TRAUMA UPDATE
News from the Trauma Center at Bryan Medical Center SUMMER 2015
Hundreds celebrate trauma champions
I
By Danny O’Byrne, Education Services
t takes innovative and aggressive treatments to bring critically injured patients back from death, and that’s just what the Nebraska Trauma System and Bryan Trauma Center celebrated April 22, along with patient families and care givers, at the 2015 Tribute to Trauma Champions. More than 500 gathered at the Embassy Suites in downtown Lincoln to recognize our 2015 trauma survivors, Nicholas Boruch of Osceola and Taylor Graham of Lincoln, and their trauma champions. n
Go to bryanhealth.com/ 2015-trauma-champions to see videos and hear their inspirational stories.
Nick Boruch (in center) saluted his first responders at the Tribute to Trauma Champions.
Taylor Graham’s (seated) first responders surrounded him and his family at the event.
2
Scenes from our annual event
1
2
3
4 (1) Nick Boruch poses with ICU nurse Abi Hoefer; (2) the champions take a bow: (3) Taylor Graham leaves his wheelchair behind to walk onstage; and (4) Dr. Reginald Burton and Taylor are all smiles before the awards.
Hundreds gathered at the Embassy Suites to recognize those who go above and beyond to save the lives of trauma patients, like Nick Boruch and Taylor Graham.
3
Awards honor McMeekin and Travis Trauma Director’s Award Each year at the Tribute to Trauma Champions, Director of Trauma Reginald Burton, MD, presents the Trauma Director’s Award. This is given to an individual who has demonstrated outstanding support and leadership to the Bryan Trauma Program through professional practice, education, advocacy, injury prevention, trauma system development and legislative involvement. This individual must also demonstrate a commitment to continually improve care for trauma patients. The recipient of the 2015 Trauma Director’s Award is Barb McMeekin. Barb started at Bryan Medical Center in 2002 as a computer analyst. Although her work is done behind the scenes, her effort and dedication to the Bryan Trauma Program is second to none. Throughout the years Barb has developed a regionwide, webbased registry for data submission for all Region 2 referring hospitals; she assisted with the Trauma Program’s transition to electronic documentation with Salar; and she personally entered all of the trauma related ICD-9 codes to ensure physicians could correctly code trauma injuries. In addition to the expertise in her field, Barb is always available, cheerful and professional.
Dr. Reginald Burton surprises Barb McMeekin with this year’s Trauma Director’s Award.
Pillar Award Shirley Travis, Bryan Health Vice President of Clinical Services and President of the Bryan Physician Network, received the first-ever Pillar Award. This award recognizes an individual who occupies a central or responsible position, is a prominent and chief supporter, marshals efforts towards positive change and inspiring others, impacts the lives of others, sustains professional distinction and provides significant lifetime contributions. Shirley has provided visionary leadership, unwavering dedication and commitment to excellence in trauma care. She will be greatly missed when she retires this summer. n
Retiring Vice President Shirley Travis received the first-ever Pillar Award April 22 at the annual Bryan Tribute to Trauma Champions.
4
Identifying Post Traumatic Stress Disorder By David Miers, PhD, LIPC
P
ost Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Bryan Medical Center Mental Health Services staff identified a primary care PTSD screening tool for Bryan Specialty Clinic nurses to use in follow-up visits with trauma patients. Patients who answer “yes” to any two of the four screening questions are informed that follow-up with a trained professional is indicated, and they also receive information on PTSD and a brochure about Bryan Counseling Center services.
Our confidential screening tool also can be accessed online at: www. bryanhealth.com/online-screenings. Screening tools for PTSD, depression and other conditions are available here.
Traumatic events that may trigger PTSD include violent personal assaults, military combat, natural or human-
caused disasters, crashes and accidents. Helping the patient’s family understand PTSD is important. The person with PTSD may act differently, such as becoming angry more easily or not wanting to do things that the family used to enjoy together. Family members may have difficulty accepting changes that PTSD can bring. Anger and frustration are normal reactions, but they can hurt relationships and even lead to dangerous situations. By talking with and supporting each other, the patient and family will be better prepared for such changes. Call the Bryan Counseling Center at 402-481-5991 to find out more about mental health services. n
The impact of PTSD on families
W
hen someone has Post Traumatic Stress Disorder, it changes family life. The person with PTSD may act differently and get angry more easily. Your loved may not want to do things you used to enjoy together. This can be scary and frustrating — it is common for people to worry that things will not go back to how they were before PTSD. How can you help? u Learn as much as you can. Knowing how PTSD affects people may help you understand what your loved one is going through. u Offer to go to doctor visits with your family member, to help keep track
of medication and therapy and to provide support. u Include your loved one in family activities, such as going to dinner or a movie. u Exercise is important for health and helps clear the mind, so do physical activities together, like walking or biking. u Encourage contact with family and friends. Support systems help people get through changes and stressful times. If your family member does not want your help, remember that withdrawal is a symptom. Give your loved one space, but tell him or her that you are always available. Things that suddenly remind the person of the traumatic event are called triggers. They can bring up stressful
feelings or cause flashbacks which make the person feel as if he or she is reliving the event all over again. It is normal to avoid things that cause stress, but staying away from activities you used to enjoy may be hard on the patient, as well as the family. Talk about triggers, so everyone knows what causes stress and helps find ways to cope. Some common triggers include social events, sounds, even smells. For example, smoke may trigger memories for someone who was hurt in a fire; loud noises or a car backfiring can remind a veteran of combat. Even being around others who were involved in your traumatic event can be a trigger. Plan enjoyable activities around anniversaries of traumatic events.
