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  • January 18, 2022

    By MedStar Team

    Structural racism is one of the most pressing issues facing healthcare today.  Unfortunately, academic medicine historically exacerbating the exploitation of vulnerable communities to achieve educational and research goals, especially in Black, Indigenous, and People of Color (BIPOC) communities. For example, many traditional research practices among marginalized communities highlight and, in most cases, magnify inequities in care. These can include:   

    • Community members are under informed about research methods and strategies. 

    • Researchers prioritize extraction of information from communities rather than community ownership of information.

    • Researchers accrue funding, prestige, and publications (in which academics’ voices predominate over the narrative perspective of community members) without similar accrual to participating communities.  

    • Researchers’ understanding of questions to be answered may lack cultural context because of their incomplete comprehension of community conditions.  

    The relationship between research institutions and many BIPOC communities is estranged and needs mending to dismantle racial disparities and inequitable research practices. As the area’s largest healthcare provider, MedStar Health is committed to do the work needed to address these issues in everything we do in order to advance health equity for everyone we serve.

    “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

    (March 25, 1966 speech to the Medical Committee for Human Rights)

     

    Advancing Health Equity in Early Childhood and Family Mental Health Research

    MedStar Health investigators Arrealia Gavins, Celene E. Domitrovich, Christina Morris, Jessica X. Ouyang, and Matthew G. Biel recently published research emphasizing the need to co-learn and to co-develop research with community members themselves to prioritize benefits for both participants and researchers. “Advancing Antiracism in Community-Based Research Practices in Early Childhood and Family Mental Health” was published in the Journal of the American Academy of Child & Adolescent Psychiatry. This work was done through the Early Childhood Innovation Network (ECIN),  a community-based partnership between two academic medical centers (MedStar Georgetown University Hospital & Children’s National Health System) and several community-based organizations in Washington, DC that strives to provide support to families through caregiver and child mental health services, family peer support, child social and emotional learning, initiatives to address social determinants of physical and mental health for families, and place-based support to families within select communities.  

    In this study, researchers found that to begin to undo the inherent inequities within academic medical research, particularly in studies involving children and caregivers, investigators need to consider how best to build equitable, long-term partnerships with communities through Community-Engaged Research (CEnR) or more specifically, Community-Based Participatory Research (CBPR). CBPR offers an alternative to traditional non-participatory research with a collaborative, strengths-based orientation that equitably involves researchers, community members and other stakeholders in all phases of research while embracing their unique expertise. 

    Recently documented increasing rates of depression, anxiety, and suicide in BIPOC youth, compounded by the disproportionate impact of the COVID-19 pandemic on BIPOC communities, has heightened the urgency for progress in community-based research.

    The research team started to utilize CBPR practices to advance antiracism in their clinical research work in child and family health along with working with BIPOC communities. This approach to integrate CBPR practices into the development, implementation, and evaluation of community-based interventions seeks to support early childhood mental health in primarily Black communities in Washington, DC. 

    Making an Impact: Insights & Lessons Learned from CBPR

    Through this work of the EICN, the research team found five valuable lessons from applying CBRP principles to research collaborations in community settings. 

    Intervention Practices

    Lessons Learned and Applied

    ECIN launched a group-based mindfulness parenting program to explore how to support the emotional health of parents at a Head Start early education center with the intention to reduce caregiver stress and enhance caregiver-child relationships.

     

    Lesson 1: Invest the time to build trusting relationships

    Providers set up several discussion groups with community partners and medical center-based researchers to review proposed assessment tools to be used with children and families receiving psychotherapy services.

    Lesson 2: Involve community partners in the development of the intervention theory of change and measurement strategy

     

    Clinical staff organized peer specialists to provide support to families with young children through 3 evidence-based strategies: enhancing parents’ knowledge about caregiving with young children;optimizingparent use of existing resources; and increasing parents’ access to social supports.

     

    Lesson 3: Create interventions in partnership with community members

    Clinical staff providedearly childhood mental health consultation (ECMHC) in preschool classrooms to enhance educators’capacitiesto support early childhood development and to recognize early signs of mental health concerns

    Lesson 4: Interpret findings in partnership with community members

    ECIN membersparticipatedin formal antiracism training with external experts to incorporate antiracism principles into ECIN’s operations and into the culture of the Network. ECIN formed a Racial Equity Community of Practice (RECOP), that supports 8 intervention teams in developing practices that advance racial equity goals.

    Lesson 5: Embed an antiracism focus in research structures and processes

     

    The research team found this community-based approach to be helpful in conducting research that will have a long-lasting impact on not only the community, but also on members of the research team. During a time where BIPOC families are experiencing the effect of COVID-related deaths and grief, unemployment, housing instability, and police violence; researchers have an opportunity to be engaged in the community and work to eliminate racial inequities within academic medicine and research. 

