To a parent living through their most terrifying moment, only one thing matters - that help is on the way for their child experiencing a medical crisis. Nothing brings relief like the sight of

With a moment’s notice, this team of critical care experts can be wheels up in one of Cook Children’s air ambulances to travel to points all over the United States, Canada and Mexico. While these aircraft are known to air traffic controllers by their unique call signs, to the anxious parents waiting on the ground, these identifiers are more than a string of letters and numbers. They are a declaration of the help and hope on the way.

“We’re walking in on a family’s worst and darkest day, and we are always cognizant of that,” said Deana McLelland, RN, Cook Children’s Teddy Bear Transport nurse. “They are always relieved to see us. I like to say our name is ‘Oh good, they’re here’ because that’s what we always hear when we walk in to pick up the tiniest of babies or the sickest of kids. I love taking care of them and feel so lucky that this is my job. I get emotional just talking about it.”

McLelland has been doing this job for 29 years. She is an original member of the Teddy Bear Transport team, having joined during its start up after working as a critical care nurse at Cook Children’s Medical Center for 6 years.

In May, she climbed aboard and began flying the friendly skies in a new addition to Cook Children’s fleet of mobile intensive care units - a Pilatus PC24 twin engine jet. The aircraft replaces one of two Cook Children’s airplanes currently in operation and enhances the health system’s ability to transport sick and injured children to Cook Children’s Medical Center for care.

“Our older airplane, which is a 1982 Beechcraft King Air twin turboprop, has served us well, but it’s time to retire,” said Stacy Putman, Cook Children’s director of Transport. “Now, we’ll have two jets to transport children from all over the country and even internationally from Canada and Mexico.”

Rapid Response

In emergency medicine, every minute counts. Cook Children’s new jet is bigger and faster than its turboprop predecessor, and can travel further distances before needing to refuel. To sick children and anxious parents, this means they get the help they need sooner.

Teddy Bear Transport averages about 30 flights per month. Many of those bring children back to North Texas to receive care close to home after becoming sick or injured while traveling. Premature babies or critically ill children from rural areas of Texas and surrounding states who need advanced care in Cook Children’s neonatal, pediatric or cardiovascular intensive care units are transported by air, too. Teddy Bear Transport also regularly flies infants diagnosed with a rare and severe genetic disorder called congenital hyperinsulinism (HI) to Cook Children’s Hyperinsulinism Center, one of only six HI Centers of Excellence in the world. Congenital hyperinsulinism can lead to dangerously low blood sugar in infants. Without timely intervention, these infants are at risk of seizures and permanent brain damage.

Cabin Features

The new jet joins a transport fleet that includes a Cessna Citation Encore+ jet, an American Eurocopter 145 helicopter and six specialty/critical care ambulances. All are equipped with medical technology comparable to what is used in neonatal and pediatric intensive care units.

“We are a mobile ICU,” Putman said. “So everything we can do in our pediatric or neonatal ICU, we can do in the airplane. We can even transport cardiovascular ICU patients on ECMO (advanced life support).”

Every transport carries a team that includes a nurse, paramedic and respiratory therapist. They are the elite of the elite when it comes to pediatric emergency medicine, as they must be as proficient in caring for a micro-preemie born at 21-weeks as they are at caring for an 18-year-old teenager. Expert skill is a must, coupled with the composure to deliver care while flying through the air or traveling the highways below.

In addition to having a little extra in-flight leg room for the transport team, the bigger plane allows for more equipment, staff and passengers when needed.

“When we transport kids on ECMO, it doubles our equipment and our on-board staff,” McLelland said. “This jet gives us more room to take anyone we need with us, and that includes parents. In the past we’ve only been able to take one parent with us because of our team configuration, but this allows us the seating to bring two with us if necessary. Sometimes that child’s survival is on the line and we don’t feel good about leaving one parent behind if we don’t have to, so this is a really important feature for keeping the family together in these critical moments.”

