Ashley's Story

Speaker 1: We were all out together, and ... All of our girls, it was girl's night. We split up from each other, and that was pretty much all I knew of the incident, until the next morning.

Speaker 2: She was involved as an unrestrained passenger in a motor vehicle crash. It was a head-on collision. She was not responsive when she came in.

Speaker 1: To see her that situation, when it could have been any of us, because we all drove home in our separate cars.

Speaker 2: When she came through those trauma bay doors, we all were like, "Oh, this isn't good." For starters, Dayton Fire, they don't ever look panicked, and they looked panicked.

Dr. Bini: We were unable, actually, to obtain a blood pressure, initially, on Ashley. Because of the fact that she was neurologically compromised, and we're concerned about her ability to support her airway, the decision was made immediately upon arrival, after doing a quick exam, was to secure her airway with endotracheal intubation.

Speaker 2: I knew, without a shadow of a doubt, the team that she had was a great team, solid team, works well together. She had Dr. Bini, but yeah. She was in really bad shape when she came in.

Dr. Bini: Now, she was profoundly tachycardic. Her heart rate was in the 120s plus, and we had palpable pulses, but were unable to obtain a blood pressure in her arm. At this point in time, that's consistent with somebody that's in profound hemorrhagic shock, secondary to trauma. We initiated a massive transfusion protocol, which is a protocol we have set in place here at the Level One Trauma Center at Miami Valley Hospital, that will actually bring all necessary blood products down to the emergency department in a cooler. We can put them on rapid infusers, and once we've established IV access, actually get blood going into the patient immediately. We had this done in a matter of minutes.

Speaker 2: She also had damaged her spleen, so when they were looking at her abdomen, they were scanning over it with the ultrasound, they could see that her spleen had fluid around it.

Dr. Bini: If it's bleeding from an extremity or a cut on the head, you apply direct pressure. Unfortunately, in this case, we have what's presumed to be a surgical source of bleeding, so you need to take her to the operating room in an expeditious manner. I believe from the time she actually hit the door, to when we left to go to the operating room, was about 13 minutes.

Speaker 2: They knew that there was something definitely wrong with the spleen. They didn't know there was a tear in her heart. It was from the blunt force trauma of her being in a head-on collision, and not being restrained.

Dr. Bini: Immediately upon entering her left chest, I didn't notice a large amount of blood in her left chest, however her pericardium, which is the sac that surrounds the heart, was markedly distended, and obviously had blood in it. I opened the pericardium with a pair of scissors, and upon doing this, a large amount of blood came out. Once that happened, it released the pressure around the heart, and her heart was actually able to start beating again.

I noted that there was still a large amount of blood pouring out of the hole I had make in the pericardium, and at that point in time, it was presumed that she had a cardiac injury, and the decision was made to convert her to a clamshell thoracotomy. What that is, is where I actually open all the way across to the other side, and essentially lift everything up, so I can get exposure to the heart, and great vessels coming off the heart.

She had a lethal injury, just from the fact that she had a blunt rupture of one of the chambers of her heart. She had two chambers of her heart that were ruptured. I don't even know of any cases that have been reported in the literature of somebody with a blunt, two chamber rupture to their heart, that's actually ever survived.

Speaker 1: How he explained it was, they basically put her back together. Kind of like a jigsaw, kind of strange thing. But it was cool, because that's what saved her. Of all of the injuries that she did have, they did a really awesome job.

Speaker 2: Dr. Bini's one of those surgeons, that when he walks in the room, he doesn't have to say anything. He commands the space, and everything just calms down.

Dr. Bini: The patient stayed alive because of the team, the blood bank, the nurses and techs that were running down and getting blood, and the anesthesiologist, Dr. Turner, who was at the head of the bed, is probably more responsible for that patient being alive, than I am.

Speaker 1: I've never seen her like that before. She was completely debilitated. She was on a feeding tube. There was machines everywhere. She couldn't talk. Here eyes were not open.

Dr. Bini: This is somebody who knew that they had truly been given a second chance at being here on this earth, at life. She was joyful with the fact that she was alive, and she could go be a mom to her child.

Ashley: It's good. It's great. It feels like it did before, but just more meaning to it, I would say. You look at things just slightly different. Even though I always looked at my son and my family, and I appreciated those things, and I grasp to them, because it was important. It's a little bit more ... You hold on to those a little bit harder.

Speaker 1: This hospital, I can say hands down, did an awesome job with my best friend, and I'm grateful. Forever be grateful, because she's alive.

Ashley: Actually, I was excited to be at Miami Valley. That's where I had my son, and gave birth, so I was really glad to be there. I was confident in the staff, and the surgeons prior to the accident, and so I was definitely grateful that they were the ones who came, and that's where I was at.

Dr. Bini: There are certain cases and people that impact you, and it becomes part of you, and you'll never forget this. This is one of those cases.

Ashley: This is Bentley, my son. To be able to still hold him, and be with him, is the biggest part of this experience. We are extremely close. We talk about everything. He lights up everything, for me. He's my heart. I know that he looks to me for guidance and support and love, so for me to be still be able to give that to him, and for him to still be able to call me Mommy, and run to me, and know that I'm here for him, is huge.