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November 17, 2017

The Proof Is in the Outcome

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“All members of the staff treated my family and friends with respect and care in some of the worst days you could imagine. They helped to walk my mom through significant treatment options and laid out all of the complications and possible outcomes. They cared for my needs and my family’s. After my stint in the ICU, I was moved to the rehabilitation floor of the hospital for three additional days before being discharged.” — Ben Marchewka

By Steve Hablewitz, ThedaStar

Maintaining manual in-line stabilization and performing cervical immobilization are skills we have been taught from day one of our EMS careers, no matter what level we practice. It has become second nature to do this on just about every trauma patient, so much so that we sometimes do it without even realizing. Ben Marchewka is walking proof of the importance of always maintaining control of a person’s c-spine, whether it’s manually holding and/or immobilizing it.

On May 15, 2016, Ben was participating in an off-road mountain bike race in Iola. He was traveling approximately 20 mph when he lost control, went over the handlebars and landed headfirst onto the ground. The helmet he was wearing was shattered. Initial reports were that Ben was breathing and had a pulse but was unconscious and not moving.

First responders, along with the Iola Fire Department and Ambulance, were dispatched to the scene. Manual c-spine was maintained until Ben’s c-spine could be properly immobilized by EMS on scene. Ben had hematomas across his forehead and abrasions to his face. He was given a GCS of 7. Vital signs were stable. His pupils were equal and reactive. He did not have blood or fluid coming from his ears or nose. The probability was high that he suffered severe head and neck trauma.

Ben needed to be intubated due to his injuries prior to the flight back to ThedaCare Regional Medical Center in Neenah. Great care was taken to ensure that Ben’s head and neck remained stabilized throughout the intubation. He was quickly loaded into the aircraft, flown to the Neenah trauma center and arrived in the emergency department as a trauma blue.

Once in the ED, it was quickly apparent how important it was that everyone involved maintained Ben’s c-spine at all times during his care. He suffered many critical injuries, including C1 fracture, C2 Dens fracture (see following article), traumatic brain injury from multiple petechial hemorrhages, bilateral pulmonary contusions and a left clavicle fracture.

Ben had surgery to stabilize his cervical fractures, as well as having two plates and 12 screws placed to rebuild his shattered clavicle. He spent 14 days in the ICU and then another three days in rehab at ThedaCare in Neenah before being discharged home to continue his physical and speech therapy at The Rehabilitation Hospital of Wisconsin in Waukesha.

Coincidentally, Ben works for Trek and is an avid competitive biker and runner. He was off work for three months, then, at his own urging, was finally given the clearance to return after months of grueling therapy. Ben says, “I had heard of horror stories of how difficult PT would be, but I think my mindset was ready for the work. I was so used to pushing myself through sports that it was good to have something that I could work on with the same focus and determination.”

Ben has returned to the sports he loves. He recently completed a half marathon and also won a Wisconsin State Cat 4/5 Time Trial in cycling. Ben added, “Great accomplishments on their own, but to have come this far, I am more appreciative of these opportunities.”

Ben is walking proof of what is possible when great care is taken to maintain c-spine stabilization/immobilization. He recently thanked the ThedaStar flight crew for helping him. We wish he could have personally said thank you to everyone involved in his care, especially that first person who put hands on Ben’s head to hold his c-spine and not let go. That is what truly made the difference in his outcome. To them we say thank you.