Ohio health system trains community to be lifesavers

A program in which health care providers train police officers, first responders and community members on properly applying tourniquets and other emergency life-saving techniques played an important role in an Ohio hospital’s response to a recent mass shooting.

“The police officers were instrumental in helping our trauma patients,” said Amanda Pulfer, M.S.N., R.N., trauma outreach coordinator at Miami Valley Hospital, a Level I Trauma Center and part of Premier Health, which treated 23 victims from the Aug. 4 shooting. Pulfer has trained first responders on not only applying tourniquets, but also making a medical assessment and treatment of hemorrhage control and shock.

The health system uses a program called Stop the Bleed, which was started by the White House in 2015 as an awareness campaign and initiative to train bystanders in bleeding emergencies. While geared toward the layperson, Premier Health trainers take the course up a notch for first responders, those with a recent military background and anyone with medical knowledge.

“You don’t want to go in and insult their intelligence,” Pulfer said. Rather, the trainers explain the types of injuries they could encounter and the importance of rapid treatment from a medical perspective

Ann Monnig, M.S.N., R.N., trauma program manager at Miami Valley Hospital, said it’s also important to train first responders on self-treatment. “Where do they carry the tourniquet on them if they have one,” she said. “What if you get shot yourself? Can you get to your tourniquet?”

But, the hope is that bystanders won’t need to treat themselves, especially those without any first-responder training.

“Safety is the most important thing,” said Pulfer. Bystanders must assess the scene – a shooting, car accident, machine malfunction, etc. – to ensure it’s safe to approach a victim. Otherwise, “you’re going to become another person that needs assistance.”

The Stop the Bleed trainers reach other parts of the community, too, including county employees, school staff and students, manufacturers, retirement and assisted living facilities, and the Dayton International Airport. In addition, the health system serves a large agricultural community, so they even teach through the local Farm Bureau. The health system trained 2,593 individuals in 2017-2018.

“I start this training with, ‘I hope you never have to use these skills,’ but realistically and statistically half the people when I’m in a training will,” Pulfer said. 

Since the general population doesn’t usually have access to commercial tourniquets, trainers challenge civilians to look around their surroundings for makeshift items, like belts and T-shirts.

Premier recently heard a success story of the training they gave at a local vocational school. The teacher and students in a shop class applied a tourniquet on another student significantly injured by a saw. They were able to stop the flow of blood before first responders arrived.

“You’re buying that person time,” said Pulfer, noting wait times for emergency responders can vary significantly by location.

When the community and first responders take quick action, it makes the hospital’s job more efficient. Monnig said having relationships with local police and fire is paramount.

“Taking care of these patients is really a team aspect,” Monnig said. “Our whole goal here as a Level I trauma center is to also look at the whole trauma system, and that starts in the community, continues at the hospital, and then even after discharge.”

Both Monnig and Pulfer said that law enforcement officials don’t always get the recognition they deserve, so Premier Health staff make an effort to follow up with officers and tell them why they were important from the medical standpoint. Plus, it gives first responders a sense of closure.

“We feel that a way to build these relationships is to include them in the team,” Pulfer said. “When we have that relationship with police, it gives us that sense of security that we can do our job because they’re protecting us and they’re doing their job.”