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I wrote this story in 1997 for the Omaha World-Herald

Copyright 1997 Omaha World-Herald
January 26, 1997 Sunday SUNRISE EDITION
SECTION: NEWS; Pg. 1A
HEADLINE: Of Heroes and Kind Hearts: Rescue of Twin Girls Took Many Hands
By STEPHEN BUTTRY
WORLD-HERALD STAFF WRITER

 Jennifer's tiny heart gave up. But no one else would.

  As paramedic Gary Wood reached to lift 3-year-old Jennifer Woracek onto a
stretcher to take her to a helicopter that would fly her to another hospital
for more life-saving treatment, the gold line on her heart monitor went flat.

  Two hours after police began an intense search for Jennifer and her twin
sister, Kourtney, an hour after the snow-caked girls arrived at the St.
Joseph Hospital emergency room, the stress of subzero cold finally wore down
Jennifer's 40-pound body.

 Paramedics quickly checked the connections between the girl and the monitor.
They were secure.
Jennifer's heart had indeed stopped beating.

 Life Flight paramedic Corrie Vrbicky told Dr. Charles Denton, "We lost the
rhythm." No one wanted to panic the girl's already distraught parents,
who were watching nearby.
Wood discreetly reached under the blanket that was wrapped around the frozen
girl, found the right spot on her chest and pressed firmly down with one hand,
pumping her heart for her.

 Vrbicky asked Dr. Denton, the emergency room physician, "Do you still want
her to go?" With a wave of his hand, the physician sent the flight crew
away, saying: "There's nothing more we can do for her here." Jennifer's chance
at survival rested with equipment at Children's Hospital that would draw her
69-degree blood from her body, warm it and pump it back into her.
She needed to get to Children's immediately.

 Helping hands would pump her heart for her.
First Wood steadily compressed her chest as she was carried out to the
helicopter.
On the three-minute flight to Children's, flight nurse Kerri Alexander
continued the rhythmic pushing on the child's chest.
At Children's, Dr. Stephen Raynor met the flight crew and placed his hand on
the girl's chest, firmly squeezing the heart as she was wheeled to
the operating room.

  A succession of heroic and healing hands saved Jennifer and Kourtney when
their early morning adventure went awry on a bone-chilling, 9-degree-below-zero
Nebraska night.

 The story of the twins' disappearance, rescue and fight for life has
captured the attention of the community and the nation.
The story reaches into the heart of parents, nearly all of whom have
been frightened at some time by the inexplicable boldness and inventiveness
of carefree 3-year-olds.

  Like the police who searched for the twins in the dark, cradled them to
their chests and dashed to the hospital, like the medical professionals
who removed the crusted snow from behind Jennifer's neck and between
Kourtney's toes, parents shudder at the story, thinking: That could have been
my child.

 A Worried Mom

       The work of the dozens of law enforcement and medical
professionals began at 4:03 a.m. on Friday, Jan. 17, when the twins' worried
mother called 911.

  Operator Lisa Jackson answered: "911 Omaha." "Yes, my name is Marlene
Woracek and my babies are missing.
It's a long story." Mrs. Woracek, confused about where the twins were,
indicated that nocturnal mischief wasn't new to the 3-year-old
co-conspirators: "At Christmastime they got up in the middle of the night,
and they came downstairs and opened all the presents and everything." While
Mrs. Woracek was on the phone, her husband, Tom, and Lindsay, their
fifth-grade daughter, continued their own search.
"Lindsay, get in!" Mrs. Woracek ordered once during the phone call.
A bit later, she directed, "Lindsay, look through the house."
Police dispatcher Sue Steffel called for an officer, and Officers Brenda
Murabito and Lou Briganti headed to the house.

  At 4:10, Mrs. Woracek called 911 again.
This time she knew the twins were out in the cold and she was upset, talking
fast and crying.
"They went outside our back door," Mrs. Woracek said.
"They have their backpack out there!
I don't know how they got our back door open." The officers were arriving as
Mrs. Woracek was on the phone.
They found Tom Woracek outside, looking for his daughters.

 The parents told the officers they had put the twins to bed at 9:30 p.m.
and the house had been tidy then.
When officers arrived, toys, pieces of Monopoly and other board games and some
contents of a desk were scattered in the living room.
Crackers were on the floor.
Some "nutty bars" had been pulled out in the kitchen.

 The officers immediately called for more police and began the dual task
of searching the house and looking outside.
A canine unit was called to help.

