Fortunately, for six-year old Sara, this day's visit to the emergency room was not a traumatic experience. Rather, it was a triumph over adversity and a day to be celebrated. There she stood, basket in hand, wide-eyed and full of smiles, handing out chocolate m&m's to the doctors and nurses who had saved her young life just weeks earlier. Simple "thank-yous" would never be enough to convey the appreciation that she and her family felt for the outstanding medical care she had received in the face of her life-threatening crisis. Nor would there ever be words quite adequate enough to express their gratitude to the many volunteer donors whose generous gifts of blood had helped make Sara's survival possible.

The day of Sara's accident had started out normally enough. The little girl whose sunny disposition was reflected in her love for drawing rainbows had gone to school as usual. And when the bell rang for recess, she had cheerfully run out to the playground with the other kids. But then it  happened. Fast. Unpredictably. Inexplicably. Sara lost her grip while swinging on the monkey bars…and fell to the ground. It wasn't a normal "get-back-up-on-your-feet-and-
play-again" type of fall. Sara was taken to the hospital emergency room immediately.

By the time her parents arrived at the E.R., X-rays had been taken, an IV started, and blood drawn for typing and cross-matching in the event that a transfusion would be needed. Sara's belly was distended and tender. The emergency room doctor, suspecting the possibility of a ruptured spleen, ordered a transfusion to be started. Sara was going in and out of consciousness. The ER nurse vividly recalls the intense activity that ensued as Sara suddenly lost blood pressure and her skin turned not blue, but pure white. She had become apneic and was in shock. Three units of blood were being transfused into both her arms at the same time through a "Y" line. But it was, as the emergency room nurse later described, "like putting a finger in a broken dike." Sara was in critical condition. She was losing blood as fast as she was receiving it. In a hushed tone, her mother recalls, "Sara was on the edge."

Although over 80% of spleenic injuries can be treated non-operatively, Sara's case was to prove the exception. A "superstat" page alerted the surgeon and a Code Blue meant Sara was rushed to the O.R. As soon as the operation began, the surgeon could see that Sara's spleen had been "totally  pulverized" by the fall off the monkey bars. It had, in fact, been completely transected from the major vessels which meant blood was flowing uncontrollably into her chest cavity and belly. The surgical team's daunting task was to stop the bleeding by locating and clamping off the vessels, remove the damaged organ, and bring Sara's blood pressure back up to normal to stabilize her. It was an emergency spleenectomy.

Today, as Sara offers m&m's to the intensive care physician who oversaw her recovery, he marvels at her resilience. "Thankfully, Sara bounced back very fast. The day following her operation, she was looking normal. By the second day, she was taken off her respirator, and a week later, she was released from the hospital. Just look at her now!" Clearly, Sara's story is just one of many happy outcomes that happen each day. It is a story for which blood donors, in their selfless, anonymous and continued spirit of giving, should feel enormous pride. For it is they, who help make such "sweet moments" possible.

Revised: 02/16/05

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