TRAUMA UPDATE
News from the Trauma Center at Bryan Medical Center FALL 2017
Lifesaving Stop the Bleed training empowers public to be first responders By Heather Talbott, MSN, RN
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ost people remember where they were in 2012 when they heard about the tragedy of the Sandy Hook Elementary School shooting. A day when six adults and 20 children lost their lives to an active shooter. On that day Dr. Lenworth Jacobs, a trauma surgeon in Hartford, Connecticut, and his team waited in their trauma bay for the injured to arrive, but they never did. Dr. Jacobs speaks of this experience often, talking about the impact not only on the community of Sandy Hook and his medical team but also on a nation wondering what we could’ve done differently to save some of those lives. Dr. Jacobs took it upon himself to review each of the autopsies, and what he found is that they each died from bleeding to death. Dr. Jacobs was angered and wanted to find a solution as unfortunately these types of events seem to be happening more often. Less than 5 months later, this physician organized the first meeting of the Hartford Consensus. The Hartford Consensus is a committee in which Dr. Jacobs chaired on behalf of the American College of Surgeons. This committee was the first of its kind in which it had all the key players at the table to address and hopefully increase survival from active shooter and intentional mass casualty events. Historically when these events occur, EMS/first responders are not allowed to go in and care for the wounded until the scene has been deemed “safe.” If you think of events that have occurred near our own communities, like the Omaha Von Maur shooting in 2007 and the Americold shooting in Crete in 2010, it shows that these events can happen anywhere to anyone. In each of these tragedies there were uninjured bystanders near the wounded. Dr. Jacobs acknowledged that at Sandy Hook there were teachers, assistants and others who were not harmed and that with the proper training and tools maybe some of those kids would have survived. The mantra that emerged from the Hartford Consensus and was echoed by the Obama administration as well as the Department
of Homeland Security is that nobody should die from uncontrolled bleeding. Stop the Bleed is a National Campaign with the goal of training 300 million Americans in basic bleeding control. The campaign was initiated by a federal interagency work group convened by the National Security Council Staff, The White House. The campaign’s goal is to build national resilience by better preparing the public to save lives by raising awareness of basic actions to stop life-threatening bleeding following everyday emergencies and man-made and natural disasters. Hopefully, readers of this Trauma Update will never be involved in an active shooter event. However, the likelihood of driving across town and coming across a motorcycle crash with the victim profusely bleeding is very possible. This campaign/education empowers those who are not medical professionals to put their hands on that victim and to try to help until EMS gets there. It takes as little as 3 minutes for an individual to bleed to death. In the city of Lincoln we are fortunate that EMS responds in 4 to 7 minutes on average. For those in rural areas it may take EMS 45 minutes or longer to get to a patient. For some patients that may be too late. The Stop the Bleed campaign empowers anyone at the scene to act as an immediate responder and save lives if they know simple tactics on what to do. This campaign supports President Barack Obama’s policy directive for national preparedness (Presidential Policy Directive 8), which targets preparedness as a shared responsibility of the government, the private and nonprofit sectors, and individual citizens. The Stop the Bleed initiative/training is being called the CPR of the 21st Century. Some high schools already are making this a mandatory training to graduate just like Basic Life Support (CPR). The actual course averages to be 1.5 hours long. There is a didactic portion of lecture with a PowerPoint presentation and then hands on where the participants get to practice placing tourniquets, holding pressure on wounds, identifying life threatening bleeding, etc. n To learn more about Stop the Bleed or to set up a training, please email stopthebleed@bryanhealth.org.
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Teamwork saves Dale’s life following crash
Dale Johnson’s amazing attitude — on display here while he vacationed in South America — is helping him overcome a life-threatening motorcycle crash.
