Killian Gonzalez, a 4-year-old boy from Nevada, is lucky to be alive. On May 22nd, he was travelling with his mother on a highway in Idaho following a birthday party. They were driving in a severe hailstorm when their vehicle skidded and collided with another car.
Killian was in a protective car seat but he suffered what experts describe as one of the most traumatic injuries a child can experience in a car crash. Put simply, his skull and spine were dislocated, a condition that surgeons frequently refer to as an internal or “clinical decapitation.”
Two Good Samaritans
Killian is alive today in large measure because of wise actions of two Good Samaritans, Leah and Joel Woodward. Their swift and smart aid helped saved the boy’s life.
As it happened, the couple were driving home from a camping trip when they came upon the accident. Joel, an off-duty police officer, surveyed a gruesome scene. Two mangled cars littered the road. The driver of one car was bloodied, disoriented and pinned inside a car.
The Gonzales were in the other car. Killian’s mother, Brandy, was injured severely, suffering multiple fractures of her arms and legs. But she was alert and trying to talk to her son, who was hunched over and whimpering as he flickered in and out of consciousness.
Brandy could not move to help her son or even unlock the car door for rescuers, so Joel broke one of the windows in order to reach Killian.
It later become clear that Killian’s skull had separated from his spine by the force of the crash. He had suffered what surgeons colloquially call an internal or clinical decapitation, which means that “the ligaments, muscles and joints that connect the base of the skull to the top of the spine are damaged.”
Doctors say four of the six ligaments connecting Killian’s skull to his spine were stretched an inch or more by the force of the accident. Dr. Nicholas Theodore, who specializes in spinal surgery at the Barrow Neurological Institute, explains that the term “decapitation” in this context is more dramatic than medical since the ligaments were not actually severed. As he notes, the use of “the term ‘decapitation’ in the true sense of cutting someone’s head off, is a bit extreme.”
Nevertheless, Dr. Theodore cautions that internal decapitation is most certainly a life-threatening injury and that children are particularly vulnerable to this kind of trauma because their neck and spinal musculature remain relatively weak and undeveloped during their early years.
Suspected Spinal Cord Injuries — Don’t Move the Victim
After breaking a window, Joel climbed into the car and carefully extracted Killian, making sure to keep the youngster’s head immobile. Medical and rescue experts say that it is essential not to move a victim of a spinal or severe neck injury any more than is absolutely necessary. As Dr. Theodore notes, in cases of suspected spinal trauma “you don’t ever want to move an injury patient unless a car is on fire. Immobilizing a child is exactly what you want to do.”
Joel gingerly handed Killian to his wife, Leah, telling her to keep the boy upright and his head steady. Leah admits her first instinct was to cradle the youngster in order to comfort and console him, but doing so almost certainly would have been fatal. Instead, she kept his head securely in place until help arrived 30 minutes later. Their calm and informed actions probably saved his life.
Reportedly, doctors at St. Luke’s Hospital did not have to perform surgery in Killian’s case. Some patients are treated by using titanium rods, wires and screws to reconnect the skull and spine, which have been fractured, dislocated or severely damaged.
Recovery
Killian since has been discharged from the hospital and is now recovering at home. He’s wearing a temporary brace collar, which supports his head and neck. Despite the severity of his injuries, which also included a broken arm and a ruptured spleen, the little boy is making an amazing recovery. His equilibrium is still off and he doesn’t want to talk about the accident, but he is able to take small steps on his own.
Car Seats Save Lives
A properly fitted, age-appropriate and approved car seat is a must for all children. Recommendations from the American Academy of Pediatrics include a rear-facing seat for toddlers up to the age of 2. Forward-facing car seats and booster seats are generally advised for pre-schoolers and grade-schoolers respectively.
Real-life car seat recommendations are best governed by individual height and weight ratios rather than age. Generally speaking, however, virtually all children under the age of 13 should only travel while buckled securely in the back seat.
—Scott O’Reilly
