Christina Frimpong teaches STOP THE BLEED^® and spoke about her experience and the importance of knowing how to respond in the event of a serious injury.

What sparked your interest in the nursing profession?

I was always drawn to nursing, even as a child. I’m a caring person by nature. My mom was very sick for a time, and I was inspired by the nurses who cared for her.

Why did you decide to become a STOP THE BLEED^® instructor?

I grew up in Toronto Community Housing, and have lost friends to gun violence. I’ve been in situations where I’ve seen someone injured and you’re scared, you don’t know what to do. But if we can help, the person has a better chance of surviving. A mentor of mine encouraged me to take the STOP THE BLEED^® course. After taking it, I was inspired and knew I had skills that I could bring to the table as an instructor.”

Why do you think it’s important to take a course like STOP THE BLEED^®?

STOP THE BLEED^® equips people with knowledge. You don’t have to be a medical expert to learn simple steps that can help save a life. The course provides hands-on experience and it’s not isolated to injuries resulting from violence. Severe bleeding can happen from a kitchen injury or bad fall too. It’s about giving people confidence to help others, or even themselves.

What might surprise people about controlling massive blood loss?

People are surprised by how deep serious wounds are. Also, the amount of pressure that is needed to stem bleeding and how incredibly tight the tourniquet needs to be. People often say “what if I’m hurting them.” The discomfort in the moment is outweighed by the importance of applying pressure and packing the wound.

How have you seen the course impact participants?

Sometimes they’ll share their own experiences, stories and point of view with me or the group. By the end of the session they are often amazed and really thankful to have learned these skills. I’m inspired by their reflections and input. We learn from each other.

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With the days getting warmer and the May long weekend quickly approaching, many of us are getting ready to enjoy some fun activities, like a trip to the cottage, hikes, or the first camping trip of the season. While it’s a great time of year to get outside, it’s also when we see many traumatic injuries take place.

Actively preventing injury is always the main objective, but being ready to respond when an incident occurs is the next best option. It helps to be prepared by carrying a first aid kit with a few essential items. We often think about packing disinfectant and ice packs, but did you know large bleeding incidents (which could be caused by a fall or using home improvement tools, for example) benefit from some specific items. A person can bleed to death in as little as 5 minutes, so it’s important to be equipped with the tools necessary to control critical bleeding before help arrives.

What to pack:

• Gloves. A few pairs of gloves provide a great barrier between you and the individual you’re helping.
• Gauze. A great material to use when applying pressure or packing a bleeding wound.
• Extra clothes or t-shirts. If you run out of gauze, an extra t-shirt or two can be used to pack a bleeding wound or apply pressure.
• A high quality tourniquet, such as the Combat Application Tourniquet (CAT). This is perhaps the most important item to include. A tourniquet can be extremely effective at stopping a life-threatening bleed and can be on for many hours until help arrives. Sunnybrook highly recommends receiving formal training in how to apply a tourniquet before adding one to your first aid kit. You can take training by registering for a STOP THE BLEED® course. A CAT Gen7 Tourniquet can be purchased when registering for our course or during class.
• A permanent marker. This can be used to mark the time of tourniquet application, which is handy if you are in a rural area where it might take longer to get help.
• A whistle. Use this to signal for help and assist first responders in locating you.

Remember, if you’re in rural or remote areas where cell coverage or WIFI is unavailable, emergency calls can only be made through a satellite phone. Check to see if your cell phone has the capability to make a satellite call. Always be sure to tell someone where you’re going and your planned schedule.

Sunnybrook wishes you a safe and happy long weekend!

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After a year of living with intense discomfort and visits to various Emergency Departments without success, Abram was finally referred to Sunnybrook vascular surgeon, Dr. Giuseppe Papia and the Vascular Limb Preservation Program.

“We recognized Abram’s condition as a symptom of peripheral arterial disease, a narrowing of the arteries caused by plaque build-up,” says Dr. Papia. “Plaque can exist in multiple areas of the body, not just the heart. In Abram’s case it was in his legs, preventing oxygen from getting to his toes.”

