Saturday, June 6, 2009

Toddler Who Swallowed Bolt Is Breathing Easier Now


Perhaps it is better to tell the end of the story first. Three-year-old Tyen Tackett is OK. His throat was sore after having an inch-and-a half-long bolt removed from his airway, but he’s out of the hospital and back at home, with Mom and Dad and his toy trains.

Last Thursday afternoon, Tyen was not OK.

His mom, Vickie Tackett, had just put him down for a nap at their Warrenton home. His dad Galen was on a plane headed to California and sister Amber was at Fauquier High School, where she is a freshman.

Shortly after laying Tyen down, Vicki Tackett heard him fussing in his crib. Tears welling in her eyes at the memory, she said, “That wasn’t like him, so I went up to check. Tyen was standing in his crib making gagging sounds and vomiting. I went to him and he grabbed my hand and tried to put it in his mouth. I could see he was having trouble breathing and his lips were starting to turn blue.

“I ran to the phone and called 9-1-1. The dispatcher was great. They told me to do the Heimlich maneuver. It didn’t seem to make any difference. They told me not to let him go to sleep, but he was lethargic and his eyes were closing.”

Emergency workers stationed with the Warrenton Rescue Squad -- Justin Clayton, battalion captain, and medics Jeffrey Harris and Lisa Davis -- arrived at the Tacketts’ home to find Tyen limp, blue and barely breathing. Clayton said, “We were going to try to pull out whatever was choking Tyen, but when the bolt moved enough to allow him to breathe more easily, we didn’t want to take any chances, and we got him right to the hospital.”

According to Dr. William Barker of the Fauquier Hospital Emergency Department, “The EMTs struck Tyen on the back, dislodging the bolt enough for him to breathe. They got him here quickly; he was in distress, but he was breathing. I looked in his throat, but couldn’t see what was blocking it. We took X-rays immediately, but in the few minutes it took for the X-rays to be ready, Tyen started vomiting again and he was having a lot more trouble breathing. Maureen Lieb, RN, who was helping me clear his airway, said she thought she saw something back in his throat.
“I looked again and thought I could see it. I reached in with the Magill forceps and was able to pull it out. The X-rays showed the bolt straight up and down, but when I pulled it out it was wedged in sideways, behind the base of his tongue.”

Clinical technician Colleen Shanney said that the Magill forceps are curved and are made just for this emergency. “There were a lot of people in the room with Tyen – anesthesiologists, respiratory therapists and emergency room nurses. They were all ready, then Dr. Barker pulled out the bolt, and Tyen started to breathe normally again.”

That’s when Vickie Tackett began to breathe normally again, too. “I felt so helpless. I never had that feeling before, like there wasn’t anything I could do for him. I kept trying to clear the airway by doing the Heimlich. His little belly is probably bruised from my trying so hard.”

Getting a fix on the timing is difficult. Tyen started to fuss at about 2:30 p.m., but after that, time got away from Vickie Tackett. When asked how long between her 9-1-1 call and the EMTs’ arrival, she smiled tiredly and said, “About five years.”

She cried softly as she wound a music box to calm her son while Emergency Department nurses took some blood and changed Tyen into a Tigger hospital gown. Tyen’s sister remained in the hospital room, relieved. Tyen’s father had been intercepted in Chicago and was on his way home.

“The Entertainer” played on the music box as Vickie Tackett talked about her little boy. “He loves music,” said Tyen’s mom. “And trains. He loves his trains.”

Tyen is no stranger to hospitals. Adopted from a Chinese orphanage two years ago, he was born with a cleft palette and a cleft lip, which have been repaired. “He doesn’t talk much yet,” said Vickie Tackett, but he understands, can say his colors, and is very curious. He is full of energy and always laughing.”

Vickie Tackett is grateful to the EMTs who saved Tyen’s life and to Dr. Barker and the staff at Fauquier Hospital. “They were wonderful,” she said. “One of the nurses gave me a hug. It’s what I needed more than anything. The hardest part was not knowing what to do for him, but it wasn’t too long after I got here that I knew he was going to be OK.”

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