    Journal of the American Academy of Child & Adolescent Psychiatry, DOI: 10.1016/j.jaac.2021.06.018

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  • January 15, 2018

    By MedStar Health

    Dr. Bitar, medical director of MedStar Harbor Women's Care with patient Christy Ryan, RN, after the delivery of her baby girl.

    MedStar Harbor Women's Care Goes Above and Beyond

    Christy Ryan, RN, was more than halfway through her pregnancy with her third child when she was offered the opportunity to join the team in the Emergency department at MedStar Union Memorial Hospital as a staff nurse. She was excited about her new job, but with it came a change in her health insurance. She needed to find a new obstetrician as soon as possible.

    “I was at a critical point in my pregnancy and was experiencing some medical challenges, so it really wasn’t an ideal time to find a new doctor,” Ryan says. “But I had to.”

    She began researching her options, focusing on practices located near her home. MedStar Harbor Women’s Care seemed to meet her needs, offering a comprehensive scope of services and an experienced team of physicians and care providers. She made an appointment with Wael Bitar, MD, medical director of the practice, and hoped for the best.

    “I knew within a few minutes of meeting Dr. Bitar that I had made the right choice,” says Ryan. “He gave me his full attention. He answered my questions, eased my fears, and promised me that despite my complicated health issues, we would have a healthy mom and a healthy baby girl. And I believed him.”

    Ryan’s pregnancy was considered high risk because she has just one kidney, increasing her risk for urological infections and kidney stones, in general, and even more so during pregnancy. Making her situation even more complicated was the fact that at 28 weeks into her pregnancy, she was diagnosed with gestational diabetes.

    From that point forward, in addition to taking new medications and meeting regularly with a dietitian, she had weekly screenings in the Fetal Assessment Center at MedStar Harbor Hospital. And every three weeks, her baby girl was measured to ensure her growth was on track.

    “Being diagnosed with gestational diabetes was a first for me, and it was life changing,” notes Ryan, already mom to two boys, Nathan, 8, and Jacob, 3. “I had to change everything about the way I was eating. I had to cut carbohydrates and all junk food.”

    It was also an emotional time, Ryan recalls. “I was pretty upset and worried,” she adds. “But every time I had a doctor’s appointment, I got the reassurance I needed. Dr. Bitar calmed me down and kept me centered.”

    On November 6, 2017, Ryan and her husband Shawn finally got to meet their daughter, Hailey. Seeing and holding her baby girl for the first time, Ryan was filled with a different kind of emotion.

    “I kept looking at Hailey and thinking that everything I had gone through during my pregnancy was worth it,” she says. “And I am so thankful that I had such a caring and supportive doctor and team by my side, working with me week in and week out to get me to that day.”

    Caring for Women of all Ages
    MedStar Harbor Women’s Care offers comprehensive obstetrical and gynecological services for women of all ages. The practice prides itself on its ability to offer care that addresses health issues that impact women at every stage of their lives. Dr. Bitar is one of three board-certified physicians who serve the practice, working alongside two nurse practitioners and a group of medical assistants.

    “Our team is very diverse, which allows us to truly accommodate patients with various medical needs and personal preferences,” explains Christina Barett, CRNP, a certified registered nurse practitioner. “We all have different backgrounds and key areas of interest or a specialty. Some of our providers speak multiple languages.”

    And, as part of the MedStar Health network, the team can easily streamline care for patients who present with more complex medical issues, and need a referral to another specialist.

    “We have relationships with physicians who focus on different kinds of medicine, and we can quickly refer a patient who has a problem or condition we can’t address,” Barett adds. “For example, we collaborate often with the gynecologic oncologists at MedStar Harbor when our patients have a need for those services.”

    One thing that also sets MedStar Harbor Women’s Care apart from other local practices is its focus on holistic health. While women come in primarily for obstetrical and gynecological care, they find that they’re able to talk about and get guidance on a wide range of health issues.

    For example, a woman who comes in for her annual checkup might end up engaging her physician in a conversation about diabetes, thyroid issues, or depression. It’s also common for questions to come up about nutrition, sleep habits, and strategies for coping with stress.

    “Our job is to see the patient as a whole person and be a liaison for her good health,” says Fawn Manning, MD. “Sometimes we are talking with a patient about very sensitive issues; in fact, it might be the first time she is having a conversation out loud about an extremely personal topic. But we want her to open up and feel comfortable confiding in us because when she does, we can point her in the right direction.”

    Dr. Manning notes that many of those conversations include laughs, hugs, and sometimes even tears and tissues. “I get to connect with my patients during the most special and personal moments in their lives, whether it’s about marriages, babies, getting through challenging