 Sgt. Mary Schindler arrived and directed the search.
Officers looked through the house, including crawl spaces, the garage and two
vehicles in the garage.
They knew children who are missing often are found hiding in their homes.

 The Woracek twins are "feisty," often plotting together in fun and mischief.
The parents told officers, "What one does not think of, the other one does."
Some of the children's clothes were missing from a stack of folded laundry on
a table.
Their coats and brown boots were missing from the house.
Their mittens and hats were still inside.

  The doors had locks to prevent children from getting out.
It was a bit confusing which door the children had used.
The front door was open, the girls apparently having mastered that lock.
The back door was locked.
But outside the back door, the girls' father had found footprints, a purple
coat and a Pocahontas backpack containing two nutty bars.

  It appears they might have gone out the front door, then tried to get in
the back door.

 Officer Russell Horine and Basko, his Belgian Malinois police dog, began
searching for the girls, using the coat and backpack for the twins' scent.

 The officers checked doorways, under porches, a carwash and gas station
across 13th Street, anywhere the tots might have sought shelter.
Sgt. Schindler told officers to check the area on the way to and around the
girls' preschool, Christ Child Center, a half-mile away at 10th and
William Streets.

 Police overhearing the radio discussion began flocking to the area.

 Officers divided into teams of two.
One searched on foot while the other crept along in a warm cruiser nearby in
case the girls were found.

  Officers Troy Kister and Warren Walter turned from 13th Street onto
Center, heading east.
It's a steep hill, rising so fast that the elevation half a block east
is about level with the peaked roof of the Woraceks' two-story house.
Three inches of snow and the incline made it nearly impossible for the cruiser
to make it up the street.
Their tires started slipping at the entrance of an alley halfway up.
While Walter turned the car around, Kister stepped out.
His eye was drawn to a tiny footprint in the snow.
At 4:40, other officers heard the first encouraging news over their radios:
"I've got fresh prints that look like small foots." Kister asked for a
canine unit.

 Walter got out of his car.
Horine and Allen Wagner hurried across the street and up the hill.
The decided to follow the footprints down the alley.
They left the dog behind, figuring it was unlikely Basko could pick up a scent
on snow in that bitter cold.

  The alley, running about 175 yards parallel to 12th and 13th Streets behind
the carwash and Troia Funeral Home, is the proverbial dark alley.

 It is lit by a single street light at the north end, on Hickory Street.

  The officers started at the south end.
Cedar, pine and scrub trees, plus the elevation, shield the alley from the
street lights of 13th Street.

 Snow 5 to 6 inches deep covered an unpaved surface with deep ruts.

  The officers trudged along, training their flashlights on the tiny
footprints.
As they got about halfway down the alley, Walter left the group to move his
and Kister's cruiser to the north end of the alley, where it would provide
warmth for the officers, and hopefully for the girls.

  After about 100 yards, Kister's flashlight illuminated the children's small
tan boots, stuck in the snow.
Shuddering at the thought of the girls in their bare feet, the officers
proceeded.
About 15 feet farther, a flashlight's beam found the twins.

 Jennifer was lying still, face down, without a coat.
Her hands were partially closed, covered with snow, as hard as ice.

 Kourtney was kneeling beside Jennifer, her purple coat unzipped.
She was wearing a red and gray sweat shirt, blue floral print sweat pants and
no socks or shoes.

 It's unclear whether Kourtney said anything immediately to the police.

  Kister's report includes a quote, "Help my sister," but doesn't state
that Kourtney said it.
Kister later said he didn't recall the girl saying that.

 Emergency room workers at St. Joseph remember Kister telling them that
Kourtney looked up at the officers with an alarmed look on her face, as if to
say, "Help my sister." The officers did.

 Kister picked up Kourtney.
Horine picked up Jennifer, and they began sprinting south, back the way they
had come.

  "We need a squad (an ambulance)," Kister radioed at 4:48.
"We found the parties." Moments later, he breathlessly called off the
ambulance.
"We're going to take her to St. Joe's.
We're going to expedite." As the officers reached the end of the alley, Sgt.
Schindler pulled up in her cruiser.
Horine handed Jennifer off to Officer Wagner, who also is a paramedic with
the Bellevue Volunteer Fire Department.

 Wagner wrapped the girl in his jacket and climbed into Schindler's car.
They raced for St. Joseph, three miles away.

  Kister handed Kourtney off to Officer Kathleen Novotny, who climbed in the
back seat of Walter's cruiser, wrapped the girl in a police jacket and cuddled
her "as close to my body as I could." Officer Novotny asked the girl her name.
She clearly answered, "Kourtney and I'm cold." As the squad cars raced to
St. Joseph, their sirens wailing and lights flashing, they radioed 911 to call
the hospital and asked other officers to bring the parents to the hospital.