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arch 20, 2017, was a beautiful day for Dale Johnson to ride his new motorcycle to the
grocery store. This local radio personality had owned this amazing bike for only a month and was excited that in less than six months he would be taking it to the Sturgis, South Dakota, motorcycle rally with his brother. Dale remembers exactly where he was when he was stopped for traffic, and a car turned and hit him. Dale was thrown from the bike and landed in the grass. Although he doesn’t remember the impact he remembers wanting to stay conscious and giving out telephone numbers, his wife’s name and his address to the responders who were first on scene. He remembers the ambulance arriving and the sound of leather being cut, and then over four and a half hours later he woke up to find himself in the Bryan Trauma Center ICU. During the time that Dale does not
remember, the Nebraska State Trauma System — which is vital when it comes to saving lives and educating the state and region — did exactly what it’s meant to do. A bystander called 911, which had a Lincoln Fire and Rescue team on the way to Dale less than a minute from the crash. Another bystander who witnessed the impact recognized that Dale was losing a lot of blood, so he placed the tourniquet he received after Stop the Bleed training from Bryan Trauma Center on Dale’s leg, and this undoubtedly helped save his life. LFR recognized that Dale needed to be transferred urgently to the Trauma Center, and that is where Dale arrived in less than 20 minutes from the time he was critically injured. Dr. Stanley Okosun immediately recognized that Dale had a life-threatening injury and upgraded him to a Category I trauma, meaning every resource was needed to be available in order to save his life. Dale was immediately intubated, and a multidisci-
plinary team began its critical role in Dale’s journey. The perfusionist hung multiple bags of O negative blood, which was required because Dale had lost so much — by the end of his hospital stay, Dale received 27 units. The OR team was ready for Dale when surgeons Dr. David Samani and Dr. Matthew Goettsch, members of the Bryan Trauma team, determined that Dale’s leg was no longer viable. He required a left above the knee amputation and with Dale’s amazing spirit, family support and the work of the trauma system, he was discharged from Bryan Acute Rehab on March 31, only 11 days after he almost lost his life. This life that was saved because of the Nebraska State Trauma System, which includes the bystander who had taken Stop the Bleed training four months prior, then recognized Dale’s life-threatening injury and acted by placing a tourniquet that allowed Lincoln Fire and Rescue to transfer him to the Bryan Trauma Center. n
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Trauma Programs As a Level 2 Trauma Center, Bryan Medical Center provides leadership in injury prevention programs, staff instruction, community outreach and education. We offer multiple CME/CE programs and community based training.
Advanced Trauma Care for Nurses® (ATCN®)
The Advanced Trauma Care for Nurses® (ATCN®) course is taught concurrently with Advanced Trauma Life Support® (ATLS®) for physicians. This program is presented by the Society of Trauma Nurses in collaboration with the American College of Surgeons Committee on Trauma. This course was developed to teach established standards on trauma care and practical lifesaving skills. This course is designed for the nurse working in emergency departments, intensive care units, the pre-hospital setting or any department related to trauma care.
Advanced Trauma Life Support® (ATLS®) ATLS Provider Course is designed to train providers including physicians, physician assistants and nurse practitioners who are in a position to provide the first hours of emergency care to trauma victims. The two day course utilizes didactic lectures and practical skill stations in order to effectively teach the principles of rapid, effective assessment and stabilization. All courses are conducted according to the guidelines of the American College of Surgeons.
Advanced Trauma Life Support® Refresher Course
ATLS® Refresher Course is designed to train providers including physicians, physician assistants and nurse practitioners who are in a position to provide the first hours of emergency care to trauma victims. The one day course utilizes didactic lectures and practical skill stations in order to effectively teach the principles of rapid, effective assessment and stabilization. All courses are conducted according to the guidelines of the American College of Surgeons.
Emergency Nursing Pediatric Course® (ENPC®) ENPC is designed to help nurses gain core-level pediatric knowledge and the skills to positively affect pediatric patient outcomes in the emergency setting.
Prehospital Trauma Life Support® (PHTLS®) is the world’s premier prehospital trauma education developed in cooperation with the American College of Surgeons to promote critical thinking in addressing multi-system trauma and provide the latest evidence-based treatment practices.
Trauma Champions Celebration of the Bryan Trauma Center and the Nebraska State Trauma System. More information is available at our website at bryanhealth.com/services/trauma/tribute-trauma-champions/
Trauma Grand Rounds Trauma Grand Rounds are held monthly to present new developments and hot topics in Trauma which will provide information that will enhance the medical teams’ clinical skills and ability to care for patients. Rounds are 60 minutes and include free lunch with registration.
Trauma Nurse Coordinator (TNC) Workshop Trauma Program Coordinators are fundamental to the development, implementation, and evaluation of their trauma program and are responsible for the organization of services and systems necessary for a multidisciplinary approach to providing care to injured patients. This workshop will provide Trauma Program Coordinators the key concepts of building and maintaining a successful trauma program.
Trauma Nursing Core Course® (TNCC®) The two day TNCC course provides nurses with core-level trauma knowledge and skills and presents a systematic standardized approach to nursing care of the patient.
Trauma Nursing Core Course® -Refresher(TNCC-R®) TNCC (Refresher) is a one day course designed to for nurses with a current TNCC verification. Designed for independent learning, ENA’s Trauma Nursing Core Course 1-Day Renewal is built around robust self-guided study materials that help you prepare for successful completion of the renewal.
Trauma Symposium This symposium is a one-day, multidisciplinary educational activity focusing on key areas of care for the injured patient throughout the continuum of care.
TO REGISTER: Go to bryanhealth.org/professional-education
Physicians and Advanced Practice Providers can register online by selecting View upcoming Continuing Medical Education online and live events; or call Brittni Clark at 402-481-5150, or email brittni.clark@bryanhealth.org Nursing and other Healthcare Providers can register online by selecting View upcoming Continuing Education & Life-Saving classes. Search by title. 2018 Trauma Programs calendar on back.
