MHFV Blog Cindy Hacker 1
Respiratory Therapist Cindy Hacker, RRT, NPS, left, transports critically ill children to M Health Fairview Masonic Children's Hospital as part of her decades-long career.

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Respiratory therapist saves lives two miles above the earth

Performing life-saving procedures in a helicopter or scrubbing in for complex heart surgeries? It’s all in a day’s work for Respiratory Therapist Cindy Hacker, RRT, NPS, who helps critically ill people keep breathing.

  • October 25, 2021
  • By Staff Writer

Cindy Hacker had a bad feeling. It was the middle of the night, and she was 10,000 feet in the air over Iowa. She and her transport team had picked up a child in critical condition from a hospital in Des Moines and were flying back to M Health Fairview Masonic Children’s Hospital.

In the helicopter, Hacker worked tirelessly to keep oxygen flowing to the patient’s airways. Halfway through the flight, she realized they were going through their supply quicker than usual – there may not be enough oxygen on board.

Hacker’s quick thinking – including a pit stop in Mason City to grab eight more oxygen tanks from the local fire department – kept the child alive through the flight. And it’s only one of countless life-saving stories she has from her 40-year career as a respiratory therapist.

In honor of Respiratory Care Week, we sat down with Hacker to learn more.

Why did you become a respiratory therapist?

At first, I went to school to become a physical therapist. I was working as a nursing assistant at an assisted-living residence. During one shift, I helped suction a patient who was having difficulty breathing. Suctioning clears a patient’s lungs of mucus and other congestion. Our patient got so much relief and was able to breathe so well after the procedure. I saw the difference that respiratory therapists make.

What is a typical week like for you as a respiratory therapist?

Each day is different. Some days, I’m in the operating room. I help put in the lines a patient needs during surgery to keep their organs functioning and allow us to monitor vital signs. In surgery, I work with a lot of children who have congenital heart defects. We put them on a ventilator after their operation to help them recover. The ventilator breathes for them, by pushing air in and out of their lungs.

Outside of surgery, we work a lot with children who have respiratory syncytial virus (RSV) or the flu. With both of those illnesses, fluid can build up in the lungs and make it hard for them to breathe. We help clear their airways.

Respiratory therapists also get called in when there’s a patient in critical condition who needs help breathing. We can either bring equipment to their room or transport them to our pediatric intensive care unit. We can also pick up critically ill patients from elsewhere and bring them in for more advanced care. I assist regularly with helicopter transports both in Minnesota and throughout the Midwest.

I’m also an extracorporeal membrane oxygenation (ECMO) specialist. An ECMO machine circulates a patient’s blood through an artificial lung, then back into their bloodstream. It supports a person’s heart and lung function while letting their organs rest – which is important if they’re in critical condition.

ECMO has played a large role in COVID-19 treatment. How did you get involved with this therapy?

I’ve been doing ECMO since 1987. We were one of the first teams in Minnesota to learn how to do it. It was still relatively new at the time, and we didn’t have anyone in the Twin Cities who could teach us. A group of respiratory therapists, including me, went to the University of Michigan and learned directly from Robert Bartlett, MD, who developed ECMO.

Until around three years ago, our department was responsible for ECMO throughout our system. Now, there’s a designated team, but I still help out on a regular basis. We’ve had a few pediatric patients need ECMO during the pandemic – most often children who were exposed to COVID-19 and then developed multisystem inflammatory syndrome (MIS-C).

What is the most memorable transport you’ve been a part of?

The first transport I did was to Des Moines to pick up a critically ill child. We give patients oxygen, but we also give them nitric oxide during the flight. This helps expand their airways so we can get more oxygen into them. We picked the patient up and started to head back to Minneapolis. We were going through a lot of oxygen, because of the nitric oxide. I asked the paramedic if we had enough oxygen and he said “yes.” But when I asked him to go check, he realized we didn’t.

We flew as low as we could and called around asking where we could pick up more oxygen. We landed at the Mason City airport and a firetruck with lights and sirens flashing sped onto the tarmac. I got down from the helicopter and loaded eight additional oxygen cylinders to make sure we had enough to get the patient safely to Minneapolis.

Another memorable transport was when we flew to Duluth to pick up a patient with a tumor in her chest. Because of the tumor, they couldn’t properly ventilate her. It started storming before we could fly back. We ended up having to take the patient to a hospital in Duluth. I placed her on a special, high-rate ventilator in the ambulance to keep her airways open. We got our EMCO machine set up as quickly as possible in the hospital, and I got to see her recover and go home with her family.

Do you have any other favorite memories from your career?

I’ve been on three service trips to China through Children’s HeartLink. A group of us from the hospital went each time, including anesthesiologists and surgeons. We performed free surgeries to fix congenital heart defects in communities where families otherwise wouldn’t have been able to afford surgery. We also trained staff at the hospitals on our methods for congenital heart defect surgery.

Respiratory therapists are an essential part of that surgery team.