Families in one Belle Mead, N.J. neighborhood look forward to their end-of-the-summer block party. Streets are closed to traffic for the festivities and children roam the quiet roads without fear of cars. For 10-year-old Elli Pizzulli and her friends, spirits were high this past September as they enjoyed the unaccustomed freedom.

Lynne Pizzulli, Elli’s mother, recalls the moment that shattered the otherwise perfect Saturday. “Elli was running down the street with a friend,” she said. “Two other girls were on bikes behind them.”

One of the bike riders drew close and shouted, “Watch out!” Elli instinctively moved to the right as did her bike-riding friend. The two collided and Elli fell to the pavement, striking her head.

Still at home preparing party food, Lynne received a call about the accident. She grabbed an ice pack and hurried to Elli’s side. “She had a good-sized bump on her head,” recalls Lynne, who convinced her daughter to leave the party. As Elli lay on the couch at home, she complained of a tingling sensation in her face. She started to vomit.

Lynne bundled Elli into the car and headed to nearby Princeton Medical Center with her husband, Tony, and 6-year-old daughter, Sami. The Pizzullis assumed Elli had suffered a concussion and were shocked when the emergency department doctor said her CT scan showed a six-centimeter epidural hematoma, a mass of blood between the skull and the brain.

Pediatric trauma care

“We were told Elli needed a level 1 trauma center and would be airlifted to the children’s hospital in Philadelphia, affiliated with Princeton,” said Lynne. “I didn’t know a lot about the Philly hospital, but I did know about Robert Wood Johnson’s pediatric hospital in New Brunswick.”

She reached out to Jeremy Grayson, MD, a friend and anesthesiologist at The Bristol-Myers Squibb Children’s Hospital (BMSCH) at Robert Wood Johnson University Hospital, who contacted his colleague, Prithvi Narayan, MD, the pediatric neurosurgeon with The Bristol-Myers Squibb Children’s Hospital at Robert Wood Johnson University Hospital and Rutgers Robert Wood Johnson Medical School.

“It was like something out of the movies,” recalled Lynne of the controlled chaos that erupted when the transport team from BMSCH arrived to transfer Elli. Comforted by a hug from the lead physician, Lynne climbed into the front seat of the ambulance as Elli was intubated and put to sleep.

“When Elli arrived, we reviewed the CT scan, which showed a skull fracture and the large blood clot on the right side, exerting pressure on her brain,” explained Dr. Narayan, who met the ambulance at BMSCH’s Pediatric Trauma Center with Dr. Grayson. “Emergency surgery was necessary to evacuate the blood clot and preserve neurological function.”

BMSCH is New Jersey’s first pediatric trauma center certified by the American College of Surgeons. “At a pediatric trauma center, the team is specially trained and experienced in taking care of children with multiple injuries to different organ systems. Everything is expedited and efficient, specifically tailored to the needs of children, which leads to excellent care and outcomes,” said Dr. Narayan.

Emergency brain surgery

He and the trauma team assembled quickly in the operating room for Elli’s emergency surgery. The team included pediatric trauma surgeon Shaheen Timmapuri, MD, and Dr. Grayson, along with emergency medicine doctors and nurses. In just over an hour, the blood clot was removed.

“Elli was silly post-surgery,” recalled Lynne, who felt reassured when Elli cracked jokes about her neck brace. Of the trauma and pediatric intensive care unit staff, Lynne said, “Everyone was helpful and supportive.”

As Elli recovered, she visited the Family Resource Center, where she and her sister, Sami, had manicures. “It raised her spirits,” said Lynne. An avid reader, Elli was excited to discover a sequel to her favorite book, Good Night Stories for Rebel Girls, there. “She was so pleased she could take it home.”

Right time, right place

One week after discharge, Elli returned to fifth grade, gradually transitioning to a full-day schedule. She’s restricted from her favorite contact sports, basketball and lacrosse, but got clearance from Dr. Narayan to play tennis. “She’s an amazing kid who is strong and very brave,” said Dr. Narayan. “It was important that Elli was transported to a pediatric trauma center in a timely manner.”

The Pizzulli family agrees. “As traumatic as this experience has been, it forced us to appreciate life and slow down,” said Lynne. “We’re not in a million places. We spend time at home playing lots of backgammon and Yahtzee! We’re grateful to be together.”

For more information on the Bristol-Myers Squibb Children’s Hospital at Robert Wood Johnson University Hospital, visit BMSCH.org.

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