrence when someone is near death, and inhaled the vomit. Terri and her roommate raced to the phone to dial 911.
Then came the first in the chain of events that saved Justin's life.
Chesapeake paramedics Lisa Sison and Eric Brown had already been dispatched to another call, further away, when they heard the Lambert call on the radio. Because they were already out, they were able to reach the Lambert house in about three minutes.
By the time the paramedics arrived, Terri's roommate had pulled one balloon out of Justin's mouth, but the boy still wasn't breathing. Sison peered down Justin's throat and saw a white balloon. She used a pair of forceps to remove it. Then Brown placed a breathing tube down Justin's throat to breathe for him and sedated him.
So now the balloons were out, but Justin was suffocating on his own vomit.
The paramedics quickly transferred Justin to the closest hospital - Chesapeake General. There, doctors desperately tried to raise the oxygen level in the boy's blood. But the level, which should be at 100 percent, Dr. Craig S. Derkay, medical director of CHKD's Ear, Nose and Throat Department said, fluctuated between the mid-30s and the upper 60s. ``We worry if the level hits 90,'' Derkay said.
Chesapeake General called Children's Hospital, asking for its emergency transport, Derkay said. Dr. Thomas Nakagawa, a CHKD pediatric intensive care physician who lives five minutes from Chesapeake General, was paged.
No. 2 in the life-saving chain of events.
Even though he's not on the staff at Chesapeake General, Nakagawa went to the hospital to meet the ambulance. He helped the emergency room doctor work on Justin, and together they managed to get his oxygen level up to about 85 percent, Nakagawa said.
Meanwhile, Derkay was just finishing an emergency surgery on a baby with an abcessed eye. Normally, he wouldn't have been in the operating room so late, nor would he have had his whole team ready and waiting.
No. 3 in the fortunate chain of events.
At 11:55 p.m., the ambulance team wheeled Justin through CHKD's emergency department without stopping, into a waiting elevator and up to a prepared operating room where Derkay was waiting.
Derkay removed the breathing tube and inserted an instrument called a ``ventilating bronchioscope,'' something like a metal telescope. Attached to it was a ventilator port to get oxygen into Justin and a bright light so Derkay could peer into the boy's lungs. What he saw terrified him.
Justin's lungs were filled with chicken and mucus.
Derkay spent nearly an hour cleaning them out, literally pulling the chunks of meat from Justin's lungs with special forceps.
When he finished, the oxygen level in Justin's blood was in the 90s, Derkay said, but a chest X-ray showed bad news.
Justin's lungs, which should have appeared black on the X-ray because of the air filling them, were stark white.
They were in shock, Derkay said.
Even more worrisome was the reduced oxygen the boy had been receiving for more than three hours. Derkay expected severe brain damage.
Terri remembers little of that night. She knows she screamed herself hoarse when she first discovered Justin choking. Knows she thought he was dead while the paramedics worked on him. But the details are still a blur.
After surgery, Justin was moved to the pediatric intensive care unit where Nakagawa started him on antibiotics for the pneumonia that doctors expected from the lung damage, and ``surfactant'' medication - usually given to premature infants to help their lungs develop.
The last in the chain of events that saved Justin's life.
The surfactant and antibiotics worked, helping Justin's lungs heal. By Tuesday, when Derkay came back on duty, Justin was awake and asking to go home.
By Thursday, a week since the accident, he was playing Nintendo and demanding to go home.
On Friday, he went home.
Justin escaped brain damage, Derkay said, because he was very healthy before the accident and because of the quick action of the paramedics, which started at least some oxygen circulating through his system before permanent damage could occur.
``It made me feel very good to see him playing games,'' Derkay said.
Balloons killed 131 American children between 1972 and 1992, according to an article in last month's Journal of the American Medical Association. That included two latex gloves, which doctors often inflate as playthings for children.
Balloons were the most common objects to cause choking deaths in children, the article noted.
The fact that most of the children killed were older than 3, the article's authors noted, means that greater public awareness of the dangers of balloons to all children, not just babies, is needed.
Last year, a new federal law requiring U.S. balloon manufacturers to put a warning label on all balloon packages went into effect. ``Warning,'' it says. ``Children under 8 years can choke or suffocate on uninflated or broken balloons. Adult supervision required. Keep uninflated balloons from children, discard broken balloons at once.''
The balloon industry also tries to educate consumers about balloon dangers through its retailers, said Dan Flynn, vice president of Pioneer Balloons in Wichita, Kan., the country's largest balloon manufacturer.
``One incident is one incident too many,'' he said, when told of Justin. ``I'm just thankful nothing worse happened out of this. We are very much concerned whenever we hear anything like this.'' MEMO: RECOMMENDATION
The Consumer Product Safety Alert Commission recommends that children
under the age of 6 not be allowed to play with uninflated balloons
without supervision. The commission does not believe that a completely
inflated balloon presents a hazard to young children. If the balloon
breaks, however, the commission recommends that parents immediately
collect the pieces of the broken balloon and dispose of them out of the
reach of young children.
Source: Consumer Product Safety Commission
HOW ACCIDENTS HAPPEN
Accidents involving balloons tend to occur in two ways: with intact
balloons and pieces of balloons.
Some children have sucked uninflated balloons into their mouths,
sometimes when they were inhaling while trying to inflate them.
Other deaths may have resulted when children swallowed uninflated
balloons they were sucking or chewing on. In one case, a child was
chewing on an uninflated balloon when she fell from a swing. The child
hit the ground and, in a reflex action, inhaled sharply. She suffocated
on the balloon.
Children have drawn pieces of broken balloons into their throats. If
a balloon breaks and is not discarded, for example, a child may continue
playing with it, chewing on pieces of the balloon or attempting to
stretch it across his mouth and sucking or blowing bubbles in it.
Balloon pieces are easily sucked into the throat.
Source: Consumer Product Safety Commission
ILLUSTRATION: Color photo by D. KEVIN ELLIOTT, The Virginian-Pilot
Justin Lambert, 4, here at Children's Hospital of The King's
Daughters, nearly choked to death when he swallowed two balloons.
KEYWORDS: ACCIDENT GENERAL by CNB