Engineered for Safety

In addition to its critical care capabilities, both of Cook Children’s jets are equipped with leading-edge safety features, including a Wide Area Augmentation System (WAAS) and Traffic Collision Avoidance System (TCAS). The WAAS enhances GPS navigation, turning it into a precision guidance system that allows aircraft to land in lower visibility and at smaller regional airports, like those in rural areas frequented by Teddy Bear Transport. One of the most important safety features of modern-day jets, the TCAS prevents potential mid-air collisions by giving pilots a heads up warning of aircraft in the area and, if needed, escape guidance to avoid collision.

Other on-board assists, like a Nexrad weather radar and a terrain warning system, guide pilots in flying above storms, avoiding dangerous wind sheer and navigating obstacles on the ground.

Grounded, But Not For Long

Even after 29 years, McLelland says her job never gets old.

“Every time that motor starts, my heart skips a beat,” she said. “Every day is a new place, a new diagnosis and a new family, and I love the variety. I still say I cannot believe I get paid to do this job.”

When a breast cancer diagnosis last year temporarily grounded her, McLelland persevered and returned to work in March after a six-month leave of absence.

“When all of this cancer stuff started, my doctor asked what three things scared me the most,” McLelland said. “I told him leaving my job was one of them and he assured me I would go back to the work I love. I could not wait to get back. I’m really lucky to get to do it for as long as I have, and I’m not done.”

McLelland can’t wait to step aboard for her first transport in the new plane. Although flying on new wings, her wheels-up preparation will be the same as it has been for two decades—suit up and pray up.

“Every single morning on the way into work, I pray for my patients and their families,” she said. “And I pray for my crew that we will be wise and discerning and tender and take good care of the children we transport.”

Teddy Bear Transport by the Numbers:

• Operates 24/7/365

• 4,100 transports annually

• 10,000 referral calls handled each year by dispatch

• Staff includes 60 neonatal/pediatric nurses, paramedics and respiratory therapists

By Eline deBruijn Wiggins

For nearly 40 years, Teddy Bear Transport has extended the reach of the Cook Children’s Promise across the country – literally. This labor of love and commitment has taken patients and medical teams to-and-from Louisiana, Florida, New York, the West Coast and everywhere in between.

With about 4,000 transports each year, the Cook Children’s Teddy Bear Transport fleet is made up of seven ambulances, two fixed-wing aircraft (one jet and one turboprop), and one helicopter.

Most calls are in the Dallas-Fort Worth area, West Texas, East Texas and Oklahoma. The children transported are about 70% pediatric patients and 30% neonatal (less than 30 days old) patients.

“Many times we are their first experience with Cook Children’s and we take pride in being able to bring the very best care, that Cook is known for, to these patients and their families,” said Teddy Bear Transport RT Melinda Austin. “These people are beyond grateful and in some situations in these smaller towns, or sometimes larger cities where they do not have the resources to care for small children, we are their hope and so most people we run into are beyond grateful.”

The transport team brings referral patients to Cook Children’s, many times for the specialty clinics and doctors.

“Referring facilities and families are happy to see us because they know we’re bringing Cook Children’s to them,” said Teddy Bear Transport Director Stacy Putman. “Cook and our team have a great reputation and they’re excited to see us walk through their doors – our teams can feel that relief at times. The hard part is we don’t always have the answers that the families want. We reassure them that they’re going to the best place possible.”

The Teddy Bear Transport team is made of 16 neonatal/pediatric nurses, 15 respiratory therapists, 20 paramedics, 10 communications specialists, and two outreach educators. When a call comes in, the team determines which aircraft or vehicle to use based on the distance to the call, and each call receives a nurse, respiratory therapist and a paramedic.

“It’s the best job in the world. When I come in for my shift, I don’t know what I’m walking into or where I’m going that day,” said R.N. Stephanie Schmit. “We get to hop into one of our aircraft or ambulance and provide care to our patients. It is an exciting job. Every day is different, every call is different.”

