School nurses learn trauma skills they hope never to use

If the worst ever happens at Annapolis Middle School, Jennifer Corkill now knows what she can do to help her students.

Corkill was among more than 300 Anne Arundel County school nurses and health assistants who were trained Monday in the grim but necessary skills to handle a school shooting: how to react to a shooter, how to triage wounded children, how to apply a tourniquet.

“We hope this is something we’ll never have to do,” Corkill said after completing the session on triaging, which involves quickly assessing injuries and prioritizing patients for treatment.

As shootings in schools have continued in recent years, the county’s public school system, health department and fire department have been working together to prepare school health employees in the event that one could happen here.

The importance of that mission was driven home this year, when two people were killed, including a student gunman, at Great Mills High School in St. Mary’s County in March. Then on June 28, five employees were killed in a shooting at the Capital Gazette newspaper office in the community where county school nurses live and work.

And the day before Monday’s training, a Baltimore man is alleged to have killed two people, wounded 11 others and then killed himself at a video game tournament in Jacksonville, Fla.

To try to prevent an attack at a school, the county has made some improvements to school security, including installing double-barrier doorways at some buildings and adding 10 more school resource police officers this year.

All the county’s public schools already are outfitted with trauma bags — kits stocked with supplies such as tourniquets, trauma dressings and chest seals, which are used to stop the bleeding of chest wounds.

“Unfortunately, if there was an active shooter event, they need to know what to do,” said Karen Siska-Creel, director of school nursing for the county health department. “We want our staff to be prepared.”

School nurses and health assistants would be the first medical providers on the scene of a shooting, so they can provide crucial, life-saving treatment to injured students or teachers.

“I think the more people who are trained, the better off we are,” Siska-Creel said.

With one week until schools open to students for the year, the county’s school nurses and health assistants gathered Monday at Southern High School for training in how to react to a mass shooting.

Outside the school, fire Lt. Cory M. Polidore and firefighter-paramedic James Clopein put the nurses through the paces of a triage exercise.

One group fanned out on the school’s sidewalk and parking lot to represent victims with slips of paper describing injuries. Other nurses rushed out to assess their injuries, using different-colored tapes to indicate whether the victims were injured and how quickly they needed to be treated.

The nurses could spend no more than a minute to assess each patient’s condition before moving on. It’s a change in mindset for these nurses, who are used to focusing on their patient — treating injuries and saving lives. It’s difficult for nurses to leave someone who is suffering.

“This requires more of the quick, critical thinking piece that we don’t do every day,” said Theresa Tolley, a nurse for Seven Oaks Elementary School and West Meade Early Education Center in west county.

Polidore said the triage training is helpful for any type of multi-injury event at school: a shooting, a bus crash, a bleacher collapse.

“The goal is to save the most lives with the amount of resources available,” Polidore said.

If school nurses start triaging patients during an incident, he said, arriving EMTs and paramedics can quickly start treating patients and transporting them to the hospital.

In the school cafeteria, nurses and health assistants went through Stop the Bleed training — the most basic, life-saving techniques for patients suffering from gunshot wounds.

The nurses and assistants gathered in small groups around lunch tables, where they practiced applying tourniquets and packing cloth into fake wounds.

After showing a group how to use a tourniquet, Pamela Smith-McNeal of the University of Maryland Shock Trauma Center challenged them to give it a try.

“Save your life! Your wound is right here!” she said again and again, pointing to a spot on each person’s arm or leg and directing them to secure the tourniquet.

“Modesty goes out the window,” she said.

Smith-McNeal also taught the nurses and assistants how to pack a wound and put pressure on until EMTs arrive.

She told them that anything could be used as a makeshift bandage to pack a gunshot wound if gauze isn’t available, even a sock or one’s own shirt.

Brand-new health assistants Amanda Sokolis and Angela Keaser watched carefully as Smith-McNeal demonstrated the tourniquet techniques.

“It is a little nerve-wracking,” said Sokolis, who will be assigned to South River High School. “What if I actually have to apply this on a student?”

Rosa Carboney, a health assistant at Odenton Elementary School, said the thought of putting these skills to use is “very scary,” but called the training helpful.

“At least we can prepare ourselves for the worst,” she said. “As long as you feel like you’re prepared, it’s better than not knowing anything at all.”

NOTE: An earlier version of this article incorrectly described training nurses received related to tourniquets, and should have stated that any materials can be used to pack a gunshot wound. It has been corrected here. The Sun regret the error.

pwood@baltsun.com

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