 ER Moves Into Action

       The 911 operator called St. Joseph, telling the
emergency room staff they had two children coming in with exposure.
The call described the children as "Code 3" - life threatening.

  At 4:55, Wagner dashed from the patrol car through the ambulance entrance
to the ER, and ran to examination room 7, carrying Jennifer bundled in his
jacket.

  Kourtney was right behind.
Officer Novotny handed the girl to Ms. Alexander, who carried her to room 9.
Kourtney told the staff her name and Jennifer's.
She was speaking softly and nurses couldn't hear everything she said.
Ms. Alexander thought Kourtney said something about "trying to get inside,"
possibly a reference to the twins' efforts to get in the locked back door of
their house.
She also asked where Jennifer was and where her parents were.

 When the mom and dad arrived minutes later, they shifted between the
girls' rooms, providing reassurance and holding frozen hands.

  Dr. Denton, with nearly 19 years of experience in the St. Joseph ER,
concentrated mostly on Jennifer, while a resident, Dr. Richard Jones, tended
to Kourtney.
Nurse Gayle Mielke and paramedic Gary Wood were at Jennifer's side, while
Angie Jedlicka took care of Kourtney.
Pam Reinke, the ER charge nurse, assisted with both girls, as did Ms.
Alexander.

 Dr. Denton first checked Jennifer to see if she was even alive.
She looked dead.
Her eyes were open and unblinking, her pupils big.
She wasn't moving.
Her pale skin had a translucent-looking pallor, interrupted by patches of
bright cherry red.

 Paramedic Corrie Vrbicky recalls thinking he'd "seen dead people look
better than that color." Her body was rigid, her legs straight, her
arms straight down by her sides.
Normally, when you pick up a child, she bends at the waist.
Wood noticed "there was no flex to her back." Finally she took a breath.
Feeling her frigid chest, Dr. Denton found a pulse.

  Ms. Mielke took her vital signs: Pulse 40 beats per minute (normal would be
about 100 to 120); respiration four breaths per minute (normal would be 20 to
the mid-30s).

 Taking the child's temperature was difficult.
The first thermometer used would not register below 85 degrees.
They got a warming blanket that had a rectal thermometer that went lower.
The reading shocked the seasoned ER staff: 20.5 degrees Celsius.
That's 68.9 degrees Fahrenheit.

 Normal is 98.6. A temperature below 86 can stop the heart.
Falling below 77 can stop breathing.

  Disbelieving, Wood and Ms. Mielke checked again with another probe.
It also said 20.5. Kourtney was not as dire.
Her temperature was 94.5, he pulse 138 and her respiration 38.

  Wood removed a chunk of compacted snow, about the size of a cereal bowl,
stuck to the back of Jennifer's neck and shirt.
Both girls' feet were encased in snow.
Nurses had to brush the snow out from between their toes.

 After Jennifer had been in the ER nearly an hour, she still had crusted
snow in the creases of her fists.
Her hand hadn't relaxed enough that medics could scrape it out, and her
body hadn't warmed enough to melt it.

 Paramedics and nurses cut away the children's frozen clothes.

 A Bair Hugger, a combination blanket and air mattress through which warm
air is pumped, was used to warm the skin.

 Kourtney's feet, which Ms. Reinke described as "deep, concord-grape
purple-black" - were immersed in 105-degree water.

 Children are difficult to start on intravenous solutions in normal
conditions.
Somehow, Ms. Mielke found a vein on her first poke into Jennifer's icy arm and
began a warm IV saline solution.
The comatose girl didn't react to being poked.

 Drawing blood, Wood was sickened to feel through the tube how cool it was.

 Denton had never seen a pediatric hypothermia case this severe.
He knew quickly that the girl's blood needed to be warmed rapidly using a
bypass procedure.
The blood would be pumped out of her body, warmed mechanically and returned.

  St. Joseph didn't have a pediatric catheter that would be needed to perform
the bypass.
Children's Hospital did.
The ER staff called Children's, which rapidly began assembling a
surgical team.

 St. Joseph began preparing Jennifer for the transfer.
A 4.5 millimeter breathing tube was inserted to pump warm oxygen into
her lungs.
Her eyes were taped shut.

 Life Flight pilot Bill Flannery began warming the medical helicopter
outside the St. Joseph ER.