Providing emergency medical care is a crucial job in itself – add on top of that the ability to provide care inside a small space on a moving aircraft. Schmit says the team works so closely together that when they’re treating a patient, they’re intuitive and can read what their colleague is going to do next.

“When we go up on the helicopter, it’s a nurse, paramedic and respiratory therapist, it’s just three of us,” Schmit said. “It’s us three and three backpacks, essentially, that we have to provide all the care. It’s a very small confined area. Sometimes we’re diving over each other to grab items and to give medicine. We work very well as a team, it’s a well-oiled machine.”

The transport team takes care of critical patients and has also been involved in transporting patients during emergency evacuations, such as Hurricane Harvey. The team members have been referred to as “the angels in blue jumpsuits.”

“Occasionally, we will get cards from families thanking us for taking care of their child, that is when we realize how meaningful our job is.  For these families and patients, this is their worst day, but for us, it’s our every day, so we have to be reminded how meaningful our job really is,” Putman said. “We engrained in our team so much to just be nice and give the care that you would want to be given to your own child.”

“The team, they do it so well that they don’t even realize that they’re doing it until they get these cards. This is our everyday life,” Putman said. “There’s no better job than on the Teddy Bear Transport team.”

I have had the privilege of working in the Emergency Department at Cook Children’s for 10 years, with three of those years as a nurse. I often have people ask me, “How do you do it every day?” or “What is the hardest part of your job?”

It’s hard to describe to an outsider just what happens inside our walls. One thing is certain, dear patients and families, I want you to know that we see you. Every Christmas I work, I remember my first one here. I walked in to find out we had already had two children die. To those families who lost their children, I want you to know that I see you and I think of you at Christmastime.

There are times when I drive home from work in complete silence and don’t even realize I forgot to turn on the radio. There are days when I have to sit in the driveway a few extra minutes before I go in to see my family, and they wonder when I am coming in.

To the mother who I sat with after she received news that her daughter’s cancer was back and metastatic, I see you and I remember you. I remember you when I walk in the door to see my daughter, who is the same age as yours. I see you when I don’t want to get up early to rush through the crazy morning. I see you when I’m lucky enough to drop my child off at school, knowing you would give anything to trade places with me.

As a nurse, I love nothing more than to send your child out the door feeling better and in good spirits. I will drop anything at a moment’s notice to have a bubble party or dance party. I’m never afraid to look silly in the name of making your child smile. I think most of us keep coming back to pediatrics because the good truly outweighs the bad. To the sweet sparkly princess who colored me a picture, told me thank you, and gave me a hug, you gave me the push to get through the rest of my day on a high note.

As an ER nurse, expectations and demands placed on me are high. I experience difficult situations every day. There are always more patients waiting who need care. I try to take a moment if I can to process what happened.

I am lucky to work with truly the best team of people who understand and who support me when I need it. It’s easy to feel lost and overwhelmed at times in our world. If you find yourself here with your child, I want you to know that each of your children impacts my life. They are the reason I come to work every day.

Megan Cole has worked at Cook Children's for 12 years, 10 of which have been in the Emergency Department. Outside of work, Megan enjoys baking, music and spending time with her family. To learn more about Cook Children's Emergency Services, click here.

Over the past five years, the Cook Children’s Emergency Department has seen over 50 fall-related injuries and more than 20 drownings during the July Fourth weekend. Parties, lake trips and higher amounts of people on the road are often the sources of injuries in children around the Fourth of July. With more distraction comes more risk of accidents such as motor vehicle, ATV/golf carts and snake bites. Many of these injuries are preventable and can be avoided with proper safety equipment and watchful eyes of parents.

In 2018, there were five drownings associated with the July Fourth weekend alone. Children in or around water should be watched by a responsible adult using the mindset of a lifeguard.

Corwin Warmink, M.D., medical director of Emergency Services, says adults should be within arm’s reach of young swimmers, especially in open water.