The Vascular Limb Preservation Program (part of the Schulich Heart Program at Sunnybrook) is a novel paradigm for delivering care. It has been gaining increasing recognition for its innovative usage of image-guided angioplasties which enlarge a narrowed artery using a balloon, restoring blood flow. This approach is commonly used for heart patients, but Sunnybrook’s vascular surgeons are using it to save legs. Once blood flow is restored, patients go home the same day without ever having undergone general anesthesia.

“Our goal is to help as many patients as we can,” says Dr. Papia. “Patients that might be slipping through the cracks because doctors are not sure what’s going on. This is why we created a program model with a dedicated nurse practitioner who navigates patients’ needs quickly so they have the best chance of saving their legs.”

Currently, there are no other programs in Ontario like the Vascular Limb Preservation Program. With a nurse practitioner as first point of contact, referrals are followed-up within 24 hours.

“We’re offering coordinated care and we want to change the way the system is managing these patients by intervening early,” says Dr. Papia. “Often arterial disease manifests itself in unique ways, beyond foot ulcers or leg pain, so if family or emergency doctors have any question, they should contact us.”

12 months later, Abram is doing extremely well. He visits Dr. Papia every 3 months and can walk rather than rely on a wheelchair. He gets a Doppler ultrasound to test his blood flow, and has had hyperbaric oxygen chamber treatment to improve wound healing.

Now 76 years old, Abram is enjoying life, “I’m so thankful that my feet have improved so much. I am walking well, maybe a little wobbly, but hey I can even dance a bit again so I am happy.”

For more information about the Vascular Limb Preservation Program or to submit a referral, please visit sunnybrook.ca.

*Only the patient’s first name is being used to maintain patient confidentiality

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June 22-28 is National Pollinator Week. Get to know more about these hard-working insects and their role at Sunnybrook. Michael Lithgow, Manager, Energy and Climate Action at Sunnybrook shares details below:

Why did Sunnybrook decide to install beehives at the Bayview campus?

The global bee population is unfortunately declining, and as a result urban beekeeping is on the rise. In many ways, cities can be an ideal location for beekeeping due to abundant flowering plants, fewer pesticides than rural areas, many sources of water… and hopefully few bears! In fact, Toronto became Canada’s first official “Bee City” in 2016. Sunnybrook wanted to support the bee population and also provide opportunities for staff and visitors to learn more about bees. Our large campus and plenty of green space is an added bonus.

Why are bees at risk and why are they important to the planet?

There are many factors behind the loss of bees. Climate change, pesticide use, loss of habitat, pollution, and parasites and predators are just some of the reasons. Bees are not only extremely important for humans, but also for entire ecosystems to function. Bees pollinate plants, allowing them to reproduce. These plants then contribute to the food system by feeding animals – aside from humans – such as birds and insects.

Photography by Kevin Van Paassen

Are there any other hospitals in Toronto that have beehives?

No other Toronto hospitals have hives, and we’re not currently aware of any other hospitals with honey bees in Canada. There are a few hospitals in the U.S. that host hives, and local non-hospital sites include places like U of T, Royal York Hotel, and the rooftop of several shopping malls.

Where are the beehives located at Bayview campus?

The hives are located on the hospital campus, about one kilometre away from the main hospital buildings.

Photography by Kevin Van Paassen

Who manages the hives and looks after the bees?

We have partnered with Fairhaven Farm to bring bees to Sunnybrook. Patricia, our beekeeper, routinely inspects the hives to ensure they are healthy.

How was this project funded?

There is no direct cost to Sunnybrook. In fact, we’re hoping to generate a modest revenue. In exchange for providing space for the beehives, Fairhaven will manage the hives and provide wholesale Sunnybrook-sourced honey to us for resale.

Do the bees produce honey? If so, what is done with it?