  Ms. Mielke, unable to spare time to look for paper to write on, scrawled
information such as vital signs and the size of the breathing tube on the bed
sheet, then hung onto the sheet "like Linus" after Jennifer had left.

 A crowd of more than a dozen police had gathered in the hallway, fearful.

 "It was obvious to us that Jennifer was in very, very bad condition," Sgt.
Schindler said.
"Quite frankly, we didn't have much hope she would get to Children's." As the
ER workers and helicopter crew were ready to begin the transfer, the heart
monitor's line went flat.

 In a warmer or larger body, that would have precipitated a bustling,
obvious resuscitation scene - defibrillation paddles providing electric shock
to the chest, a paramedic or nurse leaning over the patient to use both hands
to compress the chest.

 Defibrillation is not an option in severe hypothermia, because the patient's
system is too fragile to withstand the shock.
On a child as small as Jennifer, a single hand with firm pressure is enough to
compress the chest.
Using both hands might crush the chest.

 Dr. Denton saw no point in keeping Jennifer at St. Joseph to revive her
before she left.
Drugs normally used in cardiac arrest are useless when the body is too cold to
circulate the drugs.
The helicopter crew could keep her heart beating on the trip to Children's.

 Wood quickly reached inside the blanket and began pumping the girl's heart.
Ms. Alexander rushed to the helicopter alongside the child and took over the
heart massage.
She and Vrbicky accompanied Jennifer across town.
The girl's parents asked if one of them could fly with Jennifer.
They were told no, there wasn't enough time to prepare them for the flight.

  The helicopter lifted off at 6:08.
As it raced to the other hospital, St. Joseph's ER staff called Children's
and passed along all the information they could, including that a nurse had
jammed a piece of paper with Jennifer's blood gas readings into Ms.
Alexander's right pocket.
At 6:11, the helicopter landed at Children's.
As Ms. Alexander handed Jennifer off to Dr. Raynor, a nurse at Children's was
pulling the paper from her pocket.

 In less than five minutes, Jennifer was being wheeled from the ER to the
operating room, for the bypass that would save her life.
As she headed down the hallway, Dr. Raynor kept pressing on her chest,
keeping her heart beating.
Dr. Raynor and Dr. Kim Duncan, four nurses and an anesthetist performed the
surgery to warm her blood, an 80-minute operation.

  Dr. George Reynolds also was there during surgery and took over her care in
the pediatric intensive care unit.

 Kourtney wanted to leave St. Joseph herself.
Feeling was returning to her feet and she was hurting and cranky.
She pulled off her oxygen mask and started asking for her clothes and asking
her mother if she could leave.

 "Kourtney, I'm not the boss here," Mrs. Woracek answered.
"You have to listen to these women." After Jennifer was transferred, Kourtney
was taken to the St. Joseph pediatric intensive care unit at 7:10.
That evening she was transferred to Children's, where she and Jennifer now
share a room.

 The experience was emotionally exhausting for police and hospital staff
alike.
You can't give in to tears or fear during the crisis, several said.
But they did afterward.

 The night shift ended shortly after the girls left the ER.
Several staff members gathered for breakfast and an emotional debriefing
session.

 Police and medical workers who were parents related the girls to their own
children.

 Vribicky, father of two youngsters, went home and tried to sleep.
But he kept waking up, each time seeing Jennifer's deathly face.

  Ms. Alexander, after pumping Jennifer's heart for her during the helicopter
flight, thought it was all in vain.
She remembers coming back despondent, certain "that little girl is going to
die." Others were optimistic.
Dr. Denton, who virtually never comments on a patient's outlook, reassured
other staff members, saying he thought she would survive.

 Ms. Alexander stayed around the hospital after her shift, first for a
meeting, then hoping to hear news.
After a few hours, Dr. Denton, who also stayed around, suggested that she call
Children's.

 Ms. Alexander called the surgery department at Children's, though part of
her didn't want to hear any news, because she feared it was bad.

 "She's doing terrific," the Children's nurse told Ms. Alexander.
"She's off pump.
She's pink.
She's making urine.
We're a little worried about her toes." It was the best news Ms. Alexander
could have hoped for.
She hung up the phone and walked out with her arms raised over her head, like
an athlete celebrating a victory, and spread the joyous news.

 Her toes? The worry had moved from Jennifer's heart to her toes.




NOTES:

  World-Herald staff writers Loren Keller and Jennifer Dukes Lee contributed to
this report.