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Advanced Trauma Care for Nurses® (ATCN®) 0700-1700
Prehospital Trauma Life Support (PHTLS®) 0700-1700
Trauma Nursing Core Course® (TNCC®) 0700-1700
Advanced Trauma Life Support® (ATLS®) 0700-1700 (Oct. 11 & 12 will be held off site)
Trauma Champions 1730
Trauma Nursing Core Course® Refresher (TNCC-R®) 0700-1700
Advanced Trauma Life Support® (ATLS-R®) Refresher 0700-1700
Trauma Grand Rounds 1200-1300
Trauma Symposium 0700-1800
Emergency Nursing Pediatric Course® (ENPC®) 0700-1700
Trauma Nursing Coordinator Workshop (TNC) 0900-1600
Programs held at Bryan West Campus • Conference Center • 2300 S. 16th St. • Lincoln, NE
MORE INFORMATION CONTACT: See Page 3 of Trauma Update for more details. ToFOR register, go to bryanhealth.org/professional-education. Brittni Clark, BSN, RN
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Meet the Bryan Trauma Department
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Trauma Team is a group of specially trained health professionals who work together to provide a seamless response to a traumatic injury. The Bryan Trauma Team is available at a moment’s notice 24 hours a day to care for people who have been critically injured.
This multidisciplinary team provides care following the initial resuscitation and treatment. The team regularly reviews the patient’s plan of care during rounds to ensure the highest quality of care. For more information, contact Bryan Trauma Outreach and Injury Prevention Coordinator Brittni Clark at 402-481-5150. n
Stanley Okosun, MD, Trauma Medical Director
Alesha Scott, DO, Orthopedic Trauma Surgeon
Heather Talbott, MSN, APRN, Trauma Program Manager
Brittni Clark, RN, Outreach & Injury Prevention Coordinator
Stephanie LaMar, RN, Trauma Registrar
Sydney Latta, RN, Trauma Registrar
Deb Schleiger, CSTR, Trauma Registrar
Jennifer Middlekauff, RN, Performance Improvement Nurse
Danielle Bachman, PA-C
Lauren Chatwell, PA-C
Molly Humlicek, PA-C
Brittany Justa, PA-C
Seth Lauterbach, PA-C
Sandy Kirchner, APRN-NP
Scott Schroeder, APRN-NP
Megan Simpson, APRN-NP
Kelly Wemhoff, PA-C
Trauma Update is published for friends of Bryan Health. Your comments and suggestions are welcome. Direct correspondence to the Advancement Department at Bryan, or you may telephone the editor at 402-481-8674. Trauma Update also is available at bryanhealth.org/traumacenter. Kimberly Russel, President and CEO, Bryan Health; John Woodrich, President and COO, Bryan Medical Center; Edgar Bumanis, Director of Public Relations; Paul Hadley, Editor
TRAUMA UPDATE
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1-800-873-6572 If you would like to be added to the Trauma Update mailing list, call trauma outreach and injury prevention coordinator Brittni Clark, RN, at 402-481-5150, or email her at brittni.clark@bryanhealth.org.
Helping patients adjust, from diagnosis to living life By David Miers, PhD, LIPC
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mergency Medical Services teams respond to individuals in crises, such as car accidents, heart attacks, strokes, sports-related injuries, farm related injuries and mild traumatic brain injuries. Often these patients also have other physical health conditions. The immediate need is to treat the crisis condition and return the person to health. However, long term, the person may develop conditions such as depression or anxiety as a result of the crisis situation or a related health condition. Bryan Medical Center Counseling Center has staff that includes psychologists and therapists with special training to work with children, adolescents, adults, and families. We offer compassionate, experienced treatment for depression, anxiety, adjusting to life
changes and many other areas including the shock, anger, grief and other emotions that can accompany a medical diagnosis or chronic health condition. What is health psychology? Health psychology is a specialty that helps people dealing with chronic health conditions improve their quality of life. Health psychologists are trained to know about disease processes and phys-
iology in order to help a person deal with issues that may be a part of specific illnesses or medical crisis. Working in conjunction with medical physicians, health psychologists address the additional, sometimes silent symptoms of chronic illnesses such as depression, anxiety and stress that can impact a person’s quality of life. The goal is to help individuals cope better and learn to empower themselves on their path to recovery. Bryan Medical Center Counseling Center has clinical psychologists with special training in health psychology and other staff who have experience helping individuals with chronic health conditions. n To schedule an appointment or refer a patient, call 402-481-5991. To learn more about the Counseling Center, go to bryanhealth.org/CounselingCenter.