More than 100 Northern California first responders, emergency room personnel and other healthcare providers -- the feet on the street -- recently received some valuable trauma training by neurosurgical expert Jeffrey Dembner, M.D., Medical Director for Neurosurgical Services for NorthBay Healthcare.
Dr. Dembner taught the group how to assess and respond to head and spine trauma, in a first-of-its-kind presentation as part of the "REACH on Tour" Continuing Education Program. The seminar was hosted by NorthBay Healthcare at its Green Valley Administration Center on June 6.
REACH has conducted conferences such as these in the counties it serves in Texas, Southern California and Oregon for the past eight years, but this is the first time one has been held in Solano County, according to Darin Huard, general manager of REACH. “We like to collaborate with our partner hospitals to create a conference that focuses on topics of interest to them, and so when we reached out to NorthBay, that’s where a focus on trauma and pediatric care came in.”
The day-long educational seminar included presentations on pediatric penetrating trauma, a stroke update, reconstructive surgery, and airway management offered by medical experts from Children's Hospital & Research Center Oakland, Eden Medical Center, California Pacific Medical Center, and Santa Rosa Memorial Hospital.
Dr. Dembner's talk addressed assessing head and spine trauma from a neurological viewpoint, but before he outlined some of those assessments, he acknowledged the critical role first responders play in trauma care. "There is a huge difference between what first responders see in the field and where I fall in to care for a patient. While I have tons of resources at hand -- MRIs, CT scans, x-rays, nurses and doctors who see the patient before me -- as a first responder your resources are limited to what you have: perhaps some medical history, and your observations and assessments. My job is easy; first responders and ER personnel have the difficult job."
Dr. Dembner then noted some leading trauma statistics: Every year there are two million traumatic head injuries, or one every 15 seconds. Every five minutes someone dies of a traumatic head injury, and half of those deaths occur at the time of the injury or within two hours. The majority of these injuries require hospital care and most of them are caused by motor vehicle accidents, from a fall or an assault, or from sports injuries.
"I know you all are familiar with the ABCs -- airway, breathing and circulation-- and although a patient may be awake, responsive and be able to follow commands, they may still have a spine that is unstable or have a significant neurologic injury with no sign of external trauma."
He then provided an overview of various types of head and spine injuries, what may have caused them, and the kind of assessments -- such as dilated pupils, fluid from the ears or nose, loss of movement to arms but not legs or loss of feeling to temperature but not touch -- first responders should note. Paying attention to all the various clues can help medical personnel determine the severity of the injury from a neurological perspective.
"It can be a grisly subject, but he offered a good review of anatomy and physiology and he presented it in a knowledgeable, but approachable way," said Susan Gornall, NorthBay's director of surgical services and perioperative services. "It was a good review," concurred Pam Geiger, Staff Nurse II, Surgery for NorthBay Healthcare.
"Some of the information we heard today I haven't heard since nursing school," said Shannon Wilkins, Staff Nurse for NorthBay.
Dr. Dembner’s nod to the important role the trauma team plays in patient care was appreciated by the audience, Darin noted. “We’ve all been doing trauma for years but it’s good to be reminded of the team focus and getting back to basics, how it (patient care) starts at the beginning and works up from there. Overall, the conference had an excellent turnout and participants had many positive comments.”
NorthBay Medical Center: 707-646-5000 NorthBay VacaValley Hospital 707-624-7000