GRAPHIC: Color Mugs/2; Kourtney; Jennifer; Color Photo/1; LIFE FLIGHT: Paramedic
Corrie Vrbicky and flight nurse Kerri Alexander cared for the Woracek twins from
St. Joseph to Children's Hospital.; B&W Photo/1; ST. JOSPEH TEAM: Some of the
heroes who helped save Jennifer and Kourtney Woracek are, from left, nurse Gayle
Mielke, Dr. Charles Denton and nurse Angie Jedlicka., Bill
Batson/World-Herald/1sf/1

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Rescue of the Twins

  • 1. I wrote this story in 1997 for the Omaha World-Herald Copyright 1997 Omaha World-Herald January 26, 1997 Sunday SUNRISE EDITION SECTION: NEWS; Pg. 1A HEADLINE: Of Heroes and Kind Hearts: Rescue of Twin Girls Took Many Hands By STEPHEN BUTTRY WORLD-HERALD STAFF WRITER Jennifer's tiny heart gave up. But no one else would. As paramedic Gary Wood reached to lift 3-year-old Jennifer Woracek onto a stretcher to take her to a helicopter that would fly her to another hospital for more life-saving treatment, the gold line on her heart monitor went flat. Two hours after police began an intense search for Jennifer and her twin sister, Kourtney, an hour after the snow-caked girls arrived at the St. Joseph Hospital emergency room, the stress of subzero cold finally wore down Jennifer's 40-pound body. Paramedics quickly checked the connections between the girl and the monitor. They were secure. Jennifer's heart had indeed stopped beating. Life Flight paramedic Corrie Vrbicky told Dr. Charles Denton, "We lost the rhythm." No one wanted to panic the girl's already distraught parents, who were watching nearby. Wood discreetly reached under the blanket that was wrapped around the frozen girl, found the right spot on her chest and pressed firmly down with one hand, pumping her heart for her. Vrbicky asked Dr. Denton, the emergency room physician, "Do you still want her to go?" With a wave of his hand, the physician sent the flight crew away, saying: "There's nothing more we can do for her here." Jennifer's chance at survival rested with equipment at Children's Hospital that would draw her 69-degree blood from her body, warm it and pump it back into her. She needed to get to Children's immediately. Helping hands would pump her heart for her. First Wood steadily compressed her chest as she was carried out to the helicopter. On the three-minute flight to Children's, flight nurse Kerri Alexander continued the rhythmic pushing on the child's chest.
  • 2. At Children's, Dr. Stephen Raynor met the flight crew and placed his hand on the girl's chest, firmly squeezing the heart as she was wheeled to the operating room. A succession of heroic and healing hands saved Jennifer and Kourtney when their early morning adventure went awry on a bone-chilling, 9-degree-below-zero Nebraska night. The story of the twins' disappearance, rescue and fight for life has captured the attention of the community and the nation. The story reaches into the heart of parents, nearly all of whom have been frightened at some time by the inexplicable boldness and inventiveness of carefree 3-year-olds. Like the police who searched for the twins in the dark, cradled them to their chests and dashed to the hospital, like the medical professionals who removed the crusted snow from behind Jennifer's neck and between Kourtney's toes, parents shudder at the story, thinking: That could have been my child. A Worried Mom The work of the dozens of law enforcement and medical professionals began at 4:03 a.m. on Friday, Jan. 17, when the twins' worried mother called 911. Operator Lisa Jackson answered: "911 Omaha." "Yes, my name is Marlene Woracek and my babies are missing. It's a long story." Mrs. Woracek, confused about where the twins were, indicated that nocturnal mischief wasn't new to the 3-year-old co-conspirators: "At Christmastime they got up in the middle of the night, and they came downstairs and opened all the presents and everything." While Mrs. Woracek was on the phone, her husband, Tom, and Lindsay, their fifth-grade daughter, continued their own search. "Lindsay, get in!" Mrs. Woracek ordered once during the phone call. A bit later, she directed, "Lindsay, look through the house." Police dispatcher Sue Steffel called for an officer, and Officers Brenda Murabito and Lou Briganti headed to the house. At 4:10, Mrs. Woracek called 911 again. This time she knew the twins were out in the cold and she was upset, talking fast and crying. "They went outside our back door," Mrs. Woracek said.
