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.

The post Christina teaches others how to STOP THE BLEED® appeared first on Your Health Matters.

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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A STOP THE BLEED® participant “packs” a bullet wound with a t-shirt (Durham College).

Thomas Bezruki holds up a package of combat-grade medical gauze and a red t-shirt.

“You would be amazed at how much material it takes to pack a large, deep wound. If you don’t have gauze on hand, even a t-shirt will work,” he tells the group gathered around him, a mix of first responders from the Oshawa area, students and staff from Durham College, and the general public.

A member of the group steps forward to practice packing a deep laceration on a realistic-looking fake limb, complete with simulated blood pouring out of it. She uses almost the entire package of gauze to “pack” the wound and applies direct pressure with her hands before the bleeding finally stops.

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“Anyone who does this training can help save a life.”

– Corey Freedman, Manager, Trauma Services at Sunnybrook

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The demonstration is part of STOP THE BLEED®, a training course developed by the American College of Surgeons that provides civilian bystanders with the skills and tools to stop uncontrolled bleeding in an emergency situation. Instruction is delivered using a combination of presentations and hands-on practice.

Sunnybrook’s Centre for Injury Prevention brought the program to Canada for the first time in 2017, and has since trained thousands of people.

“We show people how to stop life-threatening bleeding following everyday emergencies, natural disasters and mass casualty incidents. Anyone who does this training can help save a life,” says Corey Freedman, Manager of Trauma Services at Sunnybrook and a certified STOP THE BLEED® facilitator.

The facilitators who helped certify over 200 people at Canada’s largest-ever STOP THE BLEED® training event on May 13, 2022.

On May 13, 2022, Sunnybrook partnered with Durham College to hold the largest STOP THE BLEED® training event ever held in Canada, helping 217 people become certified.

The event was held a week before the Victoria Day long weekend, which is often referred to as the unofficial start of trauma season. Trauma hospitals like Sunnybrook traditionally see a significant increase in traumatic injuries over the summer months, making this a key time to offer the training to large groups. Watch of video of the event on Instagram.

Course facilitators included several staff members from Sunnybrook and Bezruki, the Manager of Emergency Management at Durham College and a former Tactical Combat Casualty Care (TCCC) medic in the Canadian military.

Thomas Bezruki demonstrates the proper use of a tourniquet to stop uncontrolled bleeding (Durham College).

Bezruki says Durham College has installed over 30 STOP THE BLEED® kits, which include essential items like tourniquets, gloves and gauze, across its Oshawa and Whitby campuses. He hopes other institutions follow suit by offering the training course and installing the kits, and he encourages individuals to sign up for STOP THE BLEED® training.

“Everyone should know how to stop bleeding after an injury. The more people who know how to control bleeding in someone who is injured, the greater the chances are that person will survive,” he says.

Sunnybrook offers public and private STOP THE BLEED® training opportunities. Learn more and register for an upcoming course at sunnybrook.ca/stopthebleed.

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When the Jennifer Tory Trauma Recovery Clinic opened at Sunnybrook in April 2021, physiotherapist Carly Orava was one of the first people to join the newly-created team.

“I was excited about the creation of this clinic because we’re able to follow and care for trauma patients for up to a year after they are discharged from the hospital. This model gives us a deeper level of insight into our patients’ recovery process that we didn’t necessarily have before,” she says.

Carly says the patients they see are dealing with a variety of issues after an injury, including physical disability, pain, mental health problems and the effects of brain injuries. The new clinic operates in a dedicated space where patients receive care from a range of health professions including physiotherapy, occupational therapy, social work, physiatry, psychology, clinical psychiatry and pain services.

Before the clinic opened, a trauma patient who had been discharged but still required follow-up with multiple care providers would have needed to visit several different areas of the hospital. Patients who live further away from the hospital may have also had trouble accessing care in their home communities.

“Now, we can identify and address gaps in care pathways to make sure no one is falling through the cracks,” says Carly, who has worked with trauma patients at Sunnybrook since 2013, first as a student in the inpatient trauma unit and then at St. John’s Rehab.

The clinic, which is the first of its kind in Canada, has booked close to 1,900 appointments over the past year. Carly says that while there are ebbs and flows, no two days are the same.