5
How can I deal with anger or violent behavior? Anger is a normal reaction to trauma, but when anger leads to violent behavior or abuse, it is dangerous. Go to a safe place and call for help right away. Make sure children are safe, as well. Establishing a time-out system can help you talk with a person who has PTSD even when you or they are angry. For example, you may agree: u That either of you may call a time-out. u When a time-out is called, discussion stops. u On a hand signal or word to use to call a time-out. u To tell each other what you will be doing during the time-out and when you will return.
When you come back, take turns talking about solutions — and listen without interrupting. It is likely you both will have good ideas, so be open and focus on things you both think will work. You and your family may have trouble talking about feelings, worries and everyday problems. To communicate better, be clear and to the point. Stay positive because blame and negative talk will not help the situation. Teaching children about PTSD also is important. They may not understand why you or your spouse is feeling sad or why you get angry — this can be scary at any age. Kids also may blame themselves for situations that are not their fault, so make sure that they know you are not blaming them.
If you are having trouble talking things over, consider trying family therapy. This type of counseling involves your whole family. A therapist helps you communicate, cope and maintain good relationships. Your health professional or a religious or social services organization can help you find a family therapist who specializes in PTSD, such as the therapists at the Bryan Counseling Center. To contact the Bryan Counseling Center, call 402-481-5991. n Information for this article came from the National Center for Post Traumatic Stress Disorder. To learn more, email ncptsd@va.gov.
Bryan Trauma welcomes new team members Liz Dunklau, APRN Liz grew up in Hastings, then moved to Phoenix for a couple years before moving to Omaha, where she earned an ADN at Metropolitan Community College in 2008. She then received her BSN in 2010 and MSN in 2014 from the University of Nebraska Medical Center, all while working as an ortho/spine floor nurse at Immanuel Medical Center. One of Liz’s interests is in rural health care, and she was able to complete the Advanced Rural Hospital Care program at UNMC. In addition to being a nurse practitioner for the Bryan Trauma Service, Liz is a member of Arlington Volunteer Fire & Rescue squad. Liz and her husband, Cory, have a 16-month-old daughter, Emme. Outside of work Liz enjoys home renovation and landscaping projects. n
Scott Schroeder, MSN Scott grew up in Lincoln and earned a Biology degree from the University of Nebraska-Lincoln. In 2004, he attended Bryan College of Health Sciences and obtained a diploma in nursing. Scott has worked as a registered nurse for the past 10 years in the Neurotrauma/ ICU at Bryan Medical Center. During this time he earned a Bachelor of Science in Nursing from the University of Nebraska Medical Center, and he graduated in May with a Master’s in Nursing, specializing in the Acute Care Nurse Practitioner program at UNMC. Scott looks forward to being a nurse practitioner with the trauma program and to continue to provide excellent care for trauma patients at Bryan Medical Center. He enjoys traveling and spending time with his wife and children. n
6
Belmont Rapid Infuser standardizes Bryan Trauma Center process By Kelli Klopfenstein, Nursing Manager
B
ryan Medical Center West Intensive Care and Emergency Departments recently converted to the Belmont Rapid Infuser for critical patients needing intravenous fluids or blood products rapidly. This is the rapid infuser that the operating rooms have been utilizing for the past five years, and we have now standardized equipment to increase efficiency and reduce the risk of error. When a patient presents with severe hypovolemic/hemorrhagic shock (trauma or gastrointestinal bleeding), it is a medical emergency. Using a regular intravenous infusion pump limits infu-
sion rates to 1,000 milliliters per hour. In comparison, the Belmont Rapid Infuser can infuse up to 750 milliliters per minute, or 45,000 milliliters per hour depending on the size of intravenous catheter. The pump also warms fluid/blood products during the infusion, preventing further potential patient complications. In addition to intravenous fluids, the Belmont can transfuse packed red blood cells and plasma. The Belmont Rapid Infuser is relatively simple to use for medical professionals and can mean the difference between life and death for our patients. n
ACS reverifies Bryan as Level II Trauma Center After a review conducted by site reviewers from the American College of Surgeons (ACS) Verification Review Committee on March 30-31, Bryan Medical Center has been re-verified as an American College of Surgeons Level II Trauma Center. During the review process, the facility and staff demonstrated competence in the criteria put forth by the ACS Verification, Review and Consultation Program. This process is designed to help hospitals continuously improve trauma care. More than 400 trauma centers nationally have achieved verification from the American College of Surgeons. The Bryan Trauma Program is one of three Level II Trauma Centers in Nebraska who are