  • 3. "They have their backpack out there! I don't know how they got our back door open." The officers were arriving as Mrs. Woracek was on the phone. They found Tom Woracek outside, looking for his daughters. The parents told the officers they had put the twins to bed at 9:30 p.m. and the house had been tidy then. When officers arrived, toys, pieces of Monopoly and other board games and some contents of a desk were scattered in the living room. Crackers were on the floor. Some "nutty bars" had been pulled out in the kitchen. The officers immediately called for more police and began the dual task of searching the house and looking outside. A canine unit was called to help. Sgt. Mary Schindler arrived and directed the search. Officers looked through the house, including crawl spaces, the garage and two vehicles in the garage. They knew children who are missing often are found hiding in their homes. The Woracek twins are "feisty," often plotting together in fun and mischief. The parents told officers, "What one does not think of, the other one does." Some of the children's clothes were missing from a stack of folded laundry on a table. Their coats and brown boots were missing from the house. Their mittens and hats were still inside. The doors had locks to prevent children from getting out. It was a bit confusing which door the children had used. The front door was open, the girls apparently having mastered that lock. The back door was locked. But outside the back door, the girls' father had found footprints, a purple coat and a Pocahontas backpack containing two nutty bars. It appears they might have gone out the front door, then tried to get in the back door. Officer Russell Horine and Basko, his Belgian Malinois police dog, began searching for the girls, using the coat and backpack for the twins' scent. The officers checked doorways, under porches, a carwash and gas station across 13th Street, anywhere the tots might have sought shelter.
  • 4. Sgt. Schindler told officers to check the area on the way to and around the girls' preschool, Christ Child Center, a half-mile away at 10th and William Streets. Police overhearing the radio discussion began flocking to the area. Officers divided into teams of two. One searched on foot while the other crept along in a warm cruiser nearby in case the girls were found. Officers Troy Kister and Warren Walter turned from 13th Street onto Center, heading east. It's a steep hill, rising so fast that the elevation half a block east is about level with the peaked roof of the Woraceks' two-story house. Three inches of snow and the incline made it nearly impossible for the cruiser to make it up the street. Their tires started slipping at the entrance of an alley halfway up. While Walter turned the car around, Kister stepped out. His eye was drawn to a tiny footprint in the snow. At 4:40, other officers heard the first encouraging news over their radios: "I've got fresh prints that look like small foots." Kister asked for a canine unit. Walter got out of his car. Horine and Allen Wagner hurried across the street and up the hill. The decided to follow the footprints down the alley. They left the dog behind, figuring it was unlikely Basko could pick up a scent on snow in that bitter cold. The alley, running about 175 yards parallel to 12th and 13th Streets behind the carwash and Troia Funeral Home, is the proverbial dark alley. It is lit by a single street light at the north end, on Hickory Street. The officers started at the south end. Cedar, pine and scrub trees, plus the elevation, shield the alley from the street lights of 13th Street. Snow 5 to 6 inches deep covered an unpaved surface with deep ruts. The officers trudged along, training their flashlights on the tiny footprints.
  • 5. As they got about halfway down the alley, Walter left the group to move his and Kister's cruiser to the north end of the alley, where it would provide warmth for the officers, and hopefully for the girls. After about 100 yards, Kister's flashlight illuminated the children's small tan boots, stuck in the snow. Shuddering at the thought of the girls in their bare feet, the officers proceeded. About 15 feet farther, a flashlight's beam found the twins. Jennifer was lying still, face down, without a coat. Her hands were partially closed, covered with snow, as hard as ice. Kourtney was kneeling beside Jennifer, her purple coat unzipped. She was wearing a red and gray sweat shirt, blue floral print sweat pants and no socks or shoes. It's unclear whether Kourtney said anything immediately to the police. Kister's report includes a quote, "Help my sister," but doesn't state that Kourtney said it. Kister later said he didn't recall the girl saying that. Emergency room workers at St. Joseph remember Kister telling them that Kourtney looked up at the officers with an alarmed look on her face, as if to say, "Help my sister." The officers did. Kister picked up Kourtney. Horine picked up Jennifer, and they began sprinting south, back the way they had come. "We need a squad (an ambulance)," Kister radioed at 4:48. "We found the parties." Moments later, he breathlessly called off the ambulance. "We're going to take her to St. Joe's. We're going to expedite." As the officers reached the end of the alley, Sgt. Schindler pulled up in her cruiser. Horine handed Jennifer off to Officer Wagner, who also is a paramedic with the Bellevue Volunteer Fire Department. Wagner wrapped the girl in his jacket and climbed into Schindler's car.
