Trauma Update Spring 2012

TRAUMAUPDATE News from the Trauma Center at BryanLGH

SPRING 2012

Teen survives motocross crash, looks forward to new challenges

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pring and summer in Nebraska are great seasons to be outdoors — times when many enjoy motocross racing, a popular activity for the young and young at heart.

This form of dirt bike racing is held on tracks throughout the state.

Like most sports, it involves risk. Orthopedic and head injuries top the list. Internal injuries are less frequent, but they also occur.

Hastings native Jake Hahne and his family can speak to the potential dangers of motocross. It was Sept. 11, 2011, and 16-year-old Jake was doing what he loves most — motocross racing. At a Spring Hill Motocross competition at Deweese he was attempting to win his third motorcycle title of the day, when something went wrong. The bike crashed just a few hundred yards from the finish, and Jake landed on top of its handlebar, which dug deep into his left side. He initially thought he would be fine and went home with his family.

Transported to Trauma Center Unfortunately, that was only the beginning for Jake. He began having increasing abdominal pain and vomiting, and his parents took him to Mary Lanning Memorial Hospital in Hastings.

There, Dr. Timothy Blecha recognized the potential for serious injury and ordered a CT scan. The results confirmed that Jake had a serious abdominal injury. He had a lacerated liver, injury to his duodenum and massive injury to his pancreas.

An ambulance transferred him from Hastings to the BryanLGH Trauma Center as a Category 1 Trauma Alert, the highest level trauma activation.

Jake was greeted by trauma surgical critical care surgeon Stanley Okosun, MD, and the whole trauma team at BryanLGH West. After thorough evaluation of the radiology studies, Jake was admitted to the Trauma Critical Care Unit for further resuscitation.

“Dr. Blecha and the staff did everything exactly right,” recalls Jake’s mother, Jill Hahne. “They found he was seriously injured and sent him to BryanLGH, where he continued to receive excellent care.”

Motocross champion Jake Hahne with his parents, Rick and Jill Hahne, appreciates the care he’s received since his crash. He’s not racing this year, but during his recovery Jake developed an interest in a health care career.

Crash damaged organs The next morning, Jake was taken to the operating room, where surgeons explored his abdomen, removed his gallbladder and placed multiple drains around the pancreas. The trauma surgical critical care team was concerned that damage to his pancreas could require removal of all of the pancreas past the injured area.

Hahne story has new chapters Because the injury was so close to the duodenum, this may have left Jake a brittle diabetic the rest of his life. Preparations were made to be able to process the removed pancreas and autotransplant some of his pancreatic cells back into his liver; but on Sept. 12, after several attempts, surgeons were able to place a stent across the injured pancreatic duct and save the rest of his pancreas. The surgeons also placed a feeding tube to allow early distal feeding and rest the pancreas. Jake had three abdominal drains to remove fluid from his abdomen. He was mobile early and got out of bed and walked — he also had broken a foot in the crash, but that didn’t seem to slow him down much.

Follow up continues As Jake gradually improved, the abdominal drains were removed and he was able to begin eating regular food.

After 16 days at BryanLGH, Jake went home with his family to Hastings, but his story doesn’t end there. He had a short return to the hospital one week later because he was nauseated and vomiting — fortunately the stents were still in place and his pancreas was functioning well.

Jake has continued to follow up in the outpatient Trauma Clinic, seeing the same trauma team members who cared for him while he was in the hospital.

His feeding tube and pancreatic stent have since been removed. During Jake’s last appointment at the Trauma Clinic, he reported feeling well.

Along with the excellent care Jake received at BryanLGH, his parents say he also had a lot of support from family and friends, including his older sister, Kelli, and his girlfriend, Ashley Thomsen.

Jake’s father, Rick Hahne, adds, “We want to give special thanks to all the staff in

ACS survey team visits BryanLGH for Trauma Program recertification On March 28 and 29, 2012, American College of Surgeons surveyors were at BryanLGH to perform their reverification review of the Trauma Program.