The bees will produce honey, and the amount of honey will depend on the weather. Generally the three hives can produce an average of 100-150 pounds of honey each a year. Once the hives are established, we plan to have the honey available for purchase in the Sunnybrook gift shop and at the vendor tables through Fairhaven Farm.

Photography by Kevin Van Paassen

Should people with bee sting allergies be nervous?

Honey bees don’t usually sting people unless they are provoked by individuals who interfere with the hive. The risk of a sting is no higher having honey bees on site, and the usual precautions should be taken by allergic individuals, like carrying an EpiPen and seeking immediate medical attention if stung. Bees are focused on the flowers. Wasps, on the other hand, are usually the ones that get close and personal, spoiling our picnics and barbecues.

Is there a plan to add more hives?

As the bee colonies grow, we can help them expand into new hives. We are fortunate to have plenty of space to expand if and when appropriate.

The post Urban beekeeping: Honey bees arrive at Sunnybrook appeared first on Your Health Matters.

Imagine being evaluated for a sleep disorder from the comfort of your own bed. For those seeking insights into their sleep habits, this concept is becoming a reality.

Researchers at Sunnybrook’s Sleep Disorder Clinic are increasingly using in-home devices, like movement and heart-rate monitors and tracking apps, to make it happen.

Home monitoring allows people to be assessed without having to come to the hospital’s sleep clinic for conventional in-laboratory sleep testing. It also allows Sunnybrook to help far more people than it otherwise could, and the early trial results are showing in-home testing to be as successful as some in-hospital techniques.

“We are using novel techniques to detect sleep apnea – the most common and disabling sleep disorder – periodic leg movements in sleep, as well as sleep-wake cycles,” says Dr. Mark Boulos, a sleep and stroke neurologist in the Sleep Disorder Clinic. Dr. Boulos is overseeing the trials, which involve hundreds of participants.

Dr. Boulos is especially excited by the data the team is collecting from watch-like devices patients wear around their ankles, which monitor leg movements at night.

“There is growing evidence of a potential link between periodic limb movements in sleep and silent and overt stroke, coronary artery disease and increased mortality,” he says.

In-home assessments also allow Sunnybrook to diagnose more stroke survivors with obstructive sleep apnea, a condition where breathing can be interrupted multiple times a night. The trials have also shown promising results among patients with cognitive impairments, a group Dr. Boulos says can be hard to treat for sleep issues.

While testing for sleep apnea at home is done in other parts of the country and the world, it is not commonly done in Ontario. That means this research could be practice-changing for the province.

“With the techniques available at home, we [can] move the sleep lab into the patient’s own bedroom,” Dr. Boulos says. “We can diagnose and treat more people, likely improving patient outcomes, which is always what we want to see.”

The post In-home monitoring devices are bringing sleep tests into the patient’s home appeared first on Your Health Matters.

Researchers at Sunnybrook have implemented a new way to assess patients with kidney stones that is changing practice in emergency rooms across Toronto.

Point-of-care ultrasound, often abbreviated as POCUS, relies on bedside imaging instead of a conventional CT scan. The portable ultrasound device can be used by doctors and does not require a radiologist.

At Sunnybrook, POCUS is now the main diagnostic test used to assess low-risk patients with symptoms that suggest a kidney stone.

Part of an ongoing study, it is making a big difference for patients who frequently visit the Emergency Department (ED) with symptoms related to kidney stones, says Dr. Jordan Chenkin, lead researcher and director of the Emergency Department ultrasound program at Sunnybrook.

“Ultrasound is radiation-free. It also helps reduce the need for repeat CT scans in these patients and shortens their stay in the ED,” Dr. Chenkin says.

In fact, this innovation has cut the amount of CT scans in half for patients with recurrent kidney stones and shortened their average stay by 94 minutes. The initiative’s success has prompted other emergency departments across Toronto to adopt the technique for patients with suspected kidney stones.

