In this episode of & so much more we shine a light on Centra's involvement in the nationwide initiative, Stop The Bleed. Join our guests, Dr. William Weber, a seasoned surgeon and Centra's Trauma Medical Director, alongside Sarah Beth Dinwiddie, the Trauma Program Director, as they unravel the intricacies of traumatic injuries and the criticality of being prepared to aid those in need. With their wealth of expertise, they discuss the significance of swift response times and impart invaluable insights on how each of us can play a pivotal role in saving lives.
For more information, please visit:
https://www.stopthebleed.org
Watch on YouTube
Transcript
Cami Smith:
Hi, and welcome to & So Much More. My name is Cami Smith and I am here with Dr. William Weber, who is our trauma medical director, as well as Sara Beth Dinwiddie, who is our trauma program director. And we are going to be talking about a class today, which we are not going to instruct to you today, but we're going to talk to you about the importance of this class. The class is called Stop the Bleed, and there's so many whys behind this class. But before we get there, I want these two wonderful experts in this area to just tell us a little bit about yourself, and then we'll dig into this program that we have access to.
Dr. William Weber:
I'll start. I'm Billy Weber. I'm the trauma medical director here at Centra at Lynchburg General Hospital. I kind of got my start in all this, I went to college, didn't really think about becoming a doctor. I was a reservist in the military, wound up serving in Iraq as an infantryman. And so all of the stuff that we're going to talk about today is stuff that we learned in preparing to go over to combat. Hopefully, none of us are going to combat, but I think that these are lessons that can be very useful.
And then after I came back, I started looking into what I wanted to do, and that's when I decided to go to medical school. And I went to medical school at VCU in Richmond, and then I went to the University of Kentucky for residency, and I did fellowship down in Dallas at Baylor University Medical Center, and then I came here.
Cami Smith:
That's awesome. It's so funny to hear the history of how you got here because it's very different. It's very unique than what you typically hear. People are like, "I wanted to be a doctor my whole life." It's very cool that you ended up here when you realized this was something you had a passion for.
Dr. William Weber:
No, I didn't even particularly want to go to college. I wanted to just finish school and kind of be done with that. Then I found myself in college and finished it pretty well, did well enough to apply to medical school later on.
Cami Smith:
That's awesome. Very cool, okay. And Sarah Beth, what about you?
Sarah Beth Dinwiddie:
So I'm the trauma program director here. I've been here not quite a year yet. But my nursing background began in high school when I was volunteering as a Candy Striper and fell in love with the trauma population. And we had a couple of patients when I was young who I really just wanted to be involved and be able to help make their journey easier. And so I went to nursing school, I went to the University of Arkansas, and then I was able to travel around the country a little bit seeing different areas and different emergency rooms. And then I was at Carilion for many years as a team lead in their ER, and then have worked for their trauma service program for about seven years since then, and have just recently come to Centra. And I'm loving Lynchburg and the Forest area and being able to be involved in the hospital programs and deliver trauma care.
Cami Smith:
That's very cool. It's a beautiful area. I feel like we're very blessed to live in a beautiful area. And for a long time I considered this an extremely safe area, and I think I still do. But I think I'm part of the majority who lived in that, that could never happen to me bubble. I live in a safe area. I can walk my dog at night and it's fine. And I think that is a very, very dangerous place to live in assumption in that way, as we're finding out if we just turn the news on. And so this program we're talking about today, Stop the Bleed, as you can imagine, is a very specific program to Stop the Bleed. So Dr. Weber, why don't you start? What can you tell us about the program?
Dr. William Weber:
So this all originated out of the tragedy that happened at Sandy Hook Elementary School, where a gunman went into an elementary school. After that, President Obama commissioned a group where they went to the nearest trauma center and they had trauma experts from all around the country meet, and that was called The Hartford Group, and they came out with a document called The Hartford Consensus, where they looked at violence and the response to violence and said, "What can we do to reduce the loss of life?" And this really grew out of a larger effort from the American College of Surgeons Committee on Trauma, as well as the National Association of EMTs, partially funded by the Department of Defense, and so a lot of people had their hands in this.
