Grace Under Pressure Nurse, Hyperbaric Chamber Help Infant Fight Deadly Infection

Nurse Patrice Sweeny lies on her side inside a freezer-sized cylinder sealed shut by a steel door that clangs like a vault. In the crook of her arm is a 3-week-old baby whose life is in danger. On the other side of the glass is the baby’s mother, wishing she could cuddle with the child she has not held in days.

The child is Molly Catherine McGreevey from St. Ignatius, Mont. Twice a day, she makes a journey that no other baby has ever made at Deaconess Medical Center.

She dives.

Slid into a hyperbaric chamber, Molly spends two and a half hours, twice a day, at twice the normal atmospheric pressure so her tissues and blood can be flooded with oxygen to fight an infection trying to kill her. Her nurses, doctors and parents call this a dive because hyperbaric chambers are most commonly associated with treating scuba divers suffering from the bends. Outside the chamber, a person would have to dive 33 feet into the ocean to equal the pressure on Molly and her nurse.

The baby’s infection - necrotizing fasciitis - does not like oxygen. It is usually fatal in infants. But thanks to a three-pronged attack on the disease, Molly has improved since she was admitted on Wednesday. She will continue the hyperbaric treatments through the weekend, then doctors will reassess her.

“I think things look pretty good for Molly,” said Dr. Greg Jones, director of the hyperbaric center at Deaconess. “She turned a corner (Thursday) and she’s shown encouraging improvement in the last 24 hours.”

Difficult to diagnose and treat, necrotizing fasciitis is popularly referred to by the ugly and inaccurate term of flesh-eating bacteria. The bacteria does not eat flesh, but it does cause tissue to die. In severe cases, it can kill or cause the loss of limbs.

How Molly got the disease is unknown. She was born healthy and full-term.

Annette McGreevey noticed the area around Molly’s bellybutton was red and puffy on Sunday. An emergency room doctor near their home didn’t have any suggestions and told her to go home and watch the child overnight. Annette and her husband, Patrick, planned to return to the hospital at 3 p.m. on Monday.

“She just got worse. She was in so much pain. I couldn’t wait that long,” said Annette McGreevey. The couple also have an 8-year-old daughter, Rebecca.

Monday morning they saw another doctor, who told them to get to a larger hospital in Missoula, fast. Molly was admitted and placed on antibiotics at 3 p.m.

By Wednesday, her Missoula doctors had placed her on three of “the big dogs” of antibiotics. She was flown to Spokane when she didn’t respond.

“They took her into surgery the second we got here,” Annette McGreevey said. “I was flabbergasted.”

Doctors removed dead and infected tissue, continued the antibiotics and started the hyperbaric treatments.

Flooding Molly with oxygen prevents the bacteria from producing toxins, helps white blood cells kill the bacteria and helps prevent the necrotizing fasciitis from spreading, Jones said.

During the treatments, Molly is sedated. Since she is so young, there’s a risk she might forget to breathe. So during the entire two and half hours, a nurse “bags,” or assists her breathing.

Sweeny bags her 30 to 40 times a minute by squeezing a blue plastic device with her hand. She must do this the entire time.

Nurses who go into the chamber must be certified scuba divers who know how to clear their own ears as the pressure rises. Tubes have been inserted into Molly’s ears because she can’t clear them herself.

“I’ve dived in Hawaii and the British Virgin Islands,” Sweeny said. “But I never thought I would be doing this.”

In a sense, Sweeny is alone once she enters the chamber with Molly. If something were to go wrong, it would be 10 to 20 minutes before the chamber could be depressurized and opened.

For Sweeny, the hours spent in the chamber with Molly are unlike anything in her career spent caring for infants.

“Our goal with sick babies is touch them as little as possible” to avoid the risk of infection, Sweeny said.

And yet, for hours, she cuddles next to Molly. It makes her think about her own two children, now teenagers.

All Annette McGreevey can do is watch. There are a few brief minutes, as Molly is transferred from the intensive care unit to the chamber, when her parents can touch her.

They do. Gently. Her mother brushes her hair with a finger. Then turns to her husband for a hug.

“It’s amazing how quickly the little ones get into your heart,” Annette McGreevey said. “We don’t want to lose her.”