An internationally recognized leader in ultrasound education and research, Sunnybrook’s POCUS group is also gaining global attention for another study involving urgent cardiac care. The team is using a faster and potentially more reliable way to check a patient’s pulse, a key piece of information when assessing a potential cardiac arrest.

Dr. Chenkin says this technique utilizing POCUS has already resulted in major changes to improve patient care.

“We often see patients who are critically ill, but no obvious cause can be found. Using POCUS has revolutionized care by allowing emergency physicians to quickly look inside the body and identify potentially life-threatening conditions at the bedside.”

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Patients arrive at Sunnybrook by air ambulance from all over the province for urgent trauma care, burn care and high-risk maternal and newborn care. Whereas the ground-level helipad requires coordination with a land ambulance to take patients into the hospital through the Emergency Department, the rooftop helipad enables transportation directly from the platform to treatment areas within the hospital.

The helipad was made possible in large part thanks to the contributions of generous donors, including Gelato Cup Golf and The Rudolph P. Bratty Family Foundation.

Here’s a look at the helipad’s construction and testing journey:

The steel frame rises: Construction of the structural steel frame was a key part of the building process, providing support for the helipad high above the hospital’s main wing.

Out on a limb: A construction worker installs a safety net outrigger. The outriggers are an integral part of the structural steel frame supporting the helipad deck.

View from above: An Ornge (Ontario’s air ambulance service) pilot’s eye view of the completed helipad. The ’35’ indicates the helipad can support a takeoff weight of 35,000 pounds, accommodating the Canadian Armed Forces’ largest search-and-rescue helicopters.

Touchdown: The first landing of an air ambulance on the rooftop pad. This was part of a simulation to prepare teams for the day the helipad officially started accepting patients.

Precious cargo: As part of the test landing, two Ornge flight paramedics, Justin Smith (left) and Rob Teranishi, unload a stretcher from the helicopter.

Speedy delivery: Upon landing, the Ornge flight paramedics accompany the stretcher down the walkway toward an enclosed ramp area, where they take dedicated elevators straight to the trauma bay.

All photography by Ancil London, Doug Nicholson and Kevin Van Paassen

The post In photos: Rooftop helipad soars at Sunnybrook appeared first on Your Health Matters.

Advance care planning is a way to help you think through and talk to your chosen loved ones about your values and wishes in relation to your future healthcare, should there come a time when you are not able to speak for yourself. It is important information for your family, your loved ones and your physicians.

“If you have not had an advance care planning discussion, now is a great time to take the steps to have one,” says Dr. Sarah Torabi, a palliative care physician. “If you are ever in a medical situation, where you cannot speak for yourself about important medical decisions, an advance care plan will be very helpful to your loved ones and the health care team to make the decisions made on your behalf align with your wishes and values.” 

“Advance care planning is important for everyone, no matter their health status, or the medical issues they may face. However, in situations where sudden or severe illness is possible, this becomes even more important.” says Dr. Sonal Gandhi, a medical oncologist.

As Canada manages the impact of COVID-19, everyone should have a plan in place in case such a scenario affects them. Documenting your medical care preferences, and the person you would want to make decisions for you in the event you’re unable to speak for yourself is important for all of us. This includes not just people who may be at risk for serious complications or death from the novel coronavirus, due to advanced age or an existing medical condition. For example, people with young children, those who are on the frontlines of treating patients, or people who live alone would benefit from these conversations as well.

“However, if you do have an underlying medical condition, you should further discuss what impact any sudden illness, like COVID-19, may have on your prognosis or ability to recover,” says Dr. Gandhi. “This sort of goals of care discussion will be more useful if you have an advance care plan in place.”

“An advance care planning conversation is an opportunity to reflect on and discuss your values, beliefs, and wishes,” says Dr. Torabi. “It is an ongoing discussion, which means it can happen and evolve at various stages in your life. It is a conversation for everyone.” 

How do I begin to make an advance care plan?

