Trauma Update | Winter 2018 by Bryan Health

TRAUMA UPDATE

News from the Trauma Center at Bryan Medical Center WINTER 2018

Local Outreach to Suicide Survivors

LOSS Teams help suicide survivors cope By David Miers, PhD, LIPC, Bryan Mental Health Services, Co-founder Lincoln/Lancaster LOSS Team

he sudden, unexpected death of a loved one is an intensely traumatic event for those left behind. When that loss is due to suicide another level of trauma is often experienced. Suicide deaths still carry stigma in our society. Survivors often feel intense guilt, anger and shame in addition to normal bereavement emotions of longing, sadness and hurt. What we know about sudden and traumatic loss to suicide is that family members left behind are themselves

9-12 times more likely to die by suicide and are at a higher risk for experiencing health, relationship and occupational difficulties. Bryan Medical Center supported the development of Nebraska’s first Local Outreach to Suicide Survivor’s (LOSS) Team in Lincoln/Lancaster County in 2009. This volunteer group provides support to individuals in the Lincoln/ Lancaster County area as soon as possible after the death of a loved one to suicide. This team has been highly successful in responding to families in need, providing resources and support and (Turn to “LOSS is community’s gain” on Page 2.)

Reducing lethal means is key to stopping suicides By David Miers, PhD, LIPC, Bryan Mental Health Services, Co-founder Lincoln/Lancaster LOSS Team

uicide is a public health problem. Every year, hundreds of thousands of Americans attempt suicide, and more than 40,000 die. Communities need to take action to help prevent suicide. Reducing lethal means is an effective way to increase the chances that a suicidal person will receive the assistance they need rather than have tragic results. A powerful risk factor for suicide deaths is the ready availability of highly lethal methods. Research indicates that firearms are the method most commonly used in suicides. Poisoning also is one of the top methods of death by suicide. Bryan Medical Center is active with the Nebraska State Suicide Prevention Coalition and several years ago helped develop a hand out for health

care providers and families regarding ways to restrict gun and medication means. By working with family members and care providers to reduce a suicidal person’s access to guns and medications, we will help ensure that more people get another chance at life. This hand out is available to emergency providers, Emergency Room staff members and other health care providers as a teaching tool for means restriction education. It and other resources are found at www.bryanhealth.org/suicide-prevention and www.youthsuicideprevention.nebraska. edu and can be reproduced as needed. Bryan Medical Center provides Emergency Mental Health Services to determine if hospitalization is necessary. We have mental health nurses available 24/7 in the Mental Health Emergency Department (which is the main Emergency Department at Bryan West Campus). (Turn to “Gun Amnesty Day reduces threat” on Page 2.)

LOSS is community’s gain in helping survivors cope facilitating a healthy grieving and mourning process. Each LOSS Team has several members; for example, a call to the Lincoln Team activates three members each time — two persons who have survived a suicide of a loved one, along with a mental health practitioner. Studies has demonstrated the impact of active postvention approaches on families bereaved by suicide. Research shows that those who do not have contact with an active postvention team such as LOSS wait 4.5 years before seeking assistance, and those who have contact with a group such as LOSS reach out for support within 39 days. Since the development of the Lincoln/Lancaster LOSS Team, other communities have been assisted in developing teams. Besides teams in Beatrice/Fairbury (Blue River LOSS Team), Chadron, Kearney (Central Nebraska LOSS Team), Omaha (Omaha Metro Team), North Platte (Southwest Nebraska LOSS Team), Seward/York/ Butler/Polk (Four Corners LOSS Team)

and Norfolk, other teams are being developed elsewhere in Nebraska. Please refer to the map above for contact information. In most cases the teams are activated by law enforcement, but if a family is open to a visit with the LOSS team they can contact the team directly. For more information regarding

LOSS Teams in Nebraska and to access additional information about the various teams, visit www.nelossteams. nebraska.edu Additional information about suicide prevention can be found at www.suicideprevention.nebraska.edu. If you know someone in immediate crisis, call 911 or call the National Suicide Helpline at 1-800-273-8255. n

Gun Amnesty Day reduces threat of tragedy Local Gun Amnesty Day is successful Bryan Medical Center also is active in the Lincoln/ Lancaster County Youth Suicide Prevention Coalition. In April, the Coalition teamed up with the Lincoln Police Department to host Gun Amnesty Day. The purpose of the event was to eliminate firearms that were no longer wanted by their owners — thus preventing access to those guns by people who may be thinking about hurting themselves or others. Citizens were able to drop off firearms and ammunition with no questions asked. This amnesty resulted in collecting: 76 rifles and handguns, n More than 70 thousand rounds of ammunition n

in various calibers, n And grant funding allowed the Lincoln/Lancaster County Suicide Prevention Coalition to provide handgun lock boxes and trigger locks free of charge to the community. Forty-two lock boxes and 46 trigger locks were distributed. The event was the most successful Gun Amnesty Day ever conducted by the Lincoln Police Department. Consider replicating this type of event in your community or combine resources with nearby counties. Links to other local suicide prevention coalitions can be found at www.suicideprevention.nebraska.edu. Together, we can make our communities safer. n

