a special program of the National Emergency Medicine Association (NEMA)
Transcripts: 539-1 and 539-2
Week: 539.1 Guest: Karen McQuillan, Clinical RN, Cowley Shock Trauma, Balto., Md. Topic: Using Education to Prevent Trauma, Part One of Two Producer/Host: Steve Girard
NEMA: Preventing trauma has always been one of the goals of The Heart of the Matter, and today we're talking with Karen McQuillan, a clinical nurse specialist at the R. Adams Cowley Shock Trauma Center in Baltimore - a facility trying to prevent trauma as well as treat it. Karen, I understand the trauma nurses, those on the front lines of injury treatment, developed a special program aimed at prevention.....
McQUILLAN: We admit, literally, thousands of trauma patients each year, and the nurses, as well as the physicians and therapists work very closely with those patients in an effort to help them get better. And oftentimes, we see patients that come in where their injuries may have been able to be avoided...had they used certain safety measures, such as seat belts, or not drank, or use drugs before they actually started to drive their car. We experience first hand the pain and agony that both the patient and family go through as they start to recuperate from their injury....and get a first hand viewpoint of that, and its often very frustrating to see things that could have been avoided and see people go through so much pain. And that really prompted us to start to look at ways we can educate people to try to prevent from becoming injured. The best way to help people recover is to have the actual injury never happen, and we set out to do that by developing this program.
NEMA: It must have been tough putting the straight talk on prevention, or STOP program, together...even as experts in the area...what was the focus?
McQUILLAN: What are some of things people do or don't do that could in fact keep them safe, if they just knew a little bit more about it? Just as one example, most people know that they should wear seat belts, but even those that do may not be aware of the proper way to wear a seat belts. And so, our thought was to pick out things, topics such as that ..that we could provide more education, and provide some actual insight into why they should carry out certain safety procedures before driving, or doing different things. And also, we really wanted them to understand what trauma was all about...in other words, what some of the experiences were of the trauma patients that would cause them to think twice about making sure they use good safety when living their lives.
NEMA: Who is the target audience for the program?
McQUILLAN: The program is actually pertinent for anyone from a four year old pre-school level up through high school. We have four age-specific programs (that have been developed). And our point was to aim more toward the children and adolescent age group, with two thoughts in mind: first of all, thinking their minds are a bit more malleable, and it was beneficial for us to teach them when they were young ( some of these good, safety techniques), and secondly, that they'd be able to pass some of those on to their parents. And prompt them also to use good safety technique, such as wearing your seat belts properly, and wearing bicycle helmets and things such as that.
NEMA: Straight Talk on Prevention...professionals in health care like clinical nurse specialist Karen McQuillan, helping to educate us on preventing traumatic injuries. We'll talk about some trauma facts that may surprise you in our next program. I'm Steve Girard.
Week: 539.2 Guest: Karen McQuillan, Clinical RN, Cowley Shock Trauma, Balto., Md. Topic: Techniques to Prevent Trauma, Part Two of Two Producer/Host: Steve Girard
NEMA: We've heard from clinical nurse specialist Karen McQuillan of Baltimore's Shock Trauma Center about a program nurses there developed to educate kids kindergarten through high school about ways they can keep themselves from getting injured. Today we're talking with Karen about the aspects of trauma most kids, and adults, don't know...which help them understand the point that most trauma is preventable. Karen, some of the statistics listed in the program are surprising to me: Trauma is the number one killer of people 15 to 24...
McQUILLAN: One of the biggest causes of death in that particular age group is in fact being a motor vehicle occupant...or driver. So that is, in fact, where we tend to aim a lot of our prevention efforts. In fact, a lot of individuals of that age, even if they're not driving at the age of 15, they may in fact be an occupant in a car. Also, the other kinds of things that may cause trauma in that age group would be things such as assaults or violence, but the number one cause of trauma in that age group would be motor vehicle.
NEMA: And when you're talking about motor vehicle accidents, alcohol plays a role in half of all motor vehicle accidents involving trauma...
McQUILLAN: In most trauma centers across the country that routinely check alcohol levels upon admission, there is a significant blood alcohol concentration of the individuals being admitted into the trauma center. The people that either ingest alcohol or use other drugs...they become much less in control of their own abilities, and that puts them at great risk for trauma.
NEMA: In your program material, one line states that half of all bicycle related fatalities involve children....but what I did not realize is, that would mean half of those accidents involve adults...people who should know better about safety measures.
McQUILLAN: We get quite a few adults that are injured on bicycles, also things such as skates and skateboards...helmets can significantly reduce the severity of the brain injuries.
NEMA: What about proper use of the seat belts?
McQUILLAN: First of all, you want to wear your lap belt down across your sturdy hip-bones, and not up across your stomach. And also, you want to make sure you have your shoulder belt in place as well....but of course, across the sturdy collarbone that you have. The other thing is many people are misled by the fact that if they have an airbag, they don't have to wear their safety belts, but in fact that's not the case.
NEMA: 30 thousand people killed each year....900 thousand non-fatal injuries each year due to firearms...many of those not killed by the bullet are often crippled for life...
McQUILLAN: Yes....penetrating trauma is a large cause for a lot of injuries that definitely can be both life-threatening as well as affect the outcome of patients and their ability to function back in society. And we see with a lot of individuals that they have debilitating injuries that literally, possibly paralyze them from spinal cord injuries, or from brain injury, make them disabled. And also there are some severe extremity injuries that can be caused, and injuries to the chest and abdomen. All of those can be significantly debilitating, particularly those that affect the neurologic system....and their ability to move and to feel.
NEMA: The program is called Straight Talk on Prevention, or STOP. For more information, write to Karen McQuillan, Shock Trauma Center, University of Maryland Hospital System, 22 South Greene Street, Baltimore, Maryland, 21201. I'm Steve Girard.