  • 6. They raced for St. Joseph, three miles away. Kister handed Kourtney off to Officer Kathleen Novotny, who climbed in the back seat of Walter's cruiser, wrapped the girl in a police jacket and cuddled her "as close to my body as I could." Officer Novotny asked the girl her name. She clearly answered, "Kourtney and I'm cold." As the squad cars raced to St. Joseph, their sirens wailing and lights flashing, they radioed 911 to call the hospital and asked other officers to bring the parents to the hospital. ER Moves Into Action The 911 operator called St. Joseph, telling the emergency room staff they had two children coming in with exposure. The call described the children as "Code 3" - life threatening. At 4:55, Wagner dashed from the patrol car through the ambulance entrance to the ER, and ran to examination room 7, carrying Jennifer bundled in his jacket. Kourtney was right behind. Officer Novotny handed the girl to Ms. Alexander, who carried her to room 9. Kourtney told the staff her name and Jennifer's. She was speaking softly and nurses couldn't hear everything she said. Ms. Alexander thought Kourtney said something about "trying to get inside," possibly a reference to the twins' efforts to get in the locked back door of their house. She also asked where Jennifer was and where her parents were. When the mom and dad arrived minutes later, they shifted between the girls' rooms, providing reassurance and holding frozen hands. Dr. Denton, with nearly 19 years of experience in the St. Joseph ER, concentrated mostly on Jennifer, while a resident, Dr. Richard Jones, tended to Kourtney. Nurse Gayle Mielke and paramedic Gary Wood were at Jennifer's side, while Angie Jedlicka took care of Kourtney. Pam Reinke, the ER charge nurse, assisted with both girls, as did Ms. Alexander. Dr. Denton first checked Jennifer to see if she was even alive. She looked dead. Her eyes were open and unblinking, her pupils big. She wasn't moving.
  • 7. Her pale skin had a translucent-looking pallor, interrupted by patches of bright cherry red. Paramedic Corrie Vrbicky recalls thinking he'd "seen dead people look better than that color." Her body was rigid, her legs straight, her arms straight down by her sides. Normally, when you pick up a child, she bends at the waist. Wood noticed "there was no flex to her back." Finally she took a breath. Feeling her frigid chest, Dr. Denton found a pulse. Ms. Mielke took her vital signs: Pulse 40 beats per minute (normal would be about 100 to 120); respiration four breaths per minute (normal would be 20 to the mid-30s). Taking the child's temperature was difficult. The first thermometer used would not register below 85 degrees. They got a warming blanket that had a rectal thermometer that went lower. The reading shocked the seasoned ER staff: 20.5 degrees Celsius. That's 68.9 degrees Fahrenheit. Normal is 98.6. A temperature below 86 can stop the heart. Falling below 77 can stop breathing. Disbelieving, Wood and Ms. Mielke checked again with another probe. It also said 20.5. Kourtney was not as dire. Her temperature was 94.5, he pulse 138 and her respiration 38. Wood removed a chunk of compacted snow, about the size of a cereal bowl, stuck to the back of Jennifer's neck and shirt. Both girls' feet were encased in snow. Nurses had to brush the snow out from between their toes. After Jennifer had been in the ER nearly an hour, she still had crusted snow in the creases of her fists. Her hand hadn't relaxed enough that medics could scrape it out, and her body hadn't warmed enough to melt it. Paramedics and nurses cut away the children's frozen clothes. A Bair Hugger, a combination blanket and air mattress through which warm air is pumped, was used to warm the skin. Kourtney's feet, which Ms. Reinke described as "deep, concord-grape
  • 8. purple-black" - were immersed in 105-degree water. Children are difficult to start on intravenous solutions in normal conditions. Somehow, Ms. Mielke found a vein on her first poke into Jennifer's icy arm and began a warm IV saline solution. The comatose girl didn't react to being poked. Drawing blood, Wood was sickened to feel through the tube how cool it was. Denton had never seen a pediatric hypothermia case this severe. He knew quickly that the girl's blood needed to be warmed rapidly using a bypass procedure. The blood would be pumped out of her body, warmed mechanically and returned. St. Joseph didn't have a pediatric catheter that would be needed to perform the bypass. Children's Hospital did. The ER staff called Children's, which rapidly began assembling a surgical team. St. Joseph began preparing Jennifer for the transfer. A 4.5 millimeter breathing tube was inserted to pump warm oxygen into her lungs. Her eyes were taped shut. Life Flight pilot Bill Flannery began warming the medical helicopter outside the St. Joseph ER. Ms. Mielke, unable to spare time to look for paper to write on, scrawled information such as vital signs and the size of the breathing tube on the bed sheet, then hung onto the sheet "like Linus" after Jennifer had left. A crowd of more than a dozen police had gathered in the hallway, fearful. "It was obvious to us that Jennifer was in very, very bad condition," Sgt. Schindler said. "Quite frankly, we didn't have much hope she would get to Children's." As the ER workers and helicopter crew were ready to begin the transfer, the heart monitor's line went flat. In a warmer or larger body, that would have precipitated a bustling, obvious resuscitation scene - defibrillation paddles providing electric shock