BryanLGH was the first ACS verified Trauma Program in Nebraska and is the only Level II verified trauma center in the southeastern part of the state.

The official ACS report on the verification will not be available for several months; however, the survey team was very complimentary of the Trauma Program.

The exit interview was extremely positive with no deficiencies identified and a large number of strengths listed.

According to trauma medical director Reginald Burton, MD, “This was probably the most positive exit interview that we have ever had.”

The site surveyors carefully evaluated changes the trauma service has undergone over the last several years — including reorganization of the leadership, with the addition of Trauma Program manager Sheila Uridil and increased infrastructure with new midlevel providers, nursing and support personnel. They were greatly impressed with the outcome and were complimentary of the program.

The trauma service sincerely thanks all the care takers in the trauma system for the excellent care they provide our patients every day throughout the year.

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the ICU and to Dr. Okosun and Dr. Reginald Burton, along with the spiritual support of Father Casey Porada.”

Happy ending Jake’s story has a happy ending. Thanks to the teamwork at Mary Lanning and BryanLGH, he was able to celebrate his 17th birthday with friends and family and is back doing things he loves.

He’s taking a year off from racing to recuperate and concentrate on his junior year in high school — and now he’s considering a career in pharmacy or another area of health care. Recently he shadowed the trauma team at BryanLGH to gain new perspectives.

Remember: Athletes like Jake wear a helmet and protective padding while competing. Even with such precautions, sometimes the region’s trauma system is needed to help seriously injured patients return to life’s passions.

Kids’ Health & Safety Fair returns to BryanLGH June 9 Every year, BryanLGH offers a free Kids’ Health and Safety Fair as an opportunity to provide children and adults valuable health and safety lessons in a fun and festive atmosphere.

The 16th Annual BryanLGH Kids’ Health and Safety Fair will be held on Saturday, June 9, from 10 a.m - 2 p.m.

The fair date, generally held in August, was changed to escape the potential heat of late summer weather. The fair will be held at BryanLGH Medical Center East in the Zone B Parking Garage, 49th and Cotner.

Mark your calendars and bring your family and friends to the BryanLGH Kid’s Health & Safety Fair to increase awareness and promote injury prevention!

Collaboration leads to exceptional brain injury care

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hen trauma patients enter BryanLGH, the goal is not just to keep them alive — it’s to return them to living.

The trauma team and rehabilitation team work closely to provide the best possible outcomes. Therapists begin working with patients in the intensive care and medical units soon after patients are admitted. If their condition warrants, patients are transferred to the Acute Inpatient Rehabilitation Unit.

This is a 30-bed unit with all private rooms, located on the 3rd floor of BryanLGH’s West campus.

“Being in the same building as our trauma team members provides an extra level of safety and security for the patients

and their families,” states Rehabilitation Unit nursing manager Cindy Miller, BSN, RN. “If a patient’s condition changes, the trauma physicians are right here to see them.”

Being located in the medical center provides 24-hour access to radiology, laboratory, pharmacy and other services that are not always available to patients in freestanding rehabilitation facilities.

On average, patients with brain injuries are admitted to the BryanLGH Rehabilitation Program within about six days after an injury, compared to other patients in the region who typically have 14-day stays in acute medical units. This allows an intensive rehabilitation program to start early and helps prevent

WHAT IS A CONCUSSION? A concussion is a brain injury caused by a bump or blow to the head. It can happen in many kinds of sports for boys or girls. You can’t see a concussion. Signs and symptoms may show up right after the injury or may not be noticed until days or even weeks later.

If you notice symptoms, seek medical attention right away!

WHAT ARE SOME SIGNS? • • • • • • • •

The athlete appears dazed or stunned.

Forgets an instruction.

Moves clumsily.

Loses consciousness (even briefly).

Can’t recall events before a hit or fall.

Reports dizziness, blurry vision.