“The lakes are jam-packed and people are celebrating and not always using their best judgment. Overloading of boats is a recurring theme, everyone in a boat should have a life jacket within hands reach if not on,” Dr. Warmink said. “Letting children swim or out on open water during the Fourth of July is inviting trouble. We’ve had multiple injuries and deaths from people struck by boats while in the water and on kayaks or jet skis.”

In comparison, over the past five years, Cook Children’s has only seen three burns related to fireworks during the holiday weekend. Still, these injuries can be harmful and painful to a child. Dr. Warmink warns parents to be attentive especially during down times when activities are finished. Many injuries and deaths are preventable but can happen to anyone in 30 seconds or less of distraction.

“Fireworks rarely cause death but we often do see serious burns and occasionally injuries that could cause loss of an eye, finger or hand,” Dr. Warmink said. “Every year we have at least one tragic story that ruins not just a family's holiday, but their entire life.”

Top Injuries Seen at Cook Children’s During July Fourth Weekend

For More On This Topic:

• Lifeguard Your Child (Drowning Prevention)
• Aim For Safety (Protecting Our Children From Firearm Accidents)
• Vehicle/Car Safety
• Firework Safety Tips from SafeKids
• Is This an Emergency?

But when his daughter was diagnosed with pneumonia and admitted to Cook Children’s, he became every other worried parent … except with way too much knowledge of medicine for his own good.

Everything started a couple of weeks before Christmas.

Dr. Guzman was at work when he received a phone call from his wife, Abbie. She told him that Sophia Grace, their 6-year-old daughter, didn’t feel well.

Rarely do any of the Guzman children get sick. So this wasn’t normal for any of them, but especially Sophia. She is the “crazy child.” The one Dr. Guzman says will someday be the death of him because of her rambunctious nature.

When Dr. Guzman came home that evening, Sophia’s temperature was up to 104. He gave her a fever reducer that worked for a little bit, but he noticed his daughter wasn’t herself. She wasn’t running, playing or dancing like normal.

By the third day, he knew “something was weird.” Sophia wasn’t showing any other signs of being sick, except a fever and she was lethargic. She didn’t have a runny nose, congestion or cough.

“So I went into doctor mode,” Dr. Guzman said. “I looked at her ears and throat. I listened to her lungs. There was a change in there. Typically, these are the lungs of a kid with pneumonia.”

Dr. Guzman made an appointment for his daughter to see her pediatrician, Ben Worsley, M.D. Sophia was still running a fever steadily at 104, despite taking antibiotics. An X-ray confirmed what Dr. Guzman already expected. His daughter had pneumonia.

“I see kids every day,” Dr. Guzman said. “But when it is your child … Oh man … Your mind starts to go to places that are bad. I know the worst that could happen.”

Karen Schultz, M.D., the medical director of Pulmonology at Cook Children’s, took over Sophia’s care. Dr. Schultz and Dr. Guzman trained together during internship and residency in pediatrics and have known each other for more than 20 years.

Dr. Guzman admits to being a bit of a mess while his daughter was in the hospital. He continued to work in the Emergency Department for the first couple of days his daughter was at the medical center, until someone could take over his shift. He compartmentalized. In the ED, he was in complete control. But his heart was upstairs where he watched helplessly from the sidelines.

“I knew Sophia was in great hands,” Dr. Guzman said. “I knew we were in the right place and at a great institution. I trust everyone implicitly. I knew early on I needed to be just the dad and let everyone else do their jobs. I just felt helpless. I had no control of what was going on. It was so hard from a physician standpoint.”

Dr. Guzman learned his daughter shared his fear of needles. Yes, the emergency physician still has a fear of needles to this day and so did his daughter after being poked a few times during her stay. Suddenly the fun place her daddy worked became a hospital.

The night after being admitted, Sophia experienced breathing problems and her fever continued to spike. She wasn’t getting better.

John “Chip” Uffman, M.D., a surgeon at Cook Children’s, and Dr. Schultz met with Dr. Guzman and Abbie. Their little girl needed surgery to insert a tube into her chest and drain the fluid off her lungs from the pneumonia.