  • 9. to the chest, a paramedic or nurse leaning over the patient to use both hands to compress the chest. Defibrillation is not an option in severe hypothermia, because the patient's system is too fragile to withstand the shock. On a child as small as Jennifer, a single hand with firm pressure is enough to compress the chest. Using both hands might crush the chest. Dr. Denton saw no point in keeping Jennifer at St. Joseph to revive her before she left. Drugs normally used in cardiac arrest are useless when the body is too cold to circulate the drugs. The helicopter crew could keep her heart beating on the trip to Children's. Wood quickly reached inside the blanket and began pumping the girl's heart. Ms. Alexander rushed to the helicopter alongside the child and took over the heart massage. She and Vrbicky accompanied Jennifer across town. The girl's parents asked if one of them could fly with Jennifer. They were told no, there wasn't enough time to prepare them for the flight. The helicopter lifted off at 6:08. As it raced to the other hospital, St. Joseph's ER staff called Children's and passed along all the information they could, including that a nurse had jammed a piece of paper with Jennifer's blood gas readings into Ms. Alexander's right pocket. At 6:11, the helicopter landed at Children's. As Ms. Alexander handed Jennifer off to Dr. Raynor, a nurse at Children's was pulling the paper from her pocket. In less than five minutes, Jennifer was being wheeled from the ER to the operating room, for the bypass that would save her life. As she headed down the hallway, Dr. Raynor kept pressing on her chest, keeping her heart beating. Dr. Raynor and Dr. Kim Duncan, four nurses and an anesthetist performed the surgery to warm her blood, an 80-minute operation. Dr. George Reynolds also was there during surgery and took over her care in the pediatric intensive care unit. Kourtney wanted to leave St. Joseph herself. Feeling was returning to her feet and she was hurting and cranky.
  • 10. She pulled off her oxygen mask and started asking for her clothes and asking her mother if she could leave. "Kourtney, I'm not the boss here," Mrs. Woracek answered. "You have to listen to these women." After Jennifer was transferred, Kourtney was taken to the St. Joseph pediatric intensive care unit at 7:10. That evening she was transferred to Children's, where she and Jennifer now share a room. The experience was emotionally exhausting for police and hospital staff alike. You can't give in to tears or fear during the crisis, several said. But they did afterward. The night shift ended shortly after the girls left the ER. Several staff members gathered for breakfast and an emotional debriefing session. Police and medical workers who were parents related the girls to their own children. Vribicky, father of two youngsters, went home and tried to sleep. But he kept waking up, each time seeing Jennifer's deathly face. Ms. Alexander, after pumping Jennifer's heart for her during the helicopter flight, thought it was all in vain. She remembers coming back despondent, certain "that little girl is going to die." Others were optimistic. Dr. Denton, who virtually never comments on a patient's outlook, reassured other staff members, saying he thought she would survive. Ms. Alexander stayed around the hospital after her shift, first for a meeting, then hoping to hear news. After a few hours, Dr. Denton, who also stayed around, suggested that she call Children's. Ms. Alexander called the surgery department at Children's, though part of her didn't want to hear any news, because she feared it was bad. "She's doing terrific," the Children's nurse told Ms. Alexander. "She's off pump. She's pink. She's making urine.
  • 11. We're a little worried about her toes." It was the best news Ms. Alexander could have hoped for. She hung up the phone and walked out with her arms raised over her head, like an athlete celebrating a victory, and spread the joyous news. Her toes? The worry had moved from Jennifer's heart to her toes. NOTES: World-Herald staff writers Loren Keller and Jennifer Dukes Lee contributed to this report. GRAPHIC: Color Mugs/2; Kourtney; Jennifer; Color Photo/1; LIFE FLIGHT: Paramedic Corrie Vrbicky and flight nurse Kerri Alexander cared for the Woracek twins from St. Joseph to Children's Hospital.; B&W Photo/1; ST. JOSPEH TEAM: Some of the heroes who helped save Jennifer and Kourtney Woracek are, from left, nurse Gayle Mielke, Dr. Charles Denton and nurse Angie Jedlicka., Bill Batson/World-Herald/1sf/1