Safe in Their Treehouse

Where’s the ladybug? I can’t see it,” Liz Mullis asks her son, Jonathan.

“I can! It’s there by the plug!”

Jonathan Mullis quickly spots the painted insect—no bigger than a pinpoint—hiding on the walls of the Pediatric Sedation Unit of Eastern Maine Medical Center. Here, patients like 6-year-old Jonathan can receive special attention to make stressful or uncomfortable medical procedures more pleasant. In the past, pediatric sedation consisted of either full anesthesia or very little at all, and children were sometimes held down for procedures, leaving many of them with a traumatic memory. However, with rooms that resemble a tree house and an enthusiastic staff at EMMC, the new methods of pediatric sedation are quickly making trips to the hospital more enjoyable for families and children alike.

Children who undergo medical procedures generally experience anxiety or stress beforehand. Instead of struggling with doctors and parents, children and families now have the option of using the pediatric sedation team, which involves giving children relaxation medication through a child-sized intravenous line (IV). The staff uses distraction techniques and a numbing cream so the IV can be inserted painlessly.

In the past, oral sedatives were used, but produced varied results. “Sometimes the kids wouldn’t go to sleep, they suffered from nausea, it was all variable,” says Jenny Hughes, pediatric nurse. “Here, they all go to sleep and they all wake up feeling fine.”

The pediatric sedation team often serves children who require a series of treatments such as cancer patients, as well as kids who have trouble dealing with average medical procedures, such as MRIs, which require patients to lie very still in a small space for an extended period of time. If a child has trouble with this, then pediatric sedation may be an option for them, depending on their medical history. “The majority of kids we help are anxious and scared. Some have had traumatic experiences with sedation before, and freak out,” says Dr. Jonathan Wood. “Here, they fall asleep and wake up in a tree house.”

When a child is asleep, a member of the sedation team is always present with the child, and family members are encouraged to be in the room as well. Their success is evident in young patients like Jonathan Mullis, who came to the pediatric sedation unit after being diagnosed with a brain tumor. Although he sports a newly shaven head, Jonathan also shares a huge grin whenever Hughes or certified child life specialist Amy Baker steps into the room. So far, he’s completed one of six chemotherapy treatments, and his family maintains a positive outlook for the future.

“Visiting the hospital was a part of our daily routine for seven weeks,” says his father, Brian Mullis, “and he never once whined, cried, or said ‘I don’t wanna go today.’ They made him part of a team. We feel like the family we have in Dover-Foxcroft is expanded within the walls here.”

However, they aren’t ordinary walls. No, the walls of the pediatric sedation unit form something far more exciting—a tree house. Created in 2007 with the help of Eastern Maine Healthcare Charities and the Children’s Miracle Network, the tree house provides a unique environment with painted leaves scattered on the floor, and friendly animals covering the walls. Among the moose, rabbits, and raccoons, kids can happily forget that they’re in a hospital. Instead, they focus on a fox about to pounce on that bird, or finding the tiny painted ladybugs. The artwork, done by Mark McCullogh, Virginia Earley, and Annika Earley, even spills into the bathrooms, where the glow-in-the-dark paint reveals a hidden forest scene once the lights go out.

Combined with a specially trained staff, the pediatric sedation program provided at EMMC is like only a few in the nation, and is the only one in Maine. “Most kids who get sedation in this country don’t get it in a system that is as organized as it is here,” Wood says. “We work under the best case scenario,” adds Hughes. “We know what’s safe, and what’s not, to get the procedure done, and get it done well.”

Around 700 sedations were accomplished this year—up 21% from last year—and next year, Wood expects to complete about 1,000 sedations.
Although the program at EMMC was an early contributor to pediatric sedation, Wood also visited Dartmouth Hitchcock Medical Center—a national leader in pediatric sedation—in 2003 to learn more about their process. He’s also attended pediatric sedation consortiums and talked with other doctors about new data and the safety of the procedure. “I decided that this was something we would try to do,” Wood says. “With the right environment, and the right people, it can be an enjoyable experience.”

The right people include Dr. George Payne and Dr. Amy Movius, who came from Tacoma, Washington, with extensive experience in pediatric sedation. “She walked in having done hundreds of sedations in the six years prior to her arrival,” Wood says. “She brought a certain comfort level.” Together, Payne, Movius, and Wood represent close to 60 years experience in pediatrics. Combined with Baker and Hughes, they form an unbeatable team with one major thing in common: All of them love kids. “We’re like the grandparents,” Hughes says with a laugh. “The kids come in, we spoil them, and they leave happy.”