But when they looked at it, they looked at both combat casualties and civilian casualties from similar incidents and they realized that there's a very high percentage of people who are dying from treatable injuries, from extremity bleeding. And so when they looked at this, they made some specific recommendations. And one of the really big and important recommendations that they made and one of the really important realizations is that by providing rapid response and rapid treatment of bleeding, a lot of these patients are able to survive to reach definitive care, namely at the hospital.
Cami Smith:
Yeah. So basically, the purpose of this program is to just get them to us. I think I heard you say that earlier. Help us by getting them to us.
Dr. William Weber:
We have a trauma surgeon here in Lynchburg who is in the hospital 24 hours a day, seven days a week. We are required to see injured patients in the emergency department within 15 minutes of their arrival. And we meet that metric pretty much every time. So we're available, we're here. If you can get somebody to us, there's a whole lot that we can do. We have so many resources at the hospital, but if people are getting injured in the field, if people are getting non-survivable injuries in the field, there's nothing that we can do.
Cami Smith:
So and whoever can speak to this, how did this program get to Centra? So this was something that was out of a situation certainly felt by I think anyone who heard about it. Sandy Hook kind of shook us all to our core. How did this specific program make its way here to Central Virginia, Lynchburg, Virginia?
Sarah Beth Dinwiddie:
There's been a real push from the state and out to the trauma centers, and so it's really been a requirement for trauma centers to be able to offer the Stop the Bleed course. Centra's, our trauma nurse specialists have been pretty involved in the community for the last several years, teaching the classes. And they've done numerous school nurses groups. They've gone into some of the schools and taught some students, so they have been pretty involved.
Cami Smith:
I love that.
Sarah Beth Dinwiddie:
Probably for the last four or five years.
Cami Smith:
Yeah.
Dr. William Weber:
One of the things that they looked at when they brought this program out was we already have ACLS. We already have CPR courses and basic first aid courses. And the likelihood that most people are going to encounter somebody who has a cardiac arrest in front of them and need to provide CPR is fairly low. When they actually looked at this and did the statistical modeling, the likelihood that you're going to encounter somebody with an injury that's bleeding, whether it be from a gunshot wound, or a car accident, or somebody slipping down a hillside is pretty high. And that's something that's not really well covered in the first aid courses. This is going to help teach you to be comfortable dealing with pretty serious wounds. And it's something that honestly as a trauma surgeon, I look at this and this is very basic for me.
But if I didn't have the training that I had, I honestly think that I would look at some of these horrible wounds and say, "Oh, my gosh. I don't know what to do. I don't want to make things worse." I don't want to do just the simple steps that may help that person, that may help stem the blood loss and help us to be able to save this person's life.
Cami Smith:
Yes. And that knowledge is powerful. And Sarah Beth, I think you said it earlier, you want to empower this community. And I think when you come across a car accident, or you see somebody who has a life-threatening injury, I know that I currently, having not gone through the course, I don't have the confidence to be like, "Yes, I'm going to go do this." And so I'm fearful I would cause more damage, and I think that's probably the norm of most people. And so I think that's why this is so powerful to equip people with an action, a simple action they can take because they've done it, they've seen it done, they've practiced it at the elementary level to get them to you.
Sarah Beth Dinwiddie:
Right.
Cami Smith:
And so you said it's been available for about four to five years here in the area. What types of organizations, you mentioned school nurses and-
Sarah Beth Dinwiddie:
So anybody, anybody who is willing to listen to us talk, churches, grocery stores, the mall, any staff members that work in our community and would want us to come out and teach a class, we'd be happy to start building up that network again.
Cami Smith:
I love it.
Sarah Beth Dinwiddie:
We'd like to be able to bring people in and open a course on campus at LGH so people, individuals could just sign up for it and come and take that course as well.
Cami Smith:
I know my office here at Centra Marketing, we all want to do this. We want to prepare ourselves. We want to equip ourselves. And as you hear about these horrible situations that happen around the world, but even here in our own community, and wanting to be a part of the solution and not the problem. People slow down to look at accidents, but to be able to stop and do something, that's big.
