Bryan Trauma Update | Spring 2016

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 Bryan West Campus 2300 S. 16th St., Lincoln, NE 68502-3704

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Bill steadily recovers from bike crash injuries

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If you would like to be added to the Trauma Update mailing list, call trauma outreach and injury prevention coordinator Heather Talbott at 402-481-4087, or email her at heather.talbott@bryanhealth.org.

Midwest Trauma Society Workshop features Dumond

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News from the Trauma Center at Bryan Medical Center SPRING 2016

Address service requested

Referral to Bryan Trauma Center

ryan Trauma and Emergency Preparedness manager Robbie Dumond RN, AEMT, was a presenter at this year’s “Trauma is My Business” Winter Workshop put on by the Midwest Trauma Society in Kansas City, Missouri. Robbie’s presentation focused on Trauma Program Collaboration with EMS Systems and was very well received by the approximately 60 trauma program leaders in attendance. The workshop focuses on the key development opportunities within trauma centers and involves

TRAUMA UPDATE

presenters from regional trauma systems across the Midwest. The lectures are designed to build on experience, trauma program maturity and highlight evolving institutional needs of trauma programs. The program is held in conjunction with the American College of Surgeons Advances in Trauma Kansas City (AITKC) conference, held in early December each year. This conference attracts top national speakers and leaders in trauma care. Next year’s conference is Dec. 1 and 2, 2016. n

n the evening of June 3, 2015, Rachel and Bill Nick, along with their sons, Collin and Brady, finished dinner and headed outside to enjoy the 80 degree early-summer evening. Bill decided to take a bicycle ride while Rachel and the boys opted for a game of “h-o-r-s-e” in the cul-de-sac. Later, Rachel and the boys thought little of the sirens sounding nearby as Lincoln Fire and Rescue Station 13 is not far from their home. When Collin asked where his dad was — Bill had been gone for over an hour — Rachel reassured him as it wasn’t unusual for him to stop and visit with friends in the neighborhood. It was shortly after, when Brady announced there were police walking up to the house, that Rachel grew concerned.

Andrew Livingston, MD, were the first people Rachel met when she arrived at the Trauma Center.

Life-threatening injuries Although Dr. Okosun ruled out an open skull fracture, Bill still faced life-threatening injuries due to multiple skull fractures and bleeding throughout many areas of his brain. Bill was sedated, with a ventilator breathing for him, and his body was cooled to 91° F to reduce swelling to his brain. Twenty-four hours later, Jenelle Rock, PA, also of Neurological and Spine Surgery, shared the poor prognosis as Bill’s bleeds were “blossoming” and could result in death or longterm deficits should he survive. During the first 72 hours after the incident, Bill failed to show necessary reflexes and required continued sedation and support. After days of waiting, Rachel heard a registered nurse from the Transported to hospital ICU say, “Come with me; you’re Rachel felt her world begin to going to want to see this!” Dr. Stanley Okosun (left) poses with Bill and Rachel spin as they informed her that Bill Bill had begun to show positive Nick at the Tribute to Trauma Champions event. had been in a bad bicycle crash, reflexes and would open his eyes was not breathing at the scene, momentarily when they called his and was being transported to the Trauma Center on the Bryan West name. Rachel was unable to get Bill to flinch in the same manner but Campus. Bill wasn’t wearing a bicycle helmet when he fell from laughed with the nurses, saying, “It’s because he knows my voice his bike and struck his head on the pavement. One of the Nicks’ and how much trouble he’s in!” neighbors saw the officers arrive with the bicycle in their trunk and Rachel met with Dr. Okosun shortly after. “You could see in his offered to stay with the Nicks’ sons while the police drove Rachel to face and the way Dr. Okosun spoke that he truly cared and knew the nearby home of Bill’s mother, Joyce, and then to the hospital. we were on our way to a better outcome than originally thought. Trauma surgeon Stanley Okosun, MD, and neurosurgeon He even gave us hugs!” Rachel remembers. “He said Bill has a long

