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Faculty in Action: Stopping the Bleed
Dr. Mary Aaland practices what she preaches on blood loss prevention in trauma situations
It goes without saying that the excessive loss of blood from any cause can result in death. By some estimates, 40 percent of trauma-related deaths, whether from automobile accidents, gunshot wounds, or work-related injury, are due to bleeding. So does it also go without saying that stopping massive bleeds faster and better could save countless lives.
To that end, North Dakota native Mary Aaland, MD, FACS, associate professor of Surgery, director of Rural Surgery, and director of Clinical Research at the UND School of Medicine and Health Sciences, has been passionate in bringing the American College of Surgeons (ACS) “Stop the Bleed” training program to rural North Dakota.
“Bleeding is of particular concern to rural residents, where professional medical treatment can be hours away,” remarked Dr. Aaland following a “Stop the Bleed” event she coordinated with West River Health Services in Hettinger, N.D., this fall. The event drew 80 participants of all ages, the first 50 of whom went home with a free Stop the Bleed Kit, courtesy of the ACS Foundation. “Many victims can die from uncontrolled bleeding within five to ten minutes of an injury or accident.”
According to Dr. Aaland (right), 85 percent of all fatal crashes in North Dakota occur on rural roads. This is why she feels that just as the general public regularly learns and performs cardiopulmonary resuscitation (CPR), public education in proper bleeding control techniques, including how to apply dressings and tourniquets, should become the norm, especially in rural areas.
Dr. Aaland knows first-hand just how vital such training is, not only from her years as a trauma surgeon but most recently from an experience she had while returning home from performing surgery at a rural critical access hospital.
As she exited the Interstate Highway and began travelling down a meandering two lane road this fall, she came to the scene of a violent collision that had occurred only minutes before.
“I was the third vehicle to arrive. A midsized car had struck a semi-truck. Glass and debris were scattered everywhere. There was smoke coming out of the car due to the deployed airbags,” Dr. Aaland recalled. “The driver of the first car to arrive at the scene was waving for help. Two individuals from a second car were also providing help—calling an ambulance. I stopped behind them and pulled out my Bleeding Control Kit and ran to the smashed car.”
As Dr. Aaland remembers the scene, two children in the car’s backseat were shaken-up but relatively uninjured. The car’s driver, however, was bleeding from a large laceration of the scalp.
“So I opened my kit,” she continued. “The driver was alert but trapped. Airbags had deployed and there was blood all over. I applied my hemostatic gauze, which is part of the Stop the Bleed Kit, to the driver’s scalp wound and held it tight as I continued to assess the patient. It was awkward to maintain pressure on the wound due to the car’s condition, but I was successful in stopping the bleeding. Within a few minutes, policemen and firemen were on the scene. The ambulance arrived five minutes later, all while I was holding the wound.”
But what about accidents where a trained physician doesn’t stumble upon the scene?
“Not all injured patients are so lucky,” Dr. Aaland admits. “It is for this exact reason that teaching non-health care professionals the essentials of how to stop bleeding and equipping them with the tools to assist in this task is a must. Had I not had my Bleeding Control Kit, it would have been extremely difficult to obtain control of the driver’s injury, even though I’m an experienced trauma surgeon.”
Surgeon and good Samaritan, educator and evangelist: using her own experience to convey the value of trauma training for everyone, but especially small-town residents, Dr. Aaland says she will continue to schedule “Stop the Bleed” events in other North Dakota communities. “It’s my hope that before long the public starts to think of trauma bleed training the way it already thinks of CPR instruction: routine,” she concludes. “We can literally save trauma victims’ lives simply by slowing—if not stopping—their bleeding. And we’re moving in the right direction on this.”