TRAUMA UPDATE
News from the Trauma Center at Bryan Medical Center SUMMER 2016
Kent recovers from life-threatening boating injuries
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n May 26, 2014, Kent Seevers gained firsthand knowledge of the impact the Nebraska State Trauma System has on saving lives. Kent and five of his friends were enjoying a beautiful day on Branched Oak Lake, skiing and wakeboarding. Kent had just finished wakeboarding when he went to the front of the boat to hold the flag. Kent remembers the lake was extremely crowded that day as it was the start of the Memorial Day weekend. As one of his friends was wakeboarding, the driver of the boat took a sharp turn to avoid another boat that was in their path. Kent lost his balance and was thrown over the side of the boat. Kent recalls going over and being under the water; he felt the hull of the boat hit him but doesn’t’ recall it hurting. When he surfaced he lifted his arm out of the water and saw “a lot” of blood; that’s when he realized the propeller had shredded
Kent and Jenny Seevers appreciate the effectiveness of the trauma system, from first responders to staff at the Bryan Trauma Center, medical center and rehabilitation program. it — and then the pain set in. The propeller caused significant injuries to his arms, as well as his chest and chin. He began yelling for help as he struggled to tread water without the use of his arms. As he was pulled out of the water, another boat with two nurses from CHI-St. Elizabeth’s stopped to assist. The nurses immediately began applying pressure and wrapping T-shirts around his wounds as improvised tourniquets. (For their efforts, these nurses later received the Public Servant Hero Award from the American Red Cross.) Kent was rushed to the shore where he was met by EMTs from Raymond Fire and Rescue. The EMTs recognized the critical injuries that Kent suffered and applied a tourniquet to each arm to stop the bleeding. StarCare landed nearby, and he was loaded onto a cot and transported by air ambulance to the Bryan Trauma Center. Due to his mechanism of injury, Kent was declared a Category I trauma.
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Kent recovers from traumatic injuries Kent remembers when he arrived at the Bryan Trauma Center, there was a room full of people in the trauma bay in “work” mode. He remembers Stanley Okosun, MD, telling him that the team was going to take excellent care of him. In addition to Dr. Okosun and the Bryan trauma team, Kent also was met by orthopedic surgeon David Samani, MD, and plastic and reconstructive surgeon Cassidy Mitchell, MD. Kent was in the trauma bay for a total of 28 minutes. During that time he was intubated, had a central line placed, and received antibiotics as well as several units of blood. He spent the next 3 hours and 35 minutes in the operating room as the surgeons including vascular surgeon Robert Pitsch, MD, worked to save not only Kent’s arms but his life. When all was said and done, Kent suffered from a left pneumothorax, bilateral upper extremity complex wounds, left open humerus, radius and ulna fractures, chin laceration and left ulnar nerve injury. Kent spent five days in intensive care and had multiple surgeries. After 10 days in the hospital, he was dismissed home, returning to the Trauma Clinic with multiple follow up visits and close ongoing assessment of his progress. The trauma team was impressed by his constant improvement and positive approach, even though some days seemed long and endless. Kent persevered and, with the support of friends and family, achieved the goal of reaching his new normal. Kent spent the summer of 2014 in and out of the Specialty Clinic, seeing the trauma team, being managed for wound care, and continuing his physical and occupational therapy to assure his hand, wrist and arm function would
Kent’s chest injuries caused by the boat propeller are evident in this photo. be the best it could be. He also endured pain management, nerve conduction therapy and continuing visits with the orthopedic and plastic surgeons. Kent always came with a smile and a positive attitude. He officially completed formal rehabilitation in January of 2015. As the physical part of the body heals, the mind must heal, as well. Post-traumatic stress is a key assessment that is addressed with every patient who is evaluated. Kent was supported by the team of specialized counselors, helping him work with challenges he would face with the temporary limitations he would have to deal with. Regaining function of his hands was always a concern. As Kent reflects back on the day that changed the course of his life, he is thankful for the State Trauma System and the dedication of all who helped him.
At the time of Kent’s injury, tourniquets were not required to be carried on the ambulance; however, Raymond Fire and Rescue went above and beyond being prepared, as the crew had multiple tourniquets on their ambulance, which saved Kent’s life. He is thankful that the StarCare pilot had the experience and knowledge to land the helicopter near the boat dock, managing the winds and other physical elements of the day. He also is thankful for the Bryan Trauma Team, from those that stabilized him in the trauma bay all the way to the Trauma Clinic nurses that he became friends with. Kent is living in Lincoln and recently started his own business. He is extremely pleased with his outcome and all who were part of his recovery — including his occupational therapy assistant, Jenny, who is now his wife. n
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Sign up for these 2016 Trauma Education Courses These courses are in the Conference Center on the Bryan West Campus, unless noted otherwise. Trauma Grand Rounds Presented on Fridays, noon-1 p.m. July 22: Operation Tipping Point: Gang Violence, presented by Sgt. Jeffrey Sorensen of the Lincoln Police Department. Aug. 26: LUCAS 2 Device, presented by Jason Kruger, MD, emergency medicine specialist and medical director of Lincoln Fire and Rescue. Trauma Symposium Friday, Sept. 23. Registration is now open at www.bryanhealth.com/ trauma-symposium.