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Bill continues long journey to recovery journey ahead — at first he will be a like a baby or small child and we will have to raise him again — his words to me were, ‘We will get your husband back to you’”. Quick response A tracheostomy and PEG tube were placed, and Bill transferred to a long-term care hospital, then to acute rehabilitation and outpatient therapy services at other facilities. Rachel protected the boys, Collin (who was 10 at the time) and Brady (7), in the early phases of Bill’s injury. They stayed with family friends while Rachel and Joyce remained vigilant at Bill’s side. The first time the children saw Bill, he was on the ventilator on the LTAC unit but still looked like “Dad” to them. Both are thankful to have him home playing basketball in the driveway again as Bill was away most of the summer and returned home just the week before school began in August. Bill says he is the “unluckiest, luckiest person out there.” He escapes having to relive his traumatic injury because he has no memory of his bicycle accident. Rachel says, “I truly believe his positive outcome is due to the quick response from the first responders, quick access to care and the first class Trauma Center at Bryan.” When asked what meant most to them during their recovery, the Nicks had no hesi-

tation in naming many: The nearby Trauma Center and all the skilled health care providers there, including Dr. Okosun and all the ICU nurses; Dr. Livingston; the 12-year-old girl who saw Bill’s crash and knew to dial 911; Frances Alcarde-Suyo, the RN who was driving home after her shift at Bryan West; Lincoln Fire and Rescue staff from Station 13; the Lincoln Police Department officers who took her to the hospital; their family, friends, neighbors, school, and church — people across the community, country and even world-wide were praying for them — Bill’s cousin who hosted a “Bike for Bill” event via Facebook; Dr. Tanner Gates and Dr. James Nedrow; and the Brain Injury Association of Nebraska. Strong community “We learned what a strong community Lincoln is; excellent health care facilities and resources are available right here where we live; all of the health care professionals that we encountered — especially in the first few days and weeks — instilled in me a sense of hope,” says Rachel. “They had seen first-hand others who had gotten better … and knew Bill could, too.” A family friend and nurse at Bryan informed Rachel that charge nurse Frances Alcarde-Suyo of the Neuro Progressive Care Unit on Bryan West Campus had been the

first medical personnel to arrive on the scene. Frances came upon the crash on her drive home from work. Rachel and Joyce met with Frances, who shared how she had come upon the bystanders calling 911 following Bill’s bicycle crash. Frances shared that Bill was breathing, although shallow, and trying to respond with moans to her questions. Frances enlisted the help of bystanders to remove the bicycle still entangled with Bill’s legs so they could reposition him to support his airway until EMS arrived. This reassured Bill’s family who had originally been concerned he was without oxygen for an unknown amount of time Rachel says, “We feel truly blessed and grateful to be where we are today — Bill is at home with his family where he belongs. He returned to work part-time in December and recently has returned to driving. He is helping coach flag football again and has returned to many activities that he did before his crash. He has visual field loss in both eyes and uses hearing aids to hear. He is doing well cognitively — his memory is better than mine in some cases! We are hoping to see continued improvement. “Overall he is functioning very well,” she concludes. “He is not sure if he will return to riding his bike or not. If he does, he will be wearing a helmet.” n

events with such determination and grace throughout, in Kelly’s opinion. “She amazed me from Day 1. She never complains.” The personal care she received from CAMC helped rally her. Staff searched for movies and activities to pass the time. “The nurses treated me like their own family. They would have done about anything for me and they got to know my whole family through this,” she says. Her faith and the support that poured in from the community also helped tremendously, she says. When Merri Kaye was strong enough to check social media and receive visitors, she learned of the positive messages people had written, the cards, the prayers promised, and the food that arrived at the Bradleys’ door. “It was overwhelming how much people helped out. I’m humbled and so thankful.” Nearly three months after the crash, she posted this joyful message on

Facebook: “Home sweet home! Sleeping in my own sweet bed ... Good night everyone!” Merri Kaye has hurdled countless road blocks since that time — returning to work, returning to the gym (slowly), tackling tasks one takes for granted, like the ability to open a chip bag. The fracture to the arm bone that forms the upper part of the elbow has taken the longest to heal and caused the most problems, including nerve damage. Occupational therapy continues to help Merri Kaye regain the use of her hand.

