Trauma Training Benefits Health Services in Rural Communities
by Norm Rooker, Chief, Ouray County EMS
Apr 22, 2009 | 808 views | 0 0 comments | 8 8 recommendations | email to a friend | print
Last Thursday chests were punctured, bones had large needles bored into them and windpipes were cut as six doctors, nurses and other health care providers from the Mountain Medicine Clinic and four paramedics and EMT-Intermediates from Ouray County EMS participated in the American College of Surgeons Rural Trauma Team Development Course, RTTDC. 

The program was held at the 4-H Events and was put on by the St. Mary’s Hospital’s Trauma Coordinator, Leslie Williams, as part of their efforts to upgrade the training for all of the northern and central Western Slope rural clinics.

All too often, in the rural environment, patients walk into or are brought to the local clinic for treatment of a wide range of traumatic events ranging from being kicked by a horse, ATV or snowmobiling accidents, to falls. The RTTDC program is designed to train up clinic staffs, not just doctors, but the nurses and their support staffs to identify and recognize potentially life threatening trauma and how to take certain potentially life saving procedures to stabilize the patient’s condition before rapidly getting the patient en route to a hospital or trauma center for more definitive and follow up care.

The course consisted of a series of lectures, group discussions and skills laboratories that covered everything from IV access for the administration of fluids and medications to the use of intra osseous techniques when a suitable vein cannot be found. Intra osseous, IO, is the boring of a special needle through parts of certain bones into the marrow, which in turn allows for the administration of IV fluids or medications. OC EMS currently carries these special bone drill devices and needles on their ambulances.

St. Mary’s Hospital’s Trauma Coordinator, Leslie Williams, was joined by St. Mary's Careflight nurse Marcia Miller and trauma surgeon Craig Anderson in running the various skills stations and then scenario driven exercises. Additional procedures practiced on special training mannequins included the surgical placement of chest tubes, a technique that allows for the removal of air, blood or both that in turn will allow a traumatically collapsed lung to re-expand and begin working again.

Another lung expansion technique practiced was the needle decompression for the same problem, which is one of OC EMS’s treatment protocols.

Yet another station included various airway maintenance tools from endotracheal intubation, the passage of plastic tubes down the patient’s throat, through their vocal cords and into their trachea, to the use of another device, the King Airway. And if both of those techniques failed, the surgical creation of an airway by creating an incision in the patient’s throat and cutting into their windpipe to place a tube.

After these skills were mastered, the lectures and techniques were brought together through a series of realistic scenarios involving both the OC EMS personnel and the Mountain Medicine Clinic staff. 

At the conclusion of the RTTDC everyone felt much more comfortable with the skills and the clinic and EMS staffs got to practice working together.

The Rural Trauma Training Development Course is funded primarily by the St. Mary’s Hospital Trauma Program and partially assisted by a grant from the Colorado Department of Public Health & Environment’s EMS 50/50 matching grant program. The grant was applied for by the collaborative efforts of the Northwest and Western RETACs, Regional EMS Trauma Advisory Committees.

For more information on the RTTDC program go online to: www.facs.org/trauma/rttdc/rttdcinfo.html.
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