Calif. first responders learn from car versus bus trauma simulation
Ukiah hospital's 'Trauma Expo' brings first responders and ED staff together to experience each others' jobs during an MCI training drill
By Justine Frederiksen
The Ukiah Daily Journal
UKIAH, Calif. — Minutes after Mackenzie Albrecht was declared dead at the scene of a crash just outside Adventist Health Ukiah Valley Hospital Friday afternoon, she made a miraculous recovery.
"It's alive," her co-workers exclaimed happily as the Emergency Room nurse walked away from the car she had fictionally driven into a school bus, still wearing a "morgue" tag around her neck and her face still covered in fake blood.
Albrecht was just one of many crash "victims," including several young children on the bus, playing parts in a scene choreographed for the hospital's Trauma Expo, an exercise designed to bring people working outside the hospital — first responders staffing fire engines, ambulances and helicopters — together with people working inside the hospital so they can experience each others' jobs in a way that cannot be achieved during a real emergency.
"We realized that those of us who work in the ER didn't know what certain terms mean, or what it actually looks like when the airbag deploys," said AHUV employee Becca Denoeu, explaining how the idea for the expo was formed 10 years ago. "And (first responders such as paramedics and firefighters) don't always get to see what happens in the hospital after they drop off a patient. So we decided to bring all of the community providers together, in a controlled setting, so they can see what happens both outside and inside the hospital, bringing awareness and appreciation to each other's roles, and providing better care overall."
The scene began with a lot of fake blood and other make-up prepared by Ukiah resident Dell Linney, who was assisted by her mother while she applied items gathered from the family's rural property.
For one teen victim Linney used a chicken bone to simulate a broken bone sticking out near his wrist, and to create a head injury for Brady Banks, Linney added bits of wool collected from her family's sheep to a bald cap to simulate scorched hair.
"At least one person said I look better now than before," joked Banks of his all-too-realistic make-up job.
Perhaps the most seriously injured, however, was Blake Nelson, who had suffered a laceration to his abdomen that was designed to demonstrate how rapidly a patient's condition can change while they are being transported to the hospital.
To achieve this, Linney set up Nelson with a syringe full of fake blood that he could release into his wound through a tube running up his arm. While half of the blood was meant to be expelled at the scene, the second half was to be expelled after he reached the emergency room to demonstrate how rapidly the condition of crash patients can deteriorate.
"What's the No. 1 cause of death in trauma patients?" asked AHUV Trauma Coordinator Kristin Martin of the crowd watching her examine Nelson's wound once he was wheeled into the emergency room. The answer? "Uncontrolled external hemorrhage," or bleeding profusely from a wound.
"You should be squirting blood," Martin then said to Nelson, signaling him to push the rest of the fake blood into his wound so she could react to it by applying pressure to stop the bleeding while making sure someone else was fetching blood for a transfusion.
"Children's bodies compensate for injuries much more than those of adults," said Justin Buckingham, a Battalion Chief with Ukiah Valley Fire Authority, explaining that a serious injury in an adult will often be much more readily apparent at first than a similar injury will be in a child. "So knowing the subtle changes and warning signs to look for becomes very important when treating children."
That difference is one of the reasons why Buckingham said a scenario depicting pediatric trauma was chosen because "while it is not something we encounter very often, it is critical," and comes with other unique challenges beyond how differently children's bodies respond to trauma, such as how a patient too young to speak cannot necessarily communicate how intense their pain is or where it is coming from.
Also, learning how to treat injured children can be important on a much more basic level, as Buckingham said that very young patients can be particularly upsetting to medical responders, affecting them in ways they might not be prepared for at first.
"So it's educational, as well as a team-building exercise," Buckingham said of the expo, adding that it helps medical responders get to know the people that they usually only see for a few chaotic minutes before the next emergency call beckons. "Since staff at the hospital don't typically get to see what we do in the field, and we don't get to see what they do at the hospital, this scenario allows us to see what the others do, and the challenges they face."