“Some days I may only have a few patients scheduled, but then one of the occupational therapists identifies a patient who may benefit from physiotherapy during one of their appointments, so I will drop in to do an assessment. Or, I could be called to the inpatient trauma unit to evaluate a patient and help put together their discharge plan. You definitely have to start your day with an open mind,” she says.

As the team celebrates the successes of the clinic’s first year, they’re already looking ahead to the future.

“We’re still growing and figuring out how best to meet the needs of all our patients,” says Carly.

However, one thing she knows for sure is that the collaborative environment of the clinic has made for a seamless experience for patients.

“Our patients are happy knowing that somebody still cares about their recovery, even when the acute care phase of their journey is complete, and we are happy to be able to provide that to them,” she says.

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There was a time when Alan MacDonald was too traumatized to discuss some of the details surrounding the October 2018 accident that left him with severe electrical burns over 13 per cent of his body.

As part of his recovery program at Sunnybrook’s Ross Tilley Burn Centre, Alan has spent the past year in treatment with Dr. Sam Iskandar, a clinical psychologist at St. John’s Rehab.

Dr. Iskandar diagnosed him with post-traumatic stress disorder (PTSD) resulting from the event. PTSD is a condition that can cause symptoms such as recurrent flashbacks, nightmares, intrusive thoughts, extreme anxiety and depression, all manifested differently through the filter of each survivor’s individual psychology and life experiences.

Alan can now speak about his accident with an astonishing degree of openness. It’s a tribute, he says, to the work he’s done with the Sunnybrook team that took his emotional health as seriously as the repair of his body.

“You have to get to the point where the more you talk about it, the better you feel,” says the Bradford, Ont., resident.

The life-changing incident happened one morning at a strip mall in midtown Toronto. Alan, an electrician and business owner, had been called in with his team to help solve a problem resulting from a proposed electricity shutdown. A new bank branch was scheduled to go into the mall, and in order to safely install a new electrical disconnect, the power had to be shut down for four to six hours, which was not sitting well with the other mall tenants, who complained the outage would impact their businesses.

Alan agreed to inspect the site to see if they could manage the installation without shutting off the lights. Against his better judgment, he removed the electrical panel to install the new disconnect. He was alone in the room with the door closed due to the potential danger of the task.

“You have to get to the point where the more you talk about it, the better you feel.”
– Alan MacDonald on the 2018 accident that resulted in severe burns

“The next thing I knew, there was an explosion,” Alan says. “[It] knocked me into a pipe, where I hit my head pretty hard.” The culprit was a faulty disconnect, but that would only be discovered much later. At the moment, Alan had no clue what had happened and that he’d been hurt.

“I came out the door, and my guys are just staring at me; these big, broad guys were like, ‘Oh my God,’” Alan recalls. “I looked down, and my entire shirt was gone – just disintegrated. The only thing that was left was the zipper that went down halfway. The flesh was gone. My face was black. Then I had what looked like a piece of plastic stuck to my hand from the thumb down to the wrist, so I pulled it off. And that’s when I realized that wasn’t a piece of plastic. It was my skin.”

Alan’s team insisted on calling an ambulance. But Alan was in shock – he didn’t register any physical pain and, in fact, felt it was his responsibility to go right back in and fix the power outage.

He was rushed to the Ross Tilley Burn Centre. “I got in the ambulance and closed my eyes,” he says. “When I woke up, I was in a hospital room, and the doctor told me I was going to be okay.”

The surgical team treating Alan at the burn centre was led by Dr. Marc Jeschke, director of the Ross Tilley Burn Centre and a highly regarded surgeon and research scientist. Dr. Jeschke assessed Alan’s injuries, which included “significant” electrical burns, corneal abrasion due to the flash, and a torn rotator cuff.

Dr. Jeschke and his team performed multiple surgeries and skin grafts to repair the damage to Alan’s body. Dr. Jeschke also understood the mental toll the injuries would take on Alan and his family, and so he built a recovery program that went beyond the physical.

“Mental health is still completely under-appreciated,” says Dr. Jeschke. “I think that that’s something to emphasize – we are lucky we have access to psychiatry at Sunnybrook, and that we have access to psychology and psychiatry at St. John’s Rehab.”

Alan was referred to the in-patient burn rehabilitation program at St. John’s Rehab, the only such program in Canada. Its holistic approach to healing the mind, body and spirit has brought the centre international acclaim.