currently verified by the ACS. As Nebraska’s first American College of Surgeons verified Trauma Center, the Bryan Trauma Center is a leader in providing highly skilled care, educating professionals and responding when tragedy strikes to restore life and promote recovery and rehabilitation. The Bryan Trauma Program would like to thank all of those who participate in the trauma system for their efforts and contributions each and every day! It is because of you that our trauma center continues to be a leader in trauma care in the region. n
7
Save the date Trauma Symposium is Sept. 25
F
or the Friday, Sept. 25, Bryan Trauma Symposium, the Bryan Trauma Program offers topics that will appeal to all members of the Nebraska State Trauma System. Whether you are on a rural volunteer EMS squad, a physician in a critical access hospital or a nurse, this educational opportunity is for you. This year the Trauma Program is proud to bring in two keynote speakers who are experts in their field. Dr. Alexander Eastman Alexander Eastman, MD, is the Interim Trauma Medical Director at Parkland Memorial Hospital, as well as the Chief of Trauma at the University of Texas-Southwestern Medical Center in Dallas. Dr. Eastman is a member of The Hartford Consensus that met in 2013 as a joint committee to create a national policy to enhance survivability from mass casualty shooting events, such as the Sandy Hook Elementary shooting. In addition to being a trauma surgeon, Dr. Eastman is a member of the Dallas Police Department and is passionate about the impact first responders can have on saving lives in the field. Dr. Kenneth Lee Kenneth K. Lee, MD, is an Associate Professor in the Department of Physical Medicine and Rehabilitation at the Medical College of Wisconsin. In addition to being a professor, Dr. Lee is a Colonel in the United States
Army Reserve. While a Lieutenant Colonel, Dr. Lee served as a Company Commander of Company B, 118th Area Support Medical Battalion in Baghdad, Iraq, during Operation Iraqi Freedom. Dr. Lee delivers a most accurate, sobering and effective picture of combat that leaves his listeners with a better understanding of the origins of trauma, and an expanded appreciation of the trauma manifesting on return, such as PTSD. And there’s more! In addition to these keynote speakers, Trauma Medical Director Reginald Burton, MD, and Associate Trauma Medical Director Stanley Okosun, MD, will present What’s New in Trauma and Trauma Case Reviews. Trauma Program Manager Robbie Dumond, RN, EMT-I, will discuss State Trauma Designation — and by popular demand, there will be four breakout sessions, with hands-on activities, from a trauma simulation to understanding how telemedicine can play a role in caring for trauma patients. You do not want to miss this! Register online at bryanhealth.org and select professional education. n For more information about the upcoming symposium, contact Trauma Outreach and Injury Prevention Coordinator Heather Talbott by calling 402-481-4087, or email her at heather.talbott@bryanhealth.org.
Sign up for these Trauma Courses These courses are in the Conference Center at Bryan West Campus, unless noted otherwise. ATLS — July 30 and 31. ATLS — Oct. 1 and 2, at Seward. ATLS Refresher only — Dec. 11. TNCC — Nov. 2 and 3. ENPC — Oct. 21 and 22. Bryan Trauma Symposium — Sept. 25. Trauma Grand Rounds — Fourth Friday of every month except September, November and December. Mock Trauma — Trauma Team members come to your facility and provide Mock Trauma training in a safe, non-threatening environment. Information about these courses can be found at bryanhealth.csod.com/LMS/catalog/ Welcome.aspx. For additional questions, contact trauma outreach and injury prevention coordinator Heather Talbott at 402-481-4087, or email heather.talbott@bryanhealth.org.
Free continuing education available to you Contact Heather Talbott to inquire about free trauma education provided at your facility or in your community. Some of the topics earning CME credits and CEUs are Current Trends in Trauma, the Trauma System and EMS Trauma Case Reviews.
Trauma Update is published for friends of Bryan Health. Your comments and suggestions are welcome. Direct correspondence to the Advancement Department at Bryan, or telephone the editor at 402-481-8674. Trauma Update also is available at bryanhealth.com/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
Non-profit Org. U.S. Postage
PAID
Permit No. 267 Lincoln, NE
Address service requested
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.
May is National Trauma Awareness Month The slogan for this year’s National Trauma Awareness Month campaign, “3D Trauma Prevention,” focuses on three contributors to motor vehicle crashes: Drugs/ Drinking, Distraction and Drowsiness. In 2013, the United States saw more than 32,000 fatalities and over 2.3 million injuries from motor vehicle crashes. Of those, 31 percent involved an alcohol-impaired driver, and 18 percent involved a distracted driver. Awareness of these statistics and prevention strategies are key in decreasing and eventually eliminating these startling statistics. For information regarding Trauma Injury Prevention Strategies, please contact Trauma Outreach and Injury Prevent Coordinator Heather Talbott at 402-481-4087, or email her at heather.talbott@bryanhealth.org.