“See something, Do something”

So, we did . . . A collaborative Initiative to

enhance survival for an entire school district

THE TARGET Create a district-wide plan to

recognize and treat massive bleeding

Project Overview • Project Target:

– 22,000 K-12 students, faculty and staff – In 28 schools of the Comal Independent

School District. 589 square miles in five central Texas counties (Comal, Bexar, Hays, Kendall and Guadalupe)

Map of Project Area

Overview • Train district personnel and high

school students to recognize and

treat massive bleeding

• Strategically place tourniquets

throughout the district

Overview • Plan

1. Train-the-Trainer

2. Train school district faculty & staff

3. Tourniquet Deployment

4. Train high school students

Overview • Train-the-Trainer

– Identified key personnel on each campus (i.e. district nurses, athletic trainers)

– Training focus: standardized curriculum on bleeding control (based on Hartford Consensus & Combat Lessons Learned documents)

Overview • Train School Personnel Each campus trainer initiated and facilitated

training for their faculty and staff

NOTE: To encourage rapid deployment - Public Access Bleeding Control Stations were awarded to the first two campuses demonstrating >85% training compliance

Supplied by: North American Rescue

Overview • Tourniquet Deployment

– Over 600 CAT tourniquets were purchased from North American Rescue for distribution to school personnel

• Recent publications and data suggest that tourniquet needs may outweigh resources AND are dependent on the size of location and number of people involved. The medical response to multisite terrorist attacks in Paris. Hirsch ,et al. Lancet, VOL 386 December 19/26,2015

Overview • Train High School Students

– District curriculum is being reviewed to incorporate the Stop The Bleed content into ALL current CPR training

NOTE: Texas State Law requires all high school graduates

to receive CPR training (which includes immediate life-threatening conditions in some programs)

Overview • Comal County Bleed Team: • David Springer, CISD Safety & Security David.springer@comalisd.org

• Courtney Neseloney, CISD Health Services Coordinator courtney.nesloney@comalisd.org

• Centre for Emergency Health Sciences candice.thompson@bsb911.com

• Comal County Chiefs Association

• Bulverde-Spring Branch Fire & EMS candice.thompson@bsb911.com

• Canyon Lake Fire & EMS

• New Braunfels Fire & EMS

Subsequent slides were specifically used in this project

PERMISSION TO UTILIZE OR CHANGE ANY OR ALL MATERIALS

HEREIN GRANTED

See Something . . . Do Something

9 slides

Tourniquet Training Provide participants with bleeding

control information

Provide participants with methods for controlling bleeding when direct pressure not effective

Objectives • At the end of this program you should be able

to:

Discuss techniques for bleeding control Define indications and contraindications for

tourniquet use Demonstrate tourniquet application process

Bleeding control Direct pressure

Packing &

Pressure dressing

(if available)

Tourniquet

Indications Bleeding from an extremity that cannot

be controlled with direct pressure, packing or pressure dressing

“If it won’t quit – tourniquet”

Contraindication There are NO contraindications

for tourniquet application on an extremity when faced with

life threatening bleeding

Bleeding that requires a tourniquet

FACT . . . tourniquets are NOT for every injury

“BUT…if it won’t quit – tourniquet”

Application (1of 2)

High or Die Turn and Confirm

Look or Lose

Application (2 of 2)

Expose extremity & keep exposed Tighten to STOP bleeding Document application time Write on patient (SHARPIE)

Tourniquet should NOT be placed on Joint (knee or elbow) Over an impaled object (DO NOT remove

impaled objects)

Questions?