Advanced Trauma Life Support (ATLS) Thursday-Friday, Oct. 6 and 7, in Geneva.. Thursday-Friday, Dec. 8 and 9, in Lincoln. Advanced Trauma Life Support-Refresher (ATLS-R) Friday, Oct. 14. Emergency Nursing Pediatric Course (ENPC) Thursday-Friday, Oct. 20 and 21. Trauma Nurse Coordinator Workshop Friday, Oct. 28. Trauma Nursing Core Course (TNCC) Thursday-Friday, Dec. 29 and 30. ATLS Faculty Course Friday, Nov. 18. Mock Trauma Team members come to your facility to provide Mock Trauma training in a non-threatening environment.
Trauma on the Road 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.
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Heather continues her progress At this year’s Tribute to Trauma Champions on April 7, we recognized trauma survivors Heather Boulais and Merri Kaye Bradley and the many dedicated professionals from the statewide trauma system who were involved in saving them. The spring edition of Trauma Update featured Merri Kaye’s story; the following is about Heather and her recovery. To see powerful VIDEO video stories about their journeys, go to bryanhealth.org/tributetrauma-champions.
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3 Heather Boulais’s support team (1) includes her sister, Rachel (left), parents Cheryl and Terry, and sister, Summer. The family temporarily moved from California to Lincoln to help Heather with her recovery. First responders after Heather fell included her Union College acrobatics teammates (2) and Lincoln Fire and Rescue (3).
Heather, with Rachel’s assistance, walked onto the stage at the Tribute to Trauma Champions.
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eather Boulais was setting up her gymnastics apparatus Jan. 14, 2015, when tragedy befell the Union College student. “She’s on the Gymaires acrobatics team at Union College,” says her mother, Cheryl. “We were home in California and got a phone call that night, saying Heather had been injured.” While getting her silks ready to hang from the ceiling, her safety harness failed, sending Heather 23 feet to the gym floor. Cheryl and husband Terry — both alumni of Union College in Lincoln — discovered the network of responders that helped Heather that evening had a Union relationship. Teammates and coaches — at least one had nurse’s training — stabilized Heather’s airway while Lincoln Fire & Rescue rushed to the scene. An LFR squad member had attended Union and knew the quickest route to the gym, and Reginald Burton, MD, trauma director at Bryan, was Terry’s classmate at Union College. “From what I understand, the ambulance arrived in under four minutes, and she was in surgery less than an hour after the accident,” Cheryl recalls. “Dr. Burton was the trauma surgeon, and Dr. Daniel Tomes was the neurosurgeon.” Heather was a patient in the intensive care unit (ICU) at Bryan West Campus for 30 days, and continues to attend outpatient rehab at Madonna Rehabilitation Hospital. Cheryl says, “No one can predict how this road will go, but Heather’s only 24, and her determination and the many worldwide prayers for her are going a long way toward a successful recovery.” n
Trauma team participates in communitywide disaster exercise to prepare for Guardians of Freedom Airshow
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s part of a multi-agency communitywide effort, Bryan Medical Center’s Trauma Program and staff participated in a disaster exercise simulating an aircraft crash occurring at the Lincoln Airport. This particular exercise tested the medical center’s command structure, surge capacity, patient tracking and many other vital functions that are necessary in order to provide high-quality care during events such as this scenario. The event involved actors portraying moulaged patients who presented to the Emergency Department on Bryan East Campus and Bryan West Campus following a very realistic exercise that was conducted at the airport. The exercise simulated an aircraft fire and the need to evacuate patients from the aircraft, as well as appropriate scene triage of patients prior to transfer to the trauma center. Disaster triage and command was initiated at both campuses of Bryan Medical Center, and patients were treated for their simulated injuries through their final disposition during the exercise. Following the exercise, a communitywide hot wash of the event was attended by Bryan Medical Center staff members and every community player involved in the exercise to identify strengths, weaknesses and opportunities for improvement prior to the Guardians of Freedom Airshow, which was held May 6-8, 2016. Exercises such as these are vital to the success of the trauma program and the collaboration between agencies throughout Lincoln and Lancaster County. n
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If you see something, do something
Stop the bleed to improve survival
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r. Reginald Burton and the Bryan Trauma Program were recently involved in over 30 hours of training with 300 Lincoln Police Officers, 100 Lincoln Fire and Rescue personnel and 50 Lancaster County Sheriff’s Department personnel as part of a communitywide effort to prepare for active shooter events in the community. In addition to tactical training received, personnel were taught the principles of hemorrhage control, including tourniquet application utilizing the BCONŽ template by the National Association of Emergency Medical Technicians (NAEMT). This training was provided in response to the Hartford Consensus, a comprehensive review of the response and injury data of active shooter events in the United States from 2000-2013. This training is instrumental in saving lives during a response to an active shooter event in the community. Ongoing work is also under way to secure funding for public safety personnel within Lincoln Lancaster County to have immediate access to tourniquets and hemorrhage control supplies. If you are interested in this training, please contact Trauma and Emergency Preparedness Manager Robbie Dumond at 402-481-5150. n
Law enforcement personnel and fire fighters were part of a communitywide effort to prepare for active shooter incidents. Bryan Trauma Program staff helped teach the principles of hemorrhage control, including tourniquet application.