At St. John’s Rehab, survivors of burns, amputations and other grievous injuries have access to resources, including occupational therapy, clinical psychology and massage, that are critical to recovery. Alan worked with Dr. Iskandar, in addition to his own psychiatrist, to help him through the stages of emotional recovery and to adjust to his new life.

One of Dr. Iskandar’s main therapeutic tasks was to prevent Alan from slipping into long-term depression. He says that in many cases, even well-meaning people tend to focus on the fact that someone has physically survived a major physical trauma and are surprised to see that the person has become more taciturn and withdrawn.

“People with PTSD will continue to try and avoid people and situations that remind them of their trauma. In the case of burn injuries, that can be a barbecue, a cigarette, people associated with the event,” Dr. Iskandar says. “And then the more they avoid, the less fulfilling their life becomes, and the more depressed they may feel.”

Dr. Iskandar points out that a major injury can also have a significant impact on the survivor’s family. Someone with PTSD may not have the same capacity to deal with the daily stressors of parenting and relationships that they did before their injury, and the requirements for their care can be emotionally and physically draining for family members.

Alan says his wife, Tara, has been his “rock,” and that his three daughters have been immensely strong and supportive. But the year has brought its share of challenges at home. Once the “life of the party,” Alan became more withdrawn and occasionally angry. In March 2019, Alan spiralled into a depression while coming off his pain medications. He also experienced some mental health challenges months later, following surgery on his shoulder.

These types of setbacks are not uncommon on the road to recovery from traumatic injuries. But Dr. Iskandar notes that to the people directly affected, they can be overwhelming and trigger fear that it will be like this for the rest of their lives.

At Dr. Iskandar’s suggestion, Alan and Tara have sought out family counselling, and both are doing well. At some point in the future, Alan is planning to return to work. He says the care he has received at the Ross Tilley Burn Centre and St. John’s Rehab has given him a good shot at resuming a full life again.

“The team at Sunnybrook was just incredibly helpful,” Alan says. “The support you get there really, really makes you feel like you’re on the right track, like you’re on the road to recovery.”

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“People are scared, and they don’t know what to expect,” says Janna Di Pinto, a social worker who sees patients and families in the Tory Trauma Program at Sunnybrook.

Here are five tips for supporting a loved one through an unexpected stay in the critical care unit:

1. Education is key

Patients in the critical care unit often end up there suddenly, leaving families little time to make sense of what’s happening.

“As social workers, part of our role is to provide education on what to expect during a critical care stay. Patients can be doing well one day, and not so well the next, and it’s important for family members to know that such changes in their loved one’s condition are common,” says Di Pinto.

Staff members talk to family members about some of the expected responses and feelings they may have in this crisis event, such as:

• Feeling scattered and unable to think straight
• Processing information poorly
• Decreased short-term memory
• Decreased sense of hunger or thirst

Other helpful educational resources are available online on Sunnybrook’s Navigating the ICU website, which was developed after extensive collaboration between staff and family members.

2. Establish defined roles

In the critical care unit, families can spend a lot of time sitting at the patient’s bedside, but they aren’t sure how they can help.

Family members can contribute to their loved one’s recovery by making a playlist of the patient’s favourite songs to play at the bedside, holding the patient’s hand, bringing in photos and ensuring staff are aware of what is important to the patient.

At Sunnybrook, family members are also encouraged to participate in the care team’s daily rounds at the bedside.

“Staff can teach family members how to participate in their loved one’s care, such as encouraging range of motion exercises or redirecting a patient from pulling tubes and lines,” says Di Pinto.

3. Give yourself permission to take care of yourself

 Di Pinto says it’s important for family members to give themselves permission to take care of their own wellbeing, too.

“We don’t expect them to be at a patient’s bedside 24/7. It’s okay for them to go home, rest and then call the unit as often as they like to check in,” says Di Pinto.

Coordinating a rotating visiting schedule with others can be helpful, because it allows everyone a chance to be at the hospital while also building in time to look after themselves.

“People have many demands to juggle – maybe they live far away from the hospital, or have to return to work, or need to sort out child care. This is a time to establish a new balance and figure out new roles for themselves,” she says.

 4. Find coping strategies that work for you

Some people have a lot of anger after their loved one ends up in critical care, says Di Pinto, particularly if the admission was the result of a trauma (like a car crash) caused by someone else.