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trauma centers before joining Hospital Corporations of American in 2016 as Division Director of Trauma and EMS. Before lunch, Steph presented on Trauma Center and EMS Collaboration to help with the continuity of patient care for better outcomes. Attendees also had the privilege to hear Dan Smith, MD, Executive Medical Director for Studer Group. Dr. Smith presented on how to navigate comfort and pain in the era of the opioid epidemic. Following lunch, attendees heard Anne Boatright, MSN, RN, Sexual Assault Nurse Examiner (SANE), speak about Human Trafficking. She is a certified Forensic Nurse Examiner and is the State Forensic Nursing Coordinator and Sexual Assault Joseph Sakran, MD, of Johns Payment Program Hopkins Hospital discusses ways to prevent gun violence. He also Administrator at the presented a statewide approach For a complete Office of the Attorney for enhancing trauma care. General. description of Anne shed light upcoming onprograms, a difficult topic to help attendees understand how to care forcontact a patient who may be in the lifestyle of human traffickAndra ing. Buckley at the Attendees then listened to Fire Chief Mitch Randles address below! present on the response and lessons learned following a tornado in Joplin, Missouri. He showed attendees how health care providers had to acclimate to different scenarios due to the devastation from the tornado. To close out the day, Bryan Trauma Medical Director Stanley Okosun, MD, gave his much-anticipated trauma case

Attendees listened to key note speakers from throughout the United States address popular topics related to trauma. review in the form of a pictures lecture, which was enjoyed by all participants. Bryan Trauma team thanks everyone who attended, as well as those who contributed to the overwhelming success of this year’s symposium. The planning committee already is busy planning next year’s event. Please save the date, September 13, 2019, to attend the symposium at the University of Nebraska’s Innovation Campus. We look forward to seeing you next year! n Steph HaleyAndrews, RN, presents on Pediatric Nonaccidental Trauma.

Survivor salutes his champions By Brittni Clark, RN

to his abdomen and pelvis. During his CT scan his blood pressure started to n September 13, 2018, Bryan drop and he had active intra-abdominal Trauma Center honored Miles bleeding, so we decided he needed to go Margritz and 65 Champions to the operating room to control those who helped him beat all things.” odds and survive a life-altering car crash. Because Miles had other injuries that The evening was led by Rod Fowler of were not going to be able to be taken TV Channel 8 News. Individuals from care of in Grand Island and for managing first responders to the his long-term rehab team were honneeds, doctors ored for helping Miles determined he survive his injuries. This needed to be annual event brings to transported to light how important Bryan Trauma having a Statewide Center. Trauma System is when He was caring for a trauma flown by helipatient. copter to Bryan Miles is a guitarWest Campus ist and manager of a with his abdomusic store in Grand men left open Island. On the morning from the initial of December 20, 2017, surgery. Once Miles was on his way Miles arrived to a work breakfast, in the Bryan when another car — Trauma Center, traveling approximately Medical Director 140 mph — hit Miles’ Stanley Okosun, vehicle head on. Miles MD, of Bryan doesn’t remember Trauma and his much of the incident. team began He was taken to a hosassessing Miles’ pital in Grand Island, injuries. Musician Miles Margritz is back to playing his guitar after numerous where he was evaluatThey found surgeries. He was recognized at this ed by general surgeon Miles had a year’s Tribute to Trauma Champions Christopher Seip, MD, punctured lung for his inspirational recovery. of Surgery Group of and bleeding Grand Island. from his spleen, Dr. Seip recalls, “It was pretty obvious his colon was cut in half from the impact, he had multiple systems injured. Miles he had fractures in his skull and pelvis, had a really severe and obvious injury several rib fractures and a broken scapula, and his ankle was severely fractured. on his ankle. It was open, dislocated and Miles had an injury in every system fractured. He also had signs of trauma

of his body. In the following weeks, Miles had more than a dozen surgeries. Orthopedic surgeon Alesha Scott, DO, of Bryan Trauma placed screws to help repair Miles’ broken pelvis, and he was fitted with a thoracic lumbar sacral orthosis brace, also known as the “turtle shell,” to help with the alignment of his spine. Joshua Vest, DPM, of Capital Foot and Ankle managed the open fracture of Miles’ left ankle.

Miles and Christy pose with Ellie and Wes before the Tribute to Trauma Champions.

Bryan’s Sept. 13 event at the Lincoln Marriott Cornhusker saluted first responders and those who helped with Miles’ recovery. Dr. Vest says, “He sustained an open fracture that was in a lot of pieces — the appearance was enough for even those of us who see trauma on a daily basis to wonder if it was even possible to save his foot. “Miles had pins and bars attached to his leg for about a week while we continued to clean out the wound and let the skin calm down from the injury. He then had a second surgery to remove the external fixation device. At that time, that’s when we really put the pieces of the puzzle back together and applied some plates and screws that stay in there forever.” During Miles’ recovery what stood out was his family’s faith, and as he started to become more aware, his positive attitude. Miles and Christy Margritz, his wife, agree that life is pretty much back to normal, and Miles states that he truly enjoys the little things such as rocking their son to sleep. He adds that he has a lot more respect and awareness for the Statewide Trauma System and all the people from volunteers to surgeons that are so important to a trauma patient’s survival. n To see a video about Miles’ story, please visit www.bryanhealth.org/ trauma-champions.