Vomits or has nausea.

Has sensitivity to light or noise.

WHAT SHOULD YOU DO? 1. Seek medical attention right away.

2. Keep your child out of play — concussions take time to heal. Returning to play while the brain still is healing risks another concussion, which could have very serious consequences.

3. Tell your child’s coach about any recent concussion.

further decline in the patient’s functional status. The earlier admission also results in a shorter rehabilitation stay. The length of stay in BryanLGH’s rehabilitation program is three days shorter than at other regional providers.

BryanLGH patients also have 10 percent higher improvement in their functional measures (according to erehabdata.com).

“Early therapy involvement and the close relationships between physicians and staff really are showing great outcomes for our patients who suffer brain injuries,” says therapy manager Bonnie Kreiter, BS, PT. The collaboration and teamwork within the BryanLGH Medical Center is key to exceptional outcomes, she concludes.

Law changes rules related to sports injuries The new concussion awareness law, LB 260, goes into effect July 1, 2012.

This impacts athletes 19 years and younger who participate in organized sports — and it’s why BryanLGH is teaming up with Husker Sports Network to promote the Heads Up Nebraska concussion awareness campaign.

LB 260 states that a coach or licensed health care professional affiliated with a school should remove any athlete from an activity when there is reasonable suspicion of having a concussion. The athlete is prohibited from participating in supervised team athletic activities until cleared by a licensed health care professional.

The coach also must notify the athlete’s parent or guardian of the date and approximate time of the injury, signs and symptoms of a concussion that were observed, and any actions taken to treat the athlete.

A concussion is a traumatic brain injury that alters the way your brain functions. Concussions are one of the most commonly reported injuries in children and adolescents who participate in sports and recreational activities. The risk

of catastrophic injury or death is significant when a concussion or brain injury is not properly evaluated and managed. Although most concussive TBIs are mild, every concussion injures your brain to some extent and needs time and rest to heal properly.

The bill also requires each approved or accredited public, private, denominational or parochial school to: Make available approved training to all school coaches on how to recognize symptoms of a concussion or brain injury and how to seek proper medical treatment.

Require concussion and brain injury information be provided to students and the students’ parents or guardians before beginning practice or competition. This information must include signs and symptoms of a concussion, risks posed by sustaining a concussion and actions a student should take in response.

To learn about responsibilities of care givers, coaches, trainers, parents and athletes, visit www. headsupnebraska.com or use your smartphone’s QR application to access the code at left.

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TRIBUTE TO TRAUMA CHAMPIONS

Annual event salutes life-saving e

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ryanLGH hosted the fourth annual Tribute to Trauma Champions. This year’s event was April 12 at the Rococo Theatre in Lincoln.

The evening honored hundreds of dedicated professionals involved in saving the lives of Elizabeth Canas Luong of Crete, who survived a shooting at the Americold storage plant, and William Wimmer of Lincoln, who survived a head-on car crash on Highway 79 in rural Lancaster County.

Trauma Champion honorees were individuals from all aspects of the trauma care system, such as law enforcement and EMS providers from Crete, Wilber and Raymond; physicians; Crete Area Medical Center and BryanLGH staff members and rehabilitation professionals; as well as family, community members and ongoing care providers.

During the Tribute, survivor stories highlighting the teamwork of the Trauma Champions were shared.

Honorees included care givers and others from: • BryanLGH StarCare air ambulance, • Teams at Crete Area Medical Center’s Rural Trauma Center and the Trauma Center at BryanLGH West, • Saline County, Crete and Lincoln-Lancaster County dispatchers, • Crete Police Department, Wilber Police Department, Saline County Sheriff’s Department and Crete Rescue Squad,

Survivors William Wimmer and Elizabeth Canas Luong.

Trauma Champions shared the spotlight on the Rococo stage with survivors Elizabeth Canas Luong (front left) and William Wimmer (front right) during the annual event. Go to www.bryanlgh.org for more photos.