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Talbott attends ATLS Global Symposium, courses available at Bryan
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n March of this year, Trauma Outreach and Injury Prevention Coordinator Heather Talbott attended the 2016 ATLS Global Symposium in San Diego. Heather is the ATLS Coordinator for the Bryan Trauma Center, and this meeting allowed her to network with other ATLS coordinators from around the world. Advanced Trauma Life Support concepts and instruction originated at Lincoln General Hospital (now Bryan West Campus, which houses the Bryan Trauma Center). ATLS is taught all over the world to health care providers that care for trauma patients. The course teaches a systematic way to assess and treat a trauma patient to ensure quality outcomes. The 10th Edition of the ATLS Program is set to be released in the Fall of 2016. If you are interested in registering for an ATLS course at Bryan Trauma Center, please contact Heather Talbott at heather.talbott@bryanhealth.org. n
Dr. Burton earns ACCM Fellowship Reginald Burton, MD, FACS, FCCM, was inducted into the American College of Critical Care Medicine (ACCM) at the ACCM Awards Presentation held on Feb. 22, 2016, in Orlando, Florida. During this ceremony, 81 ACCM members were honored with the prestigious designation of Fellow. Dr. Burton is director of trauma and acute care surgery at Bryan Medical Center, and he is Region 2 medical director for the Nebraska Statewide Trauma System and a member of the American College of Surgeons National Committee on Trauma. The ACCM honors practitioners, researchers, administrators and educators who have made outstanding contributions to the collaborative field of critical care. Congratulations to Dr. Burton. n
Bryan Trauma Program staff attend Society of Trauma Nurses Conference
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ver 500 nurses gathered in Anaheim, California, to share best practices and learn about changes and updates in evidence based trauma care. Bryan Medical Center Trauma Outreach and Injury Prevention Coordinator Heather Talbott and Trauma Program Manager Robbie Dumond attended the conference and participated in specific work groups focused on improvements in trauma care. Ms. Talbott was selected to be the Nurse Planner for the Advanced Trauma Care for Nurses National Committee. Bryan Trauma Center recently introduced the Advanced Trauma Care for Nurses (ATCN) course to the state of Nebraska and is anxious to assist other trauma centers within our state in getting their programs up and running. Among the highlights of the conference was a keynote address by Sharp Healthcare Executive Vice President Daniel L. Gross, RN, DNS, on Challenges Facing Healthcare and a large white board where nurses could write all of the
reasons they are a trauma nurse. Conferences such as these are instrumental in advancing trauma programs and networking among trauma program leaders across the country. n
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
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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 Heather Talbott at 402-481-4087, or email her at heather.talbott@bryanhealth.org.
Save the date: Bryan Trauma Symposium is Sept. 23 Please join us on Friday, Sept. 23, for the 2016 Bryan Trauma Symposium. This year’s symposium will be held at Nebraska Innovation Campus starting at 0710. In addition to members of our trauma team speaking at the symposium, we are excited to bring in the following outside speakers.
Oscar D. Guillamondegui, MD, MPH, FACS Associate Professor of Surgery; Medical Director, Trauma ICU; Director, Vanderbilt Multidisciplinary Traumatic Brain Injury Clinic; Vice Chairman for Surgical Quality, Safety, and Professionalism, Nashville. Dustin Smoot, MD Chief of Surgery and Trauma, Spearfish Regional Hospital, Spearfish, South Dakota.
Suzanne B. Haney, MD Assistant Professor; University of Nebraska Medical Center, Omaha. Sgt. Jeff Sorensen Gang Unit Sergeant, Lincoln Police Department. Scott Wiebe, NREMT-P EMS Supervisor, Lincoln Fire & Rescue. Registration is now open at www.bryanhealth.com/ trauma-symposium.