Monday, June 8, 2015

Trauma preparedness: teaching the teachers

Shelf after shelf of colorful supplies line the walls of the St. John School art room in Boston’s North End. Gathered here in early June under fluorescent lights and whirling ceiling fans sits a group of 12 teachers listening attentively as their students often do, preparing for a day they hope never comes. 

“Normally we think of the first responder as being the policeman, or the fireman, or the paramedic, right?” says David King, MD, Massachusetts General Hospital (MGH) trauma surgeon, standing at the head of the class. “But if you look back at all these disasters including the Boston Marathon bombings, those were not first responders; it was the people closest to the victims. And if you look at Sandy Hook Elementary School shooting, the first responders there? That was you. That was the teachers.”

It is a heavy subject and not one discussed lightly, but King and the teachers understand it is part of the reality educators face. It also is a topic that King – an Army combat surgeon who has served in Iraq and Afghanistan – cares deeply about and is intimately involved. He participated in 2013 Boston Marathon both as a runner and caregiver – returning to MGH following the horrific attacks to operate on victims. In the aftermath of the attacks, he became involved with a group known as the Hartford Consensus, comprised of trauma and emergency medicine experts and first responders who were tasked to study violent episodes like Sandy Hook or Columbine, to identify ways to enhance survivorship of victims. The group found that traditional first responders often are delayed from performing their work until the affected area is deemed secure. Be they minutes or hours, every moment care is delayed lessens the chance victims have to survive.

“By studying these tragedies we learned just how crucial it is to prepare those who will be at the center,” says King.

It is both the findings of the consensus and his work as a surgeon that has brought him to St. John School where his two children are among its students. His goal? To provide training and equipment to teachers so they can act quickly in time of crisis. Each member of the class is given a professional-grade tourniquet and the eager students practice wrenching the black nylon and Velcro straps as tight as they can before turning a small stick-like device which provides additional leverage to tighten the tourniquet.

King demonstrates tourniquet technique

“It’s really important to pull that strap as tight as you possibly can,” King tells one teacher. “Really crank down on that thing. There you go, now you’ve got it!”

The mood has shifted slightly. The heavy feeling in the room becomes a little lighter as fear lessens and confidence emerges. These would-be first responders are getting the hang of it.

“The scenario is very scary but this isn’t,” says teacher Amy Tobin, as she points to the tourniquet. “I think it’s just great for teachers to have these skills especially because we’re learning a lot about different safety procedures.”

Like the youngsters they instruct every day, these students are not getting out of this lesson without a test. One by one they line up so King can see if they are up to the task. With focus, precision and some good old-fashioned elbow grease, each passes with ease. Smiles and handshakes punctuate the victory but these teachers can’t rest easy, they will be tested again in six months.

Tobin (right) practices with colleague Lee Bogaert

“The other side of this is a research study,” explains King. “We need to make sure we’re instructing properly and that they retain this knowledge moving forward.”

Working with partners in the private sector, King has secured donated tourniquets for each classroom.  Now, armed with the ability to use them, these teachers are equipped to respond.

“When David contacted us about this opportunity we felt we had an obligation to take him up on it, especially following the events of Sandy Hook,” says Karen McLaughlin, St. John principal. “Our teachers feel empowered to help their colleagues and students if they need to, and that’s a wonderful thing.”

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