Bismarck Foundation

SAKT Ambassador



Transport Team Saves Rural Baby

Jennifer and Cody Green of Bison, S.D. were excitedly awaiting the arrival of their second child, Levi. It was a normal pregnancy with no major concerns. On the morning of October 27, 2017 Jennifer was scheduled to be induced. At 7 a.m. Jennifer and Cody arrived at West River Regional Medical Center in Hettinger, ND, and by 1 p.m. Jennifer started pushing for what seemed to be forever.

“After several hours of pushing I was not able to deliver him on my own,” stated Jennifer. “That’s when medical staff decided it was best to utilize a vacuum to assist with the delivery.”

A vacuum extraction delivery is one in which a device with a suction cup is affixed on the crown of the baby’s head and the physician helps deliver the baby by gently pulling on the device. Vacuum extraction is a step in the delivery process prior to performing a cesarean delivery (C-section). However, like anything in life there are risks and benefits. One of the risks is an unintentional injury which causes a subgaleal hematoma. This is when a blood vessel in the baby’s scalp tears due to the traction on it. The torn blood vessel can potentially leak a significant amount of blood into the tissues outside and inside the skull. If the blood leaks into the skull it may put pressure on the brain. This can lead to neurological dysfunction, seizures or possibly death if the bleeding does not stop; and, unfortunately there is no cure or surgery to repair it. The care a baby receives is supportive while the vessel hopefully heals itself.

“After Levi was born Cody noticed fullness around Levi’s ears, cheeks and forehead,” said Jennifer. “Cody was a little nervous about it, but we also thought it was normal because of the vacuum.”

Some swelling is to be expected after a vacuum extraction. However, to make sure Levi fared well from the delivery the nurses were vigilant in monitoring him by using tactics they learned in a continuing education class taught by CHI St. Alexius Health Neonatal Intensive Care Unit (NICU) registered nurses Bonnie Cook and Cindy Steckler. The S.T.A.B.L.E. class (which is an acronym for sugar, temperature, airway, blood sugar, lab work and emotional support) is offered at onsite locations and through the Telemedicine Network. Nurses from across the state can attend the class through the network in their facilities, and they learn what to look for and what to do to stabilize a newborn.

Following Levi’s delivery the Hettinger nurses observed the swelling of his scalp. After 24 hours of age the swelling had not decreased. The nurses remembered what they learned about subagleal hematoma in their S.T.A.B.L.E. class and suspected this could be the reason for Levi’s condition. They contacted the physician who then visited with CHI St. Alexius Health’s Neonatologists. It was determined Levi needed to be transported to CHI St. Alexius Health’s NICU via the NICU Transport Team flying with Bismarck Air Medical. Bonnie Cook and Haleigh Wahl, another CHI St. Alexius Health NICU RN, were the transport nurses on duty that evening.

“When the Hettinger medical staff told us Levi needed to be flown to Bismarck, we were in shock,” said Jennifer. “I remember when Bonnie and Haleigh arrived. They were so caring and considerate. They knew I was scared but they explained everything in such a way so I would not panic.”

While in the NICU Transport Incubator, with Bonnie and Haleigh by his side, Levi arrived a little after 12 a.m. on October 29 at CHI St. Alexius Health. Blood work was obtained to determine the need for a blood transfusion or if other bleeding abnormalities existed. A MRI was also completed and confirmed the suspected diagnosis of subgaleal hematoma.

“At this point we had absolute fear because we understood the bleeding had to stop on its own as there is no cure,” said Jennifer.




    Levi Cover
Levi Family
Seven-month-old Levi with his mom, Jennifer, father, Cody, and older brother, Kaden, enjoying a summer day.

Twenty-four hours after birth, SAKT 2018 Ambassador Levi Green, was flown by CHI St. Alexius Health’s NICU Transport Team from Hettinger to Bismarck to receive the vital care he needed. As you can see, he is now a healthy seven-month-old.