Trauma team works quickly to save girl hurt in snow-tubing accident

Abbagale Jacques is a barrel racing phenom, so talented that she qualified for the World Championships this summer. But the girl from Colleton County, South Carolina, has had to stay out of the saddle since a January snow-tubing accident. Abbagale crashed into a parked trailer, leaving her with life-threatening injuries.

“She had what they considered a polytrauma,” Abbagale’s mother, Ashleigh Murray, said. That means the girl had multiple traumatic injuries. Abbagale was rushed by helicopter from the town of Ruffin, where the accident occurred, to the MUSC Shawn Jenkins Children’s Hospital in Charleston.

 

Trauma surgeon Laura Hollinger, M.D., was part of the team that met Abbagale as she arrived in the Emergency Department. “She had multiple bone fractures both within her central body as well as her extremities. She had numerous facial fractures and had multiple blunt organ bruises with bleeding on the inside as well as an aortic tear,” the doctor said.

Hollinger described the aortic tear as a rare and severe injury. “This was an immediate threat to life. We do not see blunt aortic injuries like this in the pediatric world very often. I would say that's a particularly unusual injury.” 

That injury could have killed Abbagale, she added. “I think in many patients who do not survive accidents, like those who are dead on arrival or die at the scene, it could be from a blunt aortic tear because you essentially just bleed out. You basically tear the main artery of your heart. So these are potentially non-survivable injuries.”

 

Fortunately, Abbagale did survive and was brought to a hospital that not only has pediatric specialists in more than two dozen areas but also collaborates with experts in adult health care. That connection meant Abbagale had immediate access to the MUSC Health Heart and Vascular Center and its surgeons, who have years of experience in treating aortic injuries. 

Ravi Veeraswamy, M.D., chief of Vascular Surgery, described their approach to helping Abbagale. He worked closely with Chun Li, M.D., on the next steps. “We were able to go in, put a stent graft and stabilize that area. And we did it with minimally invasive techniques. So she avoided major open surgery,” he said. A stent graft is a tube that a surgeon places in the aorta to protect the damaged area and allows blood to keep flowing through. 

So the most severe problem had been addressed, to her family’s relief. But Abbagale was still badly hurt and needed a total of four operations. Orthopedic specialists treated her broken femur, pelvis and collarbones with the help of surgical teams that supported them. Experts in other specialties, including ophthalmology, oral and maxillofacial surgery and pediatric critical care were involved in Abbagale’s care as well.

 

Hollinger is glad the teenager ended up at the MUSC Shawn Jenkins Children’s Hospital. “It took complex, high-level, multidisciplinary care to take care of this patient. I think if she had ended up in another ER first, it would've been very difficult. Particularly during an ice storm. Her care would've been delayed. And I worry about what the consequences would have been.”

It was a reminder, she said, of the importance of getting children to hospitals that specialize in pediatric care. The MUSC Shawn Jenkins Children’s Hospital is the top-ranked children’s hospital in the state, according to U.S. News & World Report. Its doctors are part of an academic medical center and stay on top of the latest innovations, research and techniques.

Abbagale is now home with an all-terrain wheelchair she uses on her family’s property. “She’s still enjoying the farm life. Nothing can hold her back; she’s a very strong girl,” her mother said.

 

Murray credits the team at the MUSC Shawn Jenkins Children’s Hospital for making that possible. “I trusted them with my baby, and I'm glad that I did. No, no question about it. MUSC is the place to go,” Murray said. “I just think it was all of the teams working very, very well together with one goal in mind – and that was to not lose her.”

And yes, Abbagale is still hoping to compete in the World Championships this summer. “So by July, we have to make sure she’s OK,” her mom said.