Miles was all smiles with medical director Stanley Okosun, MD, and Alesha Scott, DO, of Bryan Trauma.

First responders Sara Slingsby, RN, of Good Samaritan AirCare and Jeff Engberg, NRP, of Grand Island Fire and Rescue (in photo above) share the stage with Miles, as do Matt Kampfe, PT, and Matt O’Neill, PT, of Alpha Rehab of Kearney (in photo at left).

Hundreds attend Trauma Symposium By Brittni Clark, RN

he morning started out with one of the Trauma Symposium keynote speakers, Joseph Sakran, MD, presenting on Gun Violence in America and how it is becoming a public health crisis. Dr. Sakran is an assistant professor of surgery, director of emergency general surgery and associate chief of the Division of Acute Care Surgery at Johns Hopkins Hospital, Baltimore. As a former victim of gun violence, he spends a significant portion of his time as a clinician, researcher and advocate with a primary goal of reducing firearm death and disability in America. He recently founded the organization Docs Demand Action, which is a platform to help unite health care providers and provide one strong voice in ending gun violence. Later in the day, Dr. Sakran presented on A Statewide Approach to Enhancing Trauma Care. Attendees learned about maintaining continuity of care and the importance of having a statewide approach as a team. Steph Haley-Andrews, RN, presented on Pediatric Nonaccidental Trauma. Steph is an award-winning builder and

Over 200 health care providers attended the 2018 Bryan Trauma Symposium, which was Sept. 14 at the Innovation Campus.

Dan Smith, MD, Joseph Sakran, MD, Steph Haley-Andrews, RN, Stanley Okosun, MD, and Trauma Outreach Coordinator Brittni Clark, RN, pose before the Trauma Symposium. leader of successful health care teams and programs. She has spent 20 years in Academic Level I pediatric and adult

trauma centers before joining Hospital Corporations of American in 2016 as Division Director of Trauma and EMS. Before lunch, Steph presented on Trauma Center and EMS Collaboration to help with the continuity of patient care for better outcomes. Attendees also had the privilege to hear Dan Smith, MD, Executive Medical Director for Studer Group. Dr. Smith presented on how to navigate comfort and pain in the era of the opioid epidemic. Following lunch, attendees heard Anne Boatright, MSN, RN, Sexual Assault Nurse Examiner (SANE), speak about Human Trafficking. She is a certified Forensic Nurse Examiner and is the State Forensic Nursing Coordinator and Sexual Assault Joseph Sakran, MD, of Johns Payment Program Hopkins Hospital discusses ways to prevent gun violence. He also Administrator at the presented a statewide approach Office of the Attorney for enhancing trauma care. General. Anne shed light on a difficult topic to help attendees understand how to care for a patient who may be in the lifestyle of human trafficking. Attendees then listened to Fire Chief Mitch Randles present on the response and lessons learned following a tornado in Joplin, Missouri. He showed attendees how health care providers had to acclimate to different scenarios due to the devastation from the tornado. To close out the day, Bryan Trauma Medical Director Stanley Okosun, MD, gave his much-anticipated trauma case

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 Andra Buckley at 402-481-4178, or email her at andra.buckley@bryanhealth.org.

Welcome new colleagues Three new co-workers joined the Bryan Trauma team in August 2018. Andra Buckley, Trauma Outreach & Injury Prevention Coordinator Andra grew up in Lincoln and earned her Bachelor of Science from the University of Nebraska. She has experience in the field of Emergency Preparedness, serving as a program manager for a nonprofit organization working with Lancaster County residents and refugees, as well as being a volunteer in the Emergency Department at Bryan West Campus, where she later became an Emergency Department patient registrar. Andra was a training specialist in the Bryan Education Department before

joining Bryan Trauma as the new trauma outreach and injury prevention coordinator. Jennifer Livermore, APRN Jennifer grew up in Juniata. She earned an Associate Degree in Nursing from Central Community College in Grand Island, then went on to earn her Bachelor of Science in Nursing from Nebraska Wesleyan University and Master of Science in Nursing in Acute Care from the University of Nebraska Medical Center. Jennifer worked as an Advanced Practice Registered Nurse (APRN) in Pulmonary/Critical Care, Infectious Disease, Internal Medicine and Rheumatology before becoming an

Advanced Practice Provider at Bryan Trauma. Jackie Wright, RN, Performance Improvement Coordinator Jackie grew up in Lincoln. While pursuing her nursing degree at Bryan College of Health Sciences, she was a patient care technician on the East 5N medical unit on Bryan East Campus. After earning a Bachelor of Science in Nursing in 2015, she was a staff nurse on the Neuro/Trauma ICU before joining the Trauma Department team this fall as the Performance Improvement Coordinator.