Friday 28 November 2014

Health case study: Tackling acquired brain injury

What seemed like a simple concussion soon became a medical emergency for Ronan Fitzgerald, 13. His parents tell Joy Orpen they are now appealing to sports coaches to err on the side of caution when it comes to head injuries

Sheila and Brian Fitzgerald with their 13-year-old son, Ronan
Sheila and Brian Fitzgerald with their 13-year-old son, Ronan

As Brian and Sheila Fitzgerald followed the speeding ambulance containing their injured son, they wondered if they would be making the return journey behind a hearse bearing his remains.

Their drama had begun to unfold that morning. It was early November 2012. Brian, a garda, dropped sports-mad Ronan off at the Tralee Rugby Club before returning home to Sheila, who was preparing for Christmas.

About 20 minutes later, they got a call to say their son had suffered an injury during the warm-up – a slight concussion was suspected.

"I wasn't alarmed," says Sheila, a registered nurse. "When we went to the rugby field, I found Ronan lying in a dugout with an ice pack on his head and his legs elevated."

Alarm bells began to sound when Sheila saw that Ronan had vomited and that he wasn't communicating.

When Brian saw his 13-year-old son being led towards the car, he got a terrible shock.

"Two people were holding him up – he looked like a drunk trying to walk, and he was the colour of death. I knew immediately he was in trouble," he says.

It seems likely Ronan had received a bang to the head during a ruck.

The Fitzgeralds rushed Ronan to Kerry General Hospital, where a Cat scan was done.

"He was hypothermic when we arrived," recalls Sheila.

"He was literally dying in front of us," says Brian, the horror still vivid in his mind. It was soon ascertained that Ronan was suffering from an extradural haemorrhage. "In other words," explains Sheila, "he had a bleed between the dura [covering] of the brain and the skull. That's a very serious situation. They had to put him on life support immediately."

Ronan's only hope was surgery at Cork University Hospital (CUH). By now, the Fitzgeralds' other sons, Sean and Ciaran, had arrived, and soon they were all racing behind the speeding ambulance.

"I was wondering would the four of us be following him home in a hearse," Brian recalls.

Gardai escorted the ambulance as it made its mercy dash. All along that tortuous, high-speed, 60-minute journey, two paramedics, an ICU nurse and an anaesthetist battled to keep Ronan alive.

They were met by the neurosurgical team; a woman stepped forward to greet them. "I assumed she was a nurse," says Sheila. "But it turned out she was the surgeon. She's not just talented; she's beautiful, too."

The team rushed their young patient into theatre to try to relieve the bleeding. Now, all the family could do was pace, fret, and pray. "In the meantime, we thanked the paramedics," says Brian. "But, later, I realised they weren't looking us in the eye – they must have thought Ronan wouldn't make it."

Later, Brian and Sheila were heading towards ICU when they bumped into the neurosurgeon. "She was still in her scrubs and rushing to another emergency," says Brian. "We asked how it had gone and she said 'OK', but she said it cautiously," he says. The Fitzgeralds were told that the next 24 to 48 hours were crucial.

Sunday Indo Life Magazine

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