Returns to busy lifestyle Looking at her now, one would never guess the extent of her injuries. Kelly says, “She’s a person that just wanted to get back to it. As soon as she could she was going to her kids’ games and getting back into her busy life.” The biggest difference one year after the incident is that Merri Kaye did not return to coaching last fall. “At the

time, I did not know if I would be able to stand long enough to do it.” She also knew stepping away would give her more undivided time for her son and daughter’s athletics. Time is something she does not take lightly. Sometimes she thinks about those precious minutes that could have changed her fate on March 22. “Everything had to happen exactly like it did for me to be here,” she says, thanking everyone involved from the first responders to medical providers. She learned the occupant of the house near the accident dialed 911 immediately. She saw one striking picture taken to document the accident scene. Out of all the items on the console strewn about the car’s interior that day, the camera caught a mini-Bible that lay next to her, alone and undisturbed. “I was definitely being looked over that day,” she says. “To the entire Bryan Health team, thank you.” n

Bryan provides helmets following bike crashes According to the Centers for Disease Control and Prevention (2015), bicycle helmets reduce the risk of head and brain injuries in the event of a crash and, according to Think First!, bicycle helmets are 85-87 percent effective in reducing risk for brain injury. Most people are aware that bicycle helmets are for every age; however, people usually don’t realize bicycle helmets are similar to car seats in the sense that if a helmet has been involved in a crash or has been damaged, it needs to be replaced.

That’s why the Bryan Bicycle Helmet Program was created. Through the program, any patient involved in a bicycle crash can receive a free bicycle helmet. With the support of the Bryan Foundation, the bicycle helmet program has been expanded to both campuses of the Bryan Medical Center. If you are interested in supporting the Bryan Bicycle Helmet Program, contact the Bryan Foundation at 402-481-8605. n

At Tribute to Trauma Champions, Merri Kaye was reunited with first responders from Crete Fire and Rescue, Crete Area Medical Center ALS Intercept, Southwest Fire and Rescue, Lancaster County Sheriff’s Office, Air Methods and Nebraska State Patrol.

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Trauma survivor Merri Kaye thankful for Bryan health team

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arch 22. 6:30 a.m. The sun is out, but it’s still cold when Merri Kaye Bradley buckles up and leaves her driveway east of Crete. Although it’s Sunday, it’s not unusual for her to be on the road this early. She is a longtime high school and youth coach and there’s always a tournament somewhere. Today it’s club volleyball in Lincoln. She turns onto U.S. Highway 33. It’s the last thing she remembers pre-crash — the kind of crash that claims one life and separates the survivor’s life into before and after. The Merri Kaye who left the house that morning was a Hall of Fame basketball player at Doane College; wife to Kole, mother to Kaitlin and Hunter (then ages 20 and 16); a mover and doer, who served as registrar at Crete High School, as well as junior varsity volleyball coach and eighth-grade basketball coach. That Merri Kaye participated in the occasional “boot camp” workout in Lincoln, once ran a half marathon, and led a full, active life.

Tragic crash Just north of U.S. 33 and the “Denton Road” intersection, a car crosses the center line and strikes hers head on, landing nearly on top of her 2001 Buick LeSabre. Merri Kaye has no memory of the collision, just a recollection that could be memory or dream. “I remember yelling for help,” says Merri Kaye. “I was not in pain. I was not cold. Everything was pitch black. When the first responders got to me, they said I talked to them but would not open my eyes.” The other driver is pronounced dead at the scene. Merri Kaye’s chance of survival in

1-800 Trauma Transfer Line to be answered by trauma surgeons

grow. With braces on both legs, one arm immobilized from shoulder to wrist and the other wrist in a cast, her parents and nurses helped Merri Kaye with care tasks like feeding herself. Occupational therapist Kelly Little brings out a power reclining wheelchair to allow Merri Kaye to go outside and feel the spring air and life outside her room.

Ready to get moving

Merri Kaye Bradley with her parents, Julie (left) and Terry Bell. the next hours is in the single digits. Along with broken bones in her legs, pelvis, elbow and wrist, she has life-threatening injuries to her liver and spleen. After a 75-minute extrication, she is taken by air ambulance to the Bryan West Campus, where she defies those low odds of survival. When Merri Kaye wakes up, her busy life has shrunk to a hospital bed and a calendar with just one activity: healing. To understand how much healing, consider being unable to bear weight on anything but one elbow for weeks, notes Brad Howe, one of Merri Kaye’s physical therapists at Crete Area Medical Center. (She transferred between CAMC and Bryan during different stages of recovery.) Her first weeks in the hospital were spent in bed, waiting for bones to heal, an activity on pace with watching corn