“We help family talk about which coping strategies may work best for them. For example, we let people know where the quiet spaces are around the hospital, such as the chapel or going for a walk outside. We let them know it’s okay to go to the gym, spend time with friends or pets, or even just go outside and scream if they need to,” she says.

5. It’s okay to have hope 

Di Pinto says they often talk with family members about the road to recovery, and how it is a process that takes time.

“When your loved one is in critical care, there may be a fine line between being hopeful and being realistic, but it’s okay to have hope that your family member will recover.”

The post 5 tips for getting through a loved one’s stay in the critical care unit appeared first on Your Health Matters.

If I asked you to close your eyes and imagine a car crash, it might play out like a movie scene in your mind: a car skidding down the road on dark, stormy night or rain pelting the windshield of an out-of-control car surrounded by darkness.

But research suggests it’s actually the bright, sunny days that put us at greater risk of a life-threatening car crash.

The research study, conducted by Sunnybrook physician and epidemiologist Dr. Donald Redelmeier, looked at every patient hospitalized at Sunnybrook after a car crash for the past 20 years. The researchers then cross-checked the weather at the time and place of the crash (along with a week before and after for reference).

Of the total 6,962 patients that were studied, the majority of life-threatening traffic crashes happened in the daytime, and the risk increased with bright sunlight. The increased risk was about 16 per cent, was the same for drivers of all demographics, and wasn’t easily explained by glare at dawn or dusk. The same increased risk wasn’t found on days of cloudy or overcast weather. Watch the video above to find out more.

The study findings didn’t surprise Sharon Ramagnano, manager of trauma services at Sunnybrook.

“I think during the sunny summer days drivers may assume the road conditions are good and may drive faster,” she said. “There are also typically more people out on bright sunny days — more pedestrians, more cyclists, more motorcycles and more cars — and so drivers may be more distracted.”

Sharon said drivers should keep good sunglasses in the car and use the vehicle’s sun visor to help minimize glare.

“Don’t ruin a beautiful day with an ugly traffic crash,” Dr. Redelmeier said. “In particular, recognize that your judgment may be mistaken in bright sunlight and tempt you toward excess speeding. Check your speedometer and respect the police who enforce speed limits even when conditions are seemingly perfect.”

Sharon says the start of “trauma season” – the summer months, which see an increase in the number of people visiting hospital emergency rooms due to traumatic injuries ­– is a good time for a few reminders about driving safety, even though the tips aren’t anything groundbreaking.

“Stay alert and keep your eyes on the road,” she said. “Do not drink and drive. Put your phone out of sight. Use your mirrors and keep a safe distance from the cars in front and behind you.”

She said these few simple things can help keep our roads safer.

“When you get in your car, adjust your seat to the proper distance. Check and adjust your mirrors to allow for the greatest possible view. Make sure your windshield washer fluid is topped up. Put on your seatbelt and make sure your passengers do too.”

Take an extra second to check twice before turning or moving ahead, she added.

“Watch for pedestrians and cyclists. Obey the road signs at all times,” Sharon said. “Ensure you pay attention to the other cars around you that may not be paying attention to you.

“Slow down and take your time. It sounds so obvious. But it’s always good to just take a moment and remind ourselves of these things.”

Have a great, safe — and hopefully sunny — summer.

The post Refresh your driving safety in time for the summer sun appeared first on Your Health Matters.

“We know that every year fire kills 400 people in Canada, and the majority of these deaths occur in the home,” says Joanne Banfield, Manager of Trauma Injury Prevention at Sunnybrook.

With National Fire Prevention Week happening this week, the National Fire Protection Association is reminding everyone that smoke alarms don’t last forever. In fact, they need to be replaced every 10 years.

Not sure how old your alarms are? Simply remove the alarm from the wall or ceiling, and look at the date of manufacture on the back of the alarm. If the alarm is more than 10 years old, replace it with a new one. If it’s less than 10 years old, you can put it back – just be sure to replace the batteries before you do.

Having working smoke alarms in your home is the best way to alert you to a fire, and will help get you and your family safely out of the home (and keep you out of the hospital!). Test your alarms monthly by pressing the test button to ensure they are functioning properly. Remember, it’s the law to have working smoke alarms on every story of your home and outside of sleeping areas.

The post When should you replace your smoke alarms? appeared first on Your Health Matters.