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efforts • •

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BryanLGH trauma and surgical critical care director Reginald Burton, MD, (left) presents the Trauma Achievement Award to neurosurgeon Benjamin Gelber, MD.

whose members were among the first to respond to Elizabeth’s needs following the work place shooting in 2011, Lancaster County Sheriff’s Office, Raymond Rescue and Lincoln Fire & Rescue, who were first to respond at the scene of William’s crash last year, Trauma Team members, such as chaplains, Emergency Department staff, physicians, radiologic technologists and staff members from surgery, perfusion, ICU, orthopedics, pathology, pharmacy, respiratory therapy, care management, nutrition therapy, speech & physical therapy and the Trauma Outpatient Clinic, BryanLGH Acute Inpatient Rehabilitation staff, and Post Traumatic Stress Disorder counselors from BryanLGH and Blue Valley Behavioral Health.

To see videos of the survivors’ stories and see a list of honorees, go to www.bryanlgh.org or use your smartphone’s QR application to access this code.

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Tribute to Trauma Champions spotlight shines on Crete and Raymond rescue squad volunteers

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he annual Tribute to Trauma Champions recognized responders from the Crete Rescue Squad, who assisted Elizabeth Canas Luong, and Raymond Fire & Rescue, who helped William Wimmer.

Crete Volunteer Fire & Rescue Crete Volunteer Fire Department & Rescue Squad is a 50-member all-volunteer department serving the community of Crete. As a Basic Life Support squad, the volunteers are primarily EMTs. Career paramedics and nurses also contribute to the squad’s strength.

Crete has three ambulances — two for rescue calls and one for transporting patients from Crete Area Medical Center to other facilities, such as BryanLGH Trauma Center.

The volunteers work hand in hand with the local hospital, Crete Area Medical Center and emergency medical director Amy Vertin, MD, to continually expand knowledge and expertise to aide us in delivering care to the Crete community. Unique to this department are eight members who comprise the ICE rescue team for dive rescue and recovery.

Elizabeth Canas Luong (center) survived a shooting, thanks to responders like the Crete Rescue Squad (white shirts) and other local dispatchers and law enforcement personnel.

Raymond Volunteer Fire Department

By Luke Ballmer, RN, Bryan emergency and RVFD paramedic The Raymond Fire & Rescue Department was established in 1947. We currently have 30 members on the Raymond Volunteer Fire Department — all are CPR certified — consisting of fire fighters, EMTs, paramedics and nurses. RVFD is a Basic Life Support transport service and covers an area of approximately 95 square miles.

We have three fire stations, including a brand new six-bay

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Raymond Volunteer Fire Department members were among the first to assist William Wimmer (center) at the crash site. station in Raymond. Each bay is two trucks deep and has doors on both sides of the building. Station 1 has an ambulance, engine, two tankers, two grass rigs, a quick response vehicle, HAZMAT trailer, mass casualty trailer and a diver rescue rig and boat.

Station 2 is at 32nd and Arbor Road and houses up to three firefighters. An engine, grass rig and ambulance are kept at this station. Arbor Station was manned in 1987. The RVFD contracts with the village of Davey to provide emergency services, and an engine is kept at this station for fire and medical response.

In addition to medical and fire protection for the Raymond fire district, RVFD also provides medical transport for the northern half of Malcolm Fire Department’s district.

Ours is one of the few departments in the state of Nebraska that operates its own Dive Rescue Team. The team has seven members who are open water SCUBA certified. We have a trailer that holds all of the SCUBA tanks and BCDs/dive suits. We can respond to water emergencies all year because dive members also are trained in ice rescue. This is a valuable resource to the district, as Branched Oak Lake lies within our district.

We also house the mass casualty incident (MCI) trailer and a HAZMAT trailer for northern Lancaster county.

Other services we provide are cardiac monitor/defibrillator, epinephrine, Combitube, ASA, Albuterol by Nebulizer and oxygen.