“I’m a wreck at this point,” Dr. Guzman said. “I know too much. It’s my job to calm parent’s fear, but I knew all the risks too. It was all going through my head and I just wasn’t thinking clearly or rationally. I knew for my wife and for my little girl, I had to keep it together.”

Dr. Guzman gathered his composure, but couldn’t help but think about the scared parents he sees as an emergency physician. He says he has become more aware of that process. He wants to be even more patient while talking to families and really make sure they understand everything he’s telling them.

But that would come later when he returned to work. For now, he focused on his daughter’s health.

The worst part for him was watching his daughter being taken away for surgery. She held out her arms to mom and dad. “That was heartbreaking,” Dr. Guzman said.

What Dr. Guzman didn’t realize was his daughter wouldn’t remember anything about the surgery.

“It was the hardest hour and a half of our lives, waiting on some news,” Dr. Guzman said. “But Sophia just says, ‘I took giggle juice.’”

The tube drained fluid from Sophia’s lungs and she continued to receive antibiotics through an IV.

Over the next couple of days, Dr. Guzman saw Cook Children’s through a patient family’s eyes. He saw the work of the therapy dogs and the music therapy program. She received a Build-A-Bear and even a visit from Santa.

“Everyone did such a great job to get her to smile and feel good,” Dr. Guzman said. “We are so blessed to have all of these things at Cook Children’s. I didn’t appreciate it as much as I should have. For the first time since she was in the hospital, I watched Sophia’s face just light up. It was so nice to see her happy again.”

Nearly a week after being admitted to the medical center, Dr. Guzman and Abbie were finally able to smile too. The chest tube was removed and after 18 hours of sleep that Dr. Guzman calls the “dark black spot,” Sophia woke up at 5:30 in the morning. She was ready to eat. She was ready to play. Her parents were ready to finally sleep. Their daughter was on her way to recovery.

“Now for Sophia, this has become a badge of honor. She tells her two siblings, ‘I was poked six times. I have a scar on the right side of my chest. I had a tube inserted. I was the first one in the family to have surgery,” Dr. Guzman said. “She wears this proudly. At the time, we were deathly afraid. It’s nice to see how she’s been able to cope and find so many positives about her stay. It’s just so great."

After all, they’d already seen one rough and tumble boy try to wreck the house and put everything in his mouth, so they were ready for the other two. Or so they thought, until one brief, fluke of a moment.

Heidi World Slaydon gave her son Blaze, who was 18 months old at the time, a bath. Heidi placed Blaze down briefly to grab something and when she picked him up, she realized he’d bitten into a laundry detergent pod. The pod box was said to be child-proofed and Heidi placed it so high up that she used a stool to reach it. But somehow, one got on the floor.

Chris Slaydon, Blaze’s father, said his little boy couldn’t have been on the floor more than 15 seconds. But that was enough time to put it in his mouth and bite into it. After calling poison control, the Slaydons were told to monitor their little child. Within a matter of minutes, Blaze was stumbling around like he was drunk. His parents scooped up Blaze and rushed him to the emergency room in Vernon, Texas.

Teddy Bear Transport took Blaze to Cook Children’s. He spent 10 days in the Pediatric Intensive Care Unit (PICU) after ingesting the laundry detergent pod. He suffered throat burn, infiltrated lungs and a blockage of airway passage, causing him to spend 10 days on a breathing tube.

Doctors treated Blaze with a strong dosage of steroids and a year later Blaze is doing well physically. Although his dad says his son still has the occasional nightmare about the traumatic event. He’s not alone.

“I can’t describe the utter fear we had then,” Chris Slaydon said. “It was terrifying. One, you are so helpless. Two, it’s a child full of innocence. We aren’t talking about an 18 year old. This is an 18 month old. We can’t even talk with him about what’s going on. He’s still in diapers. What happened to Blaze could happen to anyone.”

Single-load laundry detergent pods hit the market in early 2012. In the May 2016 edition, Pediatrics released a comprehensive report on the dangers of "Pediatric Exposures to Laundry and Dishwasher Detergents in the United States."