I met Becky at her home a few weeks ago, and knew she had lost her nose to skin cancer years ago. I also knew that she had been fitted with a prosthetic nose by Sunnybrook’s Craniofacial Prosthetic Unit. She met me outside her sunny building and directed me on where to park. As I walked towards her to say hello (and if I hadn’t been looking for it), I literally wouldn’t have noticed her nose at all. The way it fit her face was so seamless that the only thing I noticed was her.

We sat and talked for a long time in her living room. All the surgeries and time recovering physically have been no match to the emotional challenges Becky has faced following her surgeries. She explained that as hard as some decisions are, you have to take a chance if they might save your life. In losing her nose, Becky survived. But after being fitted with a custom prosthesis at Sunnybrook, she’s now thriving. She can go out in public and not have to answer a million personal, and often difficult, questions about her appearance.

Becky Thomson visits Sunnybrook’s Craniofacial Prosthetics Unit.

Anaplastologists David Morrison and Todd Kubon say the prosthetics they meticulously craft are a success when they aren’t noticed at all. Both masters in their field, they spend their days meeting with patients, assessing their individual needs and determining if they want to move forward with a prosthesis. Some don’t, and Todd says one of the most important things is helping patients feel comfortable as they are.

If they do want a prosthesis, David and Todd get down to the artistry of rebuilding noses, cheeks, foreheads, ears and eye sockets. Patients may come to the clinic following a birth defect, trauma or cancer treatment. In each case, within about two weeks, they are able to help rebuild the most visual part of a person’s identity: their face.

Watch my video to hear Becky’s inspiring story, and meet David and Todd, two of the many people that make Sunnybrook so special.

The post After losing her nose to cancer, Becky shares her story to help others appeared first on Your Health Matters.

They are the glorified jobs you see endlessly profiled on cop and drama shows. The first responders to a scene faced with the gruesome task of documenting a life shattering tragedy into evidence bags. It’s one thing to watch these television portraits while unwinding at the end of a long work day. It’s quite another to live the reality. But that’s something Sergeant Tim Burrows and Constable Hugh Smith do everyday. Overseeing media communications, they are responsible for attending any major collision that Traffic Service is involved in. Fatalities are not uncommon. Talk about a tough job.

“The ones we are on are usually as people would say, spectacular,” says Smith. “It’s the carnage involved, how violent the collision really is. What gets to the officers when we’re investigating is, this was so preventable. Why are we here at 3 in the morning, and someone has passed away? Then you find it was due to either some kind of impairment, or distracted driving. By the time they look up, it’s all over for somebody.”

Smith and Burrows have, collectively, 44 years experience, and have banned the word “accident” from their nomenclature, preferring terms like “incident” or “collision”. So here’s what they can definitively say: every collision is both life altering (if not life threatening) and preventable, and anyone who sees what they do will never be the same.

Enter Sunnybrook’s P.A.R.T.Y program. Short for “Prevent Alcohol and Risk-Related Trauma in Youth”, it’s the medical version of scared straight. Twice a week, a group of high school students come close to stepping in the shoes of Smith, Burrows and other first responders. They view graphic videos of real incidents, tour the trauma and critical care units, and meet with patients whose lives have been irreparably altered as a result of poor decisions-like drinking or driving or not wearing a seatbelt. In short, these teens smash into the worst-case scenario head on.

P.A.R.T.Y. is a particular source of pride for Sunnybrook. Born here, it’s now been adopted and copied locally and internationally. And now, important 10-year data on the program finally quantifies what those involved have long-suspected: it really works. The new study, published in the Journal of Trauma, finds teens who attended P.A.R.T.Y. had fewer injuries, driving offenses and collisions, not to mention a reduction in serious and catastrophic injuries.

Burrows and I met last week for a drive around the west end of the city. He told me the biggest challenge with any safety measure is changing behavior, something P.A.R.T.Y. does with a bang. “If you can start that at the youth, that’s where you’re going to get the win because it keeps on growing.” He also defends the graphic nature of the program. Unlike the shows and video games kids are bombarded with, P.A.R.T.Y. is clear in its message that real life has no reset button.

Smith agrees, saying that each student will leave enriched in some way from the P.A.R.T.Y. experience. “Maybe not the whole program, but they’re going to take something that relates to them. Hopefully that little message, as we say, spreads to 2 friends and so on.”

Here’s to that. Learn more about the P.A.R.T.Y. Program

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