On a recent Thursday morning, 55 Carroll County Public Schools nurses gathered in the cafeteria of the Career and Technology Center to review their ABCs — the ABCs of stopping bleeding.
That alphabetic mnemonic for stopping blood loss is, according to the presentation given by Lindsay O'Meara, a registered nurse with University of Maryland Shock Trauma Center, to Alert 911, identify the location and severity of the Bleeding and to apply Compression — sterile gauze, a tourniquet, even a T-shirt held fast by your hand — to stop the flow of blood.
"People often shy away and have a fear of bleeding and we are trying to teach people to not do that if there is life-threatening bleeding," she said. "To actually get their hands on it and stop it and help save a life."
As the nurses took turns tying tourniquets on each other and practiced packing the wounds of practice dummies with sterile gauze, O'Meara explained how the workshop is part of a national effort, launched in support of the Obama administration's push for better preparedness in the face of mass casualty situations.
"Stop the Bleed is national campaign that was developed after the Sandy Hook shooting a few years ago. It is supported by the American College of Surgeons and the White House," O'Meara said. "Just as you would teach everyone to be first-aid certified, CPR certified, we would like everyone to be Stop the Bleed certified."
As with CPR, O'Meara said immediate responders — often a layperson already on the scene — can make a huge difference for someone who is bleeding while awaiting paramedics or other first responders to arrive. Death from a wound with major blood loss may take only three to five minutes, but preventing that death, or at least giving the person more time to get medical treatment, is surprisingly easy — it just takes a little pressure.
Bleeding from even a major wound to the torso, such as a gunshot wound, can be effectively controlled by packing the wound with gauze and applying pressure with your hands, and holding it, O'Meara said, until emergency medical professionals arrive. Sterile gauze from a trauma first-aid kit is preferred, she said, but in an emergency, anything will do; the American or state flag in the classroom, the T-shirt on someone's back.
"If they have to take antibiotics later," O'Meara said in her presentation, "they can thank you for saving their life while taking their antibiotics."
In the case of wounds to the arms or legs, a Combat Application Tourniquet, or CAT tourniquet can be used, O'Meara said. These are specialized straps that are tightened with a rod and found in specialized trauma first aid kits — improvising with other materials in this case is not recommended, she said.
Nurses are certainly educated on treating blood loss in training, but not all practice in a trauma field. Nichole Sclereth, the school nurse at Taneytown Elementary, said she was glad for the chance at a refresher, tightening a tourniquet — it is supposed to be uncomfortably snug — on the upper arm of a colleague.
"It's been awhile since I have done bedside nursing and had to practice with tourniquets, so it's good," she said. "I can take it back and educate some of my staff members — we can prepare."
No one ever wants to find themselves in a mass casualty situation, but that's exactly why it's important to practice to be ready to mitigate the damage if it occurs, according to Carroll County Public Schools Supervisor of Health Services Filipa Gomes. When the school system learned about the Stop the Bleed campaign over the summer, it was decided that as many staff members as possible should be trained, and not just nurses — middle school principals have also received the training, she said.
"The idea behind this is to train as many people as possible, so even classroom teachers," Gomes said. "In case of a catastrophic event, one nurse can't take care of everybody, so the idea is to spread the knowledge and the word."
And while Stop the Bleed was conceived as a response to Sandy Hook, the benefits of having more people prepared to treat traumatic bleeding bleeds over into more common scenarios as well, O'Meara said.
"Someone can have a work-related injury, a child can fall off of a swing set, someone's hand can go through a car window or you can come up on a car accident," she said. "There's tons of reasons why someone could have life-threatening bleeding and it's a way to identify that and stop that."
For all those reasons, Westminster Elementary School Nurse Wendi Layne said she did not find it strange to be practicing packing gunshot wounds on a plastic dummy with the thought of possibly using the skill in a real-life catastrophe.
"It's absolutely useful, it's absolutely necessary and hands-on practice always helps, even if it's a dummy," she said. "In this day and age, you have to be prepared."
A previous version of this story incorrectly identified the amount of time in which a person can bleed to death from a major wound. That critical time frame is three to five minutes.
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