The study found that of the 117 children who required intubation, 104 were exposed to laundry degergent packets. During the study, 2013-2014, there were two deaths and both were linked to laundry detergent packets.

Because the number of children making contact with these pods, ConsumerReports^® announced that it would not include pods on its list of recommended laundry detergents and strongly urged households with children 6 and under not to keep them in the house.

Laundry pod exposures reported to Texas Poison Center Network (Oct. 1, 2014 – July 16, 2015):

Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children’s, says children under school age are particularly at risk due to the packaging of the pods looking like candy, so ingestion is more likely. Smaller children also are more at risk for severe complications.

The most common effects are vomiting, coughing, choking, fatigue or drowsiness and eye irritation/pain. But it can be much more serious.

“Deaths have occurred and these exposures can be quite severe, causing respiratory depression and failure,” Dr. Warmink said. “The easiest solution is to not keep any such detergent in the house, if you have children … especially under age 6. If you choose to use them, even after all the warnings, keep them in an absolutely child-proof, high cabinet. Although, I’m not sure if there is such a thing”

Just ask the Slaydon family.

“I’m not angry with the company or anything like that,” Chris Slaydon said. “This is a chemical and it’s manufactured to be extremely potent and concentrated. But because of that, it’s a lot more dangerous to kids. You can try to watch your kids 24/7, but it only took seconds for us to take our eyes off of Blaze. People need to be aware this can happen to them. Kids get into stuff. I don’t really blame anyone. I just want parents to be aware that it can happen to them and if you have a little child, don’t keep these products in your house.”

Learn more about poison prevention, by clicking here. 

Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children’s, knows that guns will be a popular gift this holiday season for not only children, but for adults too.

According to the journal Injury Prevention more than one-third of American adults own a gun. Last year, Cook Children’s saw 10 total injuries related to shootings of a gun (ranging from a BB to rifle). Since 2009, Cook Children’s has seen 104 shootings and three deaths.

Dr. Warmink asks parents to explain to children that BB guns can be dangerous, with harm ranging from severe eye damage to liver and kidney injuries.

Dr. Warmink says it’s important that parents educate their children about gun safety and make sure kids know to leave the area if another child, or someone other than their parent, has a gun.

“We live in Texas and I know many kids are raised hunting and have guns in the home,” Dr. Warmink said. “But if you give your child a gun for the holidays or if the adult in the house is given a gun, it’s important to take the proper precautions. The thing we want parents to remember is to keep guns locked, unloaded and separate from ammunition”

1. Lock the gun and keep it out of reach of kids. Hiding the gun is not enough.

2. Unload your gun. Take all ammunition out of the firearm.

3. Store the keys for the gun in a cabinet or safe different from your household keys. Keep the keys out of the reach of children.

Along with guns and replica firearms, such as airsoft guns that use hydraulics to shoot pellets, Dr. Warmink lists these gifts as dangerous and even life threatening:

• Ripstik Casterboard, Skateboards, roller skates …
• Pull toys with strings over 12 inches
• Trampolines
• Backyard playground equipment
• Hard plastic swords

Sharon Evans, Trauma/Injury Prevention coordinator at Cook Children’s, knows that owning a bike or scooter is part of growing up. But she encourages parents to take the proper precautions before placing wheeled gifts under the tree.

“Parents, please don’t forget a helmet for all riding toys,” Evans said. “Make sure the helmet is on properly and read the instructions.”

For younger children, Dana Walraven, manager of Community Health Outreach at Cook Children's and coordinator of the Safe Kids Tarrant County Coalition, warns parents to be aware of any small parts or potential choking hazards from their own toys or perhaps older siblings.

“The holidays can be an especially dangerous time for the little ones,” Walraven said. “Pick out toys and activities that will be appropriate for their age. On Christmas, designate an adult to supervise the children. It’s surprisingly easy to lose track of small children and with just a little planning we can keep choking hazards away from them. When it comes to young children, preparation is key.”