Dr. William Weber:
Well, I'll say this too. I work in a hospital, we've got unbelievable resources. We've got a magnet that takes pictures of the inside of your body. We're actually looking at now taking these Stop the Bleed kits and putting them around the hospital, so that if God forbid something ever happens at the hospital, that we're ready, that we have kits available for people, and really simple, simple things, just packing wounds, tourniquets. I remember when I first took a first aid course, I guess it was probably in the 1990s. It was a tourniquet was the absolute last resort, and they cautioned us that not to use a tourniquet under almost any circumstances. Now we want you to use tourniquets.
If somebody has extremity bleeding that we can stop with a tourniquet, we want you to uses a tourniquet. And as soon as the patient comes to the hospital, we evaluate whether or not that tourniquet's needed, if it's been on there for 15 or 20 minutes, it doesn't make a whole lot of difference. A tourniquet, and we're going to take a look at that, we're going to stop the specific bleeding vessels. But if that person's already been sitting there bleeding for a long time, that's not always something that's salvageable. But if it's somebody's arm and we get a tourniquet around it, we make that bleeding stop. That's something that we can save their life in almost every circumstance.
Cami Smith:
Wow.
Sarah Beth Dinwiddie:
I think a lot of the fear was, the push against tourniquet, was that people would lose those limbs if you put a tourniquet on, and that's not what we've seen at all. People who end up losing limbs lose them because of the injury to the limb, not because of the tourniquet that was in place.
Cami Smith:
Okay. So there's some mis-education here.
Sarah Beth Dinwiddie:
Yes.
Dr. William Weber:
Yeah. And that was the teaching for a long time. And really what changed that was when the military looked at their experience and they said, "We are ... " I think it was somewhere in the neighborhood of 25% of people who died in combat were from extremity injuries. And so as they started pushing the tourniquets out and pushing for tourniquet use, in around 2007, the military was completely fielded tourniquets to all of their frontline combat units and encouraged that usage. I remember when I was in, we were trained to put ... We'd carry two tourniquets so that God forbid, we lost two limbs, we could put the tourniquets on. And we were trained to put them on ourselves, to put them on our friends. We were trained to use them all the time.
Cami Smith:
And it saved lives.
Dr. William Weber:
Saved lives.
Cami Smith:
That is the goal.
Dr. William Weber:
Absolutely.
Sarah Beth Dinwiddie:
Yes.
Cami Smith:
So you guys have some props.
Dr. William Weber:
Yes.
Cami Smith:
I'm very excited to see. And so now these are specific items used in this course. Correct?
Sarah Beth Dinwiddie:
Mm-hmm.
Cami Smith:
Okay.
Dr. William Weber:
So these are not just specific items that are used in this course. And you can hear the Velcro unsnapping now. But these are Velcro tourniquets. They've got some plastic snaps. They've got a plastic rod on them. Not only are these used in this course, but if somebody comes in with uncontrolled hemorrhage from a limb into the emergency department, the first thing that I'm going to do is I'm going to ask for one of these tourniquets. And we have them in the emergency department. So you simply open it up into a big loop, you undo the Velcro fasteners, and you simply slide it over the extremity, avoid putting it over top of a joint, and make sure that it's above the injury, and then just pull it tight. And you can hear the Velcro kind of cinching down.
And then once it's tight, there's another piece of Velcro, and kind of a plastic stick on it, and you just simply twist that. It can go on top of clothing. It's just about as effective on top of clothing as it is underneath clothing. And you just keep twisting it until most of the bleeding stops. Really, we like to stay the bright red bleeding stops. But keep twisting it until most of the bleeding stops. There's usually still a little bit of bleeding that continues. And that's okay, that can be stopped usually with a little bit of pressure. But once that's twisted and it's tight, then there's some plastic kind of C loops in there that you can just slide that plastic stick into and that will hold it in place. And you put the piece of Velcro on top of that.
