By Sarah Beth Dinwiddie, BSN, RN, Trauma Outreach Coordinator, Trauma Services–Carilion Roanoke Memorial Hospital
As a level one trauma center, Carilion Roanoke Memorial Hospital Trauma Services has an obligation to provide injury prevention education and resources to our community. Our injury prevention efforts are focused on our leading causes of injury as well as injury patterns that see increased frequency in our community. A new initiative this year has been implementing the Stop the Bleed™ campaign in the Roanoke Valley. Because hemorrhagic shock is the leading cause of preventable death, we offer bleeding control classes monthly at Carilion Roanoke Memorial Hospital. We are also working with the local school systems to ensure that each school has a safety net of resources and education that allows bleeding control prior to the arrival of emergency services. In addition to a presentation provided by National Association of Emergency Medical Technicians (NAEMT), our course includes hands-on training with tourniquets and wound packing. Participants place a tourniquet on a classmate’s leg and arm to develop muscle memory with this skill and are able to act in an emergency situation. They also pack a wound on a simulated leg (Luna TrueClot® Wound Packing Task Trainer) that has an arterial bleed. When they pack the simulated leg, the TrueClot gauze reacts with the simulated blood so that participants get a realistic experience. Clots form and bleeding stops with pressure held on the bleeding vessel just as if they were packing a live person’s wound with hemostatic gauze. At the completion of the course, participants have demonstrated proper tourniquet placement and bleeding control with wound packing. Our courses are open to the general public and to healthcare providers. We have been successful in training lay people including billing clerks, health educators, and secretaries as well as healthcare providers from pre-hospital providers through trauma surgeons. Feedback from all levels has been positive and participants are on board with spreading the campaign throughout the community.
Since we have started the Stop the Bleed™ campaign in the Roanoke Valley, the trauma center has seen improvements in bleeding control efforts that are initiated in the field. In one case in particular, a tourniquet was placed in the field which literally saved a life. Community members are becoming more comfortable with bleeding control and using skills from this class in order to control bleeding and decrease the mortality and morbidity surrounding exsanguination.
Since initiating the program within the trauma center, we have been requested to provide training to several EMS agencies as well as to local physician offices. We have also had the opportunity to train 28 local public school nurses who now carry a bleeding control kit which means that each Roanoke City public school has the ability to control bleeding for one patient until emergency services arrives. We have trained over 200 people in our community and are working to expand training as well as resources within the community.