'I knew something was wrong': Mom helps doctors find shard of glass in girl's chest
DOVER, N.H. – When 6-year-old Alaina Harrington accidentally broke a glass against her chest, no one suspected at the time that a shard had pierced her chest wall, putting her in mortal danger.
Both of Alaina's parents, Maeghan Silvestri and Chad Harrington, of Kensington, N.H., are nurses. Their quick triage work and insistence that something was not right with their young daughter eventually led doctors to find and remove a small shard of glass from her chest that had caused one of her lungs to collapse.
"It was March 14, and my husband had just worked a 12-hour shift," Silvestri recalled. "My daughter wanted to help get dinner ready for him. She had a glass in her hand, and her little brother Hayden wanted to help, too. They tussled a bit over the glass, both wanting to get their dad a drink."
Erin Napier's honest post: Can we ever really let go of mom guilt?
Trying to keep control of the glass, Alaina knocked it accidentally against a door frame, and then she caught it and pulled it to her chest.
It broke.
"My husband yelled, 'No one move,' fearing someone would get cut on the broken glass lying around," said Silvestri. "It happened so fast and there were pieces all over the floor. My husband noticed a spot on Alaina's chest, on her shirt. He asked her and she said it must be cranberry juice. We didn't have any cranberry juice. I set her on the table, trying to keep her calm because she doesn't do well with blood."
Silvestri said Alaina had a spot on her chest about the size of a pencil eraser.
"It had stopped bleeding, so I got her an ice cream cone to keep her calm," she said. "She said she felt funny, funny when she breathed and we thought she was anxious because there was blood."
‘We cremated someone else's cat’: They thought their cat was dead. Then, it came home.
“I knew something was wrong because something felt funny in my chest when I breathed,” said Alaina.
Asked if she was afraid, Alaina said, "Pretty much, yeah. I think I was able to be brave because I thought they were just going to tweeze out the smallest piece of glass and I wouldn’t even feel it.”
Putting the pieces together
While the kids played the day the accident happened, Silvestri did something that might have helped to save Alaina. She gathered up the pieces of the glass and reassembled them.
"There was a piece missing," said Silvestri. "Was it on the floor? We scoured the kitchen but couldn't find it. While she wasn't in distress, I decided to take her to the emergency room anyway. I figured best-case scenario, there is nothing and I am overreacting. Worst case, they have to dig out a piece of glass."
On the way to the hospital, Alaina was not having difficulty breathing and said she wanted to go home to see her brother, and to go to bed.
At the hospital, Alaina was seen by a paramedic and then by Dr. Derek Trapasso, who is director of MassGeneral for Children, at Exeter Hospital.
Recent news: Biden-Putin meeting, Israel airstrikes, infrastructure plan
Trapasso said it was a busy night at the emergency department and when he first heard of the child in triage with a laceration to her chest wall, he thought, 'This will be an easy and quick one."
"He was so great, he must have children around her age," said Silvestri. "He got down and talked with her at her level. At first he said it was pretty unrealistic to think something too serious had happened. Then he felt her chest and asked me to come and feel. He said that's crepitus."
Crepitus, explained Trapasso, occurs when there is air in the wall. It's almost like feeling crunchy Rice Krispies. Silvestri, being a nurse knew what is was.
"We took her for an X-ray and we saw the collapsed lung," said Trapasso. "Alaina was not in distress and not having difficulty breathing, but we needed to place a chest tube to evacuate the air and re-inflate her lung."
"I called my husband and told him to drop off Hayden with his grandparents and to come," she said. "Alaina had a pneumothorax. Her lung had collapsed. I will never forget that moment."
'The happy ending we always want to see.'
Trapasso said Alaina was stable but they needed to put in a chest tube and transport her to Boston. Dr. Jay Swett, the surgeon on call, came in to place the chest tube.
"Dr. Trapasso stayed with us through the entire process," said Silvestri. "Now we were heading to Boston, to MassGeneral.
"Because of the relationship we have between the hospitals, we are better prepared to help parents with the transition," said Trapasso.
"Once they arrived, Alaina was placed in PICU (pediatric intensive care unit)."
"There seemed to be a million hands on her, and she did pretty well considering," said Silvestri. "In hindsight, it is a teaching hospital so we had residents, attendings and interns all involved. It was overwhelming for her, but she was a trooper."
Dr. Alan Goldstein, a pediatric surgeon at MassGeneral, found the glass at about 3 a.m. , after Silvestri urged him to look further. She showed him a photo of the reconstructed glass with the one piece missing.
"I had eyes on her, and I instinctively knew this wasn't over yet," she said. "They managed to re-inflate and make stable her lung, but hadn't found the glass. They were talking about sending her home. She was uncomfortable. I was worried that if they sent her home and she fell on her chest, she might move the glass. I was worried about an infection. I asked for another ultrasound and told them I think the glass is still in there."
Goldstein did an exam of Alaina and found a hard spot just above the small wound.
'Mothers know best'
"She felt no pain if we touched her below the wound," said Silvestri. "She most definitely did when touched above it."
It was the glass. Goldstein took Alaina back into the operating room.
"Mothers know best," said Silvestri. "They came back with the glass in a cup. I said I wanted to keep it."
"Meaghan recognized the potential of the shard still being there and her mother's intuition was right on," said Trapasso. "It was the happy ending we always want to see."
Trapasso said that had the shard remained in Alaina's chest, she would have continued to get worse. He said the glass under her skin had the potential for issues, but if the lung became more involved, it could impact the way her heart operates.
"When she came out of anesthesia, she was back to the girl I knew," said Silvestri. "They spoiled her rotten. They gave her a stuffed animal, blankets and a beaded craft board. She wanted to talk to her brother, and she wanted to go home. All is well now."
"What a happy ending," said Trapasso. "She is a beautiful child and her mom is a better parent than me, to think to put that glass back together. Stories like this one are the very reason we are here with our pediatric hospital program, the very reason for what we do."
Now fully recovered, Alaina said: “I want everyone to know that I liked how they took care of me and if they get hurt, they don’t have to be scared because there are good people to take care of them."
Follow Karen Dandurant on Twitter: @kdandurant.