• THINK about what is important to you for others to know if you can’t speak for yourself
• LEARN about and familiarize yourself with your medical conditions.
• DECIDE on your substitute decision maker (SDM). This is the person that you trust and can make future medical decisions if you cannot.
• TALK about your values and wishes with your SDM, family, close friends, doctor and other healthcare providers.
• RECORD your SDM and communicate your wishes. For help, go to SpeakUp Ontario website

Resources:

• Speak Up Ontario – Resources for Individuals and Families
• Sunnybrook – advance care planning resources
• Time to Talk: Encouraging Serious Illness Conversations

The post Making an advance care plan appeared first on Your Health Matters.

“I was at a training facility with a foam pit learning backflips with the motorbike when it fell with all its weight on top of me. I knew right away something wasn’t right.”

Alex was immediately airlifted to Sunnybrook’s trauma centre, and it was determined that he had a critical injury to his spinal cord, mainly at the C6 vertebra. Surgeons took bone from his hip and pelvis to rebuild the C6 and then fused his C5, C6, and C7 vertabrae using metal brackets to restore some stability to his spine. The damage, however, was too great and Alex was an incomplete quadriplegic, meaning he has varying paralysis from the neck down.

He was a patient on Sunnybrook’s trauma ward for about two weeks and was transferred to Lyndhurst Centre where he stayed as an inpatient for five months to learn how to mobilize with the wheelchair and take care of himself.

Through all of the challenges, Alex has not lost his positive outlook on life. He volunteers for Sunnybrook’s P.A.R.T.Y. Program where he shares his story with teens during the school year. He also speaks with groups in many parts of Ontario, and on behalf of the Rick Hansen Foundation.

“Talking about my injury and my journey helps me a lot in my recovery, and hopefully it helps others too. You can’t take all the risk out of life, but if my story makes someone think twice and prevents an injury then I’ve made a difference.”

Alex also regularly volunteers at Sunnybrook’s Veterans Centre, the largest in Canada. His grandfather is a war veteran, and Alex has a great interest in Canada’s military history, particularly World War I and World War II. “I bring coffee around to the vets, and talk with them. We have some great laughs. It’s something that I really enjoy.”

Alex says, “I want people to know that we all have the ability to dig deeper and overcome great difficulties. A positive attitude, perseverance, communication and support are crucial, but what we find and use within ourselves to build these qualities differs from person to person and can change over time. The important thing is to find that inner strength and discover your own method of empowering it so you can keep moving forward. As Churchill said, ‘If you’re going through hell, keep going.’”

The post ‘I want people to know that we all have the ability to dig deeper and overcome great difficulties.’ Motocross injury survivor shares his story. appeared first on Your Health Matters.

In 2010, Steve, an education student at Trent University, was driving into Peterborough to have dinner with friends. In response to a text, Steve picked up his phone and typed “I’m on my w–.”

He never completed the word. A car ahead of him had stopped to turn left. Steve, unable to stop in time, swerved into oncoming traffic and collided head-on with another vehicle.

At the scene, Steve was unconscious and one of his thighbones was protruding from his left leg. Paramedics concluded the 28-year-old had suffered a severe brain injury, and that his femur was broken in two places.

Steve was airlifted to Sunnybrook. When he was stabilized in the trauma bay he had an operation on his leg and was admitted to our Critical Care Unit. Steve remained in a coma for 19 days. He needed another operation, and in total spent almost two months at Sunnybrook before being discharged home. Steve then began his long rehabilitation journey first as an inpatient where he learned to walk again, then as an outpatient.

Today, Steve still deals with the effects of his injuries. He aims to educate the general public about brain injury, and through Sunnybrook’s P.A.R.T.Y. (Prevent Alcohol and Risk-Related Trauma in Youth) Program, Steve speaks to junior high and high school students about the dangers of distracted driving. He focuses on advocating for brain injury and sharing his story.

“I concentrate on the positive and believe disabled people can live a full, beautiful, and meaningful life,” says Steve. “I can’t change the past, but I hope in sharing my story I can prevent others from picking up their phone while driving. No text is ever worth it.”

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