Naturally, Merri Kaye eventually asks for a timetable of when she will walk and go home. The doctor’s answer gives her perspective and a glimpse of how severe the crash was. “He basically said: ‘Be thankful you are where you are.’ He talked about how much blood they gave me and the unknowns about my brain at first. That’s when I realized that I might not have made it here,” says Merri Kaye. Recovery passes day-by-day. “She’s just tougher than nails, but it was a slow process,” Brad says. “One weekend I told her I wasn’t going to come in because there wasn’t anything we could do, yet. When I got the message she could stand to do a pivot transfer I’d never been so glad to come in on a Sunday because we could finally do something. Just standing and pivoting was monumental.” That milestone provided a big emotional boost for someone whose inpatient status kept her away from her husband, her daughter’s and son’s athletic games — even Hunter’s junior prom. “I’ll never forget the day she started smiling like herself again. To see her emotional recovery, that was probably as powerful as the physical recovery,” Brad says. Few people could have handled the

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he Trauma Service at Bryan Medical Center is re-organizing the process for which trauma transfers and consultations are received. As of March 1, 2016, the 1-800-873-6572 Trauma Transfer Line is being answered directly by the trauma surgeon on call. This will provide physicians and physician extenders with a personalized service and immediate acceptance or consultation of injured patients. As a part of this process, after the trauma

surgeon speaks with providers, the nursing staff from the Emergency Department on Bryan West Campus will then contact nursing staff at the referral facility to receive a report on the patient. It also is permissible for your staff to contact the Emergency Department on the Bryan West Campus at 402-481-5142 to give report if they have not received contact from Bryan prior to the patient’s departure from their facility.

patients with any type of injury into the Bryan Health System. As with all process changes we anticipate there will be positives and negatives. If you experience any difficulties as a result of this change, please contact Robbie Dumond, Trauma Program manager, at 402- 481-5150 immediately so that your concerns can be addressed. We look forward to being able to provide you with a more personalized service to meet your needs. n

We ask that you use the 1-800- 873-6572 phone line to transfer all

Sign up for these 2016 Trauma Education Courses These courses are in the Conference Center on the Bryan West Campus, unless noted otherwise.

by Jason Kruger, MD, emergency medicine specialist and Medical Director of Lincoln Fire and Rescue.

Trauma Nursing Core Course (TNCC) Thursday-Friday, Nov. 3 and 4.

Trauma Grand Rounds Presented on Fridays, noon-1 p.m.

Trauma Symposium Friday, Sept. 23.

ATLS Faculty Course Friday, Nov. 18.

May 27, University of NebraskaLincoln Nebraska Transportation Center Director Laurence Rilett and Midwest Roadside Safety Facility Director Ron Faller.

Advanced Trauma Life Support (ATLS) Thursday-Friday, Oct. 6 and 7. Thursday-Friday, Dec. 8 and 9.

Mock Trauma Team members come to your facility to provide Mock Trauma training in a non-threatening environment.

Advanced Trauma Life Support-Refresher (ATLS-R) Friday, Oct. 14.

For additional questions regarding courses or free trauma education provided at your facility or in your community, contact trauma outreach and injury prevention coordinator Heather Talbott at 402-481-4087, or email heather.talbott@bryanhealth.org.

June 24: Traumatic Foot and Ankle Care in the Acute Care Setting, presented by orthopedic surgeon Keith Hughes, MD. July 22: Operation Tipping Point: Gang Violence Aug. 26: LUCAS 2 Device, presented

Emergency Nursing Pediatric Course (ENPC) Thursday-Friday, Oct. 20 and 21. Trauma Nurse Coordinator Workshop Friday, Oct. 28.

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We pay tribute to Champions

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his year’s Tribute to Trauma Champions, presented by Union Bank and Trust, was April 7, at the Lincoln Marriott Cornhusker Hotel and Convention Center. We recognized trauma survivors Heather Boulais and Merri Kaye Bradley and the many dedicated professionals from throughout the statewide trauma system who were involved in saving them. Union College student Heather fell more 20 feet while she prepared for gymnastics practice. Merri Kaye, of Crete, was injured when her car was hit head-on by another vehicle. To see powerful video stories about their journeys to recovery, VIDEO please go to bryanhealth. org/tribute-trauma-champions. Trauma surgeons Stanley Okosun, MD, (left) and Reginald Burton, MD, were all smiles while posing with trauma survivors Merri Kaye Bradley and Heather Boulais.

Heather Boulais, with her sister Rachel’s assistance, walked onto the stage.

Bryan trauma registrar Deb Schleiger, CSTR, received this year’s Director’s Award from Reginald Burton, MD.