On Feb. 24, 2022, 4-year-old Nora Matthiesen was outside, playing in the snow with her dad and sister.
And it’s a miracle she was, because just one year earlier, her family didn’t know if she’d be alive.
‘It’s the worst day you could have as a parent’
Jed and DeAnn Matthiesen are Nora’s parents, and live on a farm outside Luverne, Minnesota.
That day, Jed was planning on shearing sheep – one of Nora and her sister Mara’s favorite things to watch. DeAnn joined Nora and Mara outside. After a little while, Mara got cold, so she and DeAnn went inside. Nora stayed out to keep watching.
Jed loaded up his tractor with the bags they needed to use to bag the sheep’s wool.
“I lost track of little Nora here,” he said holding Nora while she smiled, laughed, and bounced on his lap.
“And I backed up, felt the tractor lift up on the rear end. And it was a bad feeling because I looked around, I knew exactly what had happened. I pulled around and there she was, laying underneath the tractor wheel,” Jed said through tears.
“It’s a feeling you can’t explain. You never want to go through it in your life,” he added.
Jed sprinted back to the house to get DeAnn and call 911.
“I heard a panic at our front window, and it was Jed. And he was yelling at me that I needed to come outside, and I could just tell the fear in his face,” DeAnn said through tear-filled eyes.
First responders hear the call
Jill Johnson and Tricia Huiskes are EMTs at Sanford Health in Luverne. They heard the call come in and were the first responders at the scene.
“We looked at what the page was, and it said that there was a child that was run over by a tractor. Your heart sinks, and you think the worst,” Johnson recalled.
Huiskes said as she was racing the ambulance toward the scene, her mind was racing as well.
“I remember driving and trying to picture what the scene was going to be like. A lot of thoughts run through your head. It’s a small town, so will you know the family? When you get there, what condition will the patient be in?” she said.
They rushed Nora and her mom to the Sanford Luverne emergency room.
“I rode with her to the emergency room and remember leaving Jed, just how scared he was. I was scared for him, and I was scared for my daughter,” DeAnn recalled.
When they got to the Luverne emergency room, Nora was intubated, given medication and sedated. DeAnn remembers the medical staff saying “she was going downhill pretty quickly.”
Flown to Sioux Falls, with a team waiting
It became clear Nora needed to be flown by air ambulance to Sanford USD Medical Center in Sioux Falls, South Dakota.
Once she was there, an entire team of specialists were waiting for her – Dr. Ashley Sandeen, a pediatric intensivist, Dr. Scott Keckler, a pediatric surgeon, Dr. Mir Ali, a pediatric intensivist, and Dr. Eric Trumble, a pediatric neurosurgeon.
They explained the accident caused Nora to have:
- Three skull fractures
- Intracranial bleeding (bleeding inside the skull)
- Cerebral edema (fluid build-up around the brain)
- Non-reactive pupils, signifying poor brain stem function
- A severely swollen brain
- Injuries to her lungs, chest wall, liver, and spleen
Each of the providers had separate jobs to do, but all worked together fluidly to save Nora’s life.
Dr. Keckler said having an all-hands-on-deck approach available at Sanford was critical.
“We can offer all the services that a severely injured child would need. With our collaboration and our good rapport with all of our team members, we can deliver great care,” he said.
Extent of Nora’s injuries
Dr. Ashley Sandeen said at the time of arrival, Nora’s brain was already severely swollen.
“We saw some of the significant side effects of that swelling and trauma. She had seizures and the pressures inside her head were very high,” she said.
For context, a normal level of intracranial pressure is less than 20. Nora’s was 35.
“On day one I had a very strong feeling (and) concern that she would not survive,” added Dr. Mir Ali.
Dr. Ali went on to explain that when a brain is injured, “it becomes angry.” When a brain becomes angry, it starts to swell. It typically takes two to three days for the swelling to peak, which caused Dr. Ali and others significant concern because Nora’s brain was already very swollen.
Dr. Ali said there are three components inside a skull that all work together. The bone that is covering the brain, the blood that supplies oxygen to the brain, and cerebrospinal fluid, “which acts as a buffer to the brain.”
If one of those components increases, the others must compromise. So, if the skull is hard and intact, the brain doesn’t have anywhere to swell.
Injuries ‘ended up probably saving her life’
Believe it or not, this worked to Nora’s advantage, Dr. Trumble explained.
Because Nora had 3 separate skull fractures, this helped the brain to swell safely.
“The tractor had literally run across the back of her head and crushed that portion of the skull. So, that was obviously a very concerning finding. In the long run, it ended up probably saving her life because what we do when patients have severe head injuries with global edema is we take off a piece of the skull.
“The fracture she had had already had a free-floating piece of the back of the skull. And so, that allowed the brain to swell without causing permanent damage in her case,” he explained.
This allowed providers to be more aggressive in treating her intracranial pressure, while she was in a coma for roughly one week.
‘Miracle child’ comes home
Four weeks after her accident, Nora was back on the farm.
She’s healthy, plays with her sisters, runs around in the snow, and does everything a child would normally do.
If you’d just met her, you would have no idea any of this had happened to her.
“She’s our miracle child. We didn’t know what to expect or where we’d be at a year from then. She made great strides and progress. We were very blessed. God was looking after us and we’re just very fortunate to have her here yet today,” said Jed.
And that’s something Nora herself knows, DeAnn said.
“The other day my sister was riding in the car with her, and she said, ‘Nora, you are just so cute.’ And Nora said, ‘I know, because I’m a miracle.’”
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