We work closely with surrounding departments to provide mutual aid as requested. Each month we hold a business meeting and train for fire and medical scenarios. New recruits to the department also train on a separate recruit night.

We are always looking for passionate people who are interested in joining the department. Our website is www.raymondvfd.org, and if you are interested in joining, you can fill out an application on our website and learn more about us.

Cranestorm 2012

Brain injury awareness takes flight T

raumatic Brain Injury (TBI) is a serious public health problem in the United States.

Each year, traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability.

Recent data show that, on average, each year approximately 1.7 million people sustain a traumatic brain injury. In Nebraska, about 36,000 individuals are disabled due to suffering brain injuries. The Nebraska Brain Injury Association started a project — Cranestorm 2012 — with the goal of having 36,000 origami cranes folded to represent these Nebraskans.

The project raised awareness of brain injuries, as more than 62,000 were folded by individuals throughout the state of Nebraska and beyond.

BryanLGH Rehabilitation Team members

and patients folded more than 1,000 cranes for this project.

“We see and treat a very large number of individuals with traumatic brain injuries in our inpatient and outpatient rehabilitation programs,” says Rehabilitation Services director Linda Stones, MS, RN. “It is important to us to raise awareness to improve the care of those who experience a brain injury and also to raise awareness in preventing brain injuries.”

March is recognized as Brain Injury Awareness Month. Along with folding the cranes, the BryanLGH Rehabilitation Team attended the March 29-30 Nebraska Brain Injury Conference in Kearney.

The cranes were displayed in March at the Capitol in Lincoln and at the Museum of Nebraska Art in Kearney in April and May.

BryanLGH Rehabilitation and trauma patient Clarissa White (above) helped fold origami cranes for Cranestorm.

Patients Jamie Jackson (left) and Roberta Brown checked out the crane display at the Capitol.

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Trauma Update is published for friends of BryanLGH Medical Center. Your comments and suggestions are welcome. Direct correspondence to the Advancement Department at BryanLGH, or telephone the editor at 402-481-8674.

Kimberly Russel, President, BryanLGH Health System; John Woodrich, President, BryanLGH Medical Center; Edgar Bumanis, Director, Public Relations; Paul Hadley, Editor.

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Radenslaben retires

Farewell to longtime nursing director

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Ruth Radenslaben, MSN, RN, will retire in June 2012.

linical director Ruth Radenslaben, MSN, RN, will retire in June 2012.

Radenslaben has served in many roles at this institution. She graduated from Bryan School of Nursing in 1969 and began her career as a staff RN at Bryan Memorial Hospital.

Radenslaben was a Bryan School of Nursing instructor in the Surgical Nursing Program from 1971-1981, then returned to the hospital in 1981 and was director of nursing for emergency/ trauma.

In 1987, Radenslaben became an instructor in the Surgical Technology Program at Southeast Community College. In 1990, she rejoined Bryan as director of nursing, emergency/trauma.

Since 1991, she has been the nursing clinical director responsible for the Emergency Department, Trauma, BryanLGH StarCare, Lincoln E.D. Connections and the Specialty Clinic. In addition to her hospital contributions, she has been an integral part of the restructuring of

emergency medicine oversight. Beginning as a member of the Mayor’s EMS Oversight Review Commission and currently a member of the EMS Oversight Authority Board and Management Committee, her dedication to this collaboration is valued. Her expertise in emergency medicine and the respect she has among various professionals were instrumental in bringing many different entities together to provide the highest quality of care to Lincoln and Lancaster County residents.

Radenslaben has been a longtime supporter/ advocate of trauma services and has provided visionary leadership on many organizational projects and initiatives. Her decision making has been focused on what is best for the patient, never losing the inspiration of nursing at its core.

Employees consider her caring and compassionate, and her presence will be missed by everyone she has cared for, instructed, mentored and led.

We wish her well and send words of gratitude for all she has done for so many.