Cami Smith:
And so for those what or listening, I love how you just explained that in such a way to give them a visual. There's even a place that says, "Time." You would write when you put it on, I'm assuming.
Dr. William Weber:
You'd write when you put it on. And that's helpful to know, particularly for long periods of time when the tourniquet's been up. But again, we are not going to make any decisions about amputating a limb or anything based on how long the tourniquet has been up.
Cami Smith:
Okay. Wow. And you were able to just put that on your own arm. I mean, that was so doable.
Dr. William Weber:
It is. But it's one of those things, and you can hear the Velcro again as I'm undoing this, it's one of those things that I just think that when you come across something, your first reaction is to freeze. Your second reaction is to be so afraid of causing damage, of causing more harm. And while these things, anything that we do can cause some damage, if there's really a lot of bleeding, you're not going to cause more problems by putting one of these one.
Sarah Beth Dinwiddie:
Is it painful?
Cami Smith:
That's a great question.
Dr. William Weber:
When you get it tight enough, it will be a little bit uncomfortable.
Cami Smith:
You're going to feel it.
Dr. William Weber:
It's going to be uncomfortable. I mean, you are cutting off the blood flow to that limb.
Sarah Beth Dinwiddie:
But that means it's working too. Right?
Dr. William Weber:
And that means it's working.
Sarah Beth Dinwiddie:
It's doing what it's supposed to be doing.
Cami Smith:
Okay. And that's something a nonmedical professional, you don't want ... Am I hurting you?
Sarah Beth Dinwiddie:
Right, yes.
Cami Smith:
You don't want to do that. But to know that even the slightest bit of pressure is good. They're supposed to feel that on some level. It's going to be painful. So that is good to know. I'm sure there's so much, this is just one small portion of I'm sure what the course is.
Dr. William Weber:
I guess this is kind of the big gun. This is the big gun that you would use when you can't get the bleeding under control. There's a couple steps beforehand, just simply packing the wound or applying pressure. Those are things that we should be doing first, but if there's really arterial bleeding, if there's massive bleeding, then we probably are going to need to step up to the tourniquet. But again, this is kind of the big gun. And we talk about what to do in these situations in the course, then we go over in granular detail how to treat these wounds, how to escalate up to, from simple bandages, to packing, to tourniquets. We talk about some different things that they can do.
And then we go through scenarios with ... I haven't seen the actual pieces that we use, but there's some arms with wounds on them, and they've got different ways of pumping the blood through them, of pumping a fluid through them, so that we can simulate some bleeding. So it gives you a little bit of that stress response and a little bit of that feedback to actually just hopefully if something like this, God forbid, happens in front of you, that you will be able to do something that is going to be helpful, that is going to help that person survive.
Cami Smith:
Yeah. I love that. That's so powerful. Thank you both for coming in and for having this very important discussion and talking about this education that is available. I think that's the crazy part. This is available now. We can equip ourselves now to do this. And so we talked a little bit about where it is, in churches and schools and other community organizations. And so I think for those of you who are listening, a very important takeaway is think about where you are in public spaces, whether you're going into community, or think about if you're going to the grocery store, equip yourself. But also, if you wanted to work to equip a certain organization or community, you can do that.
So the way that you do that is you can go to stopthebleed.org. And there's information on the website for you to check out. You can also email stopthebleed@centrahealth.com. And that I think is so cool because so many people, they want to have a conversation. They want something that is specific to them delivered back to them. They want to be able to connect with a person, and so this is a way where you can do that. So go to their website or email someone, whatever your desired preference of communication is, but do it and get that ball rolling. And so yeah, those are the ways you guys can get involved. And for those of you who do work here at Centra, and I love that we have a community where we can lean on each other to learn these things as well, one thing that kind of struck me is I work walking distance to the hospital. And so if anything should happen, I feel like I'm in a safe environment.
But that is still a walk to the hospital. And so equipping myself even here down the street is so important. And so never take your circumstance, never let your circumstance keep you from doing something that could potentially save a life. So thank you, guys, for listening. And thank you, guys, again for being here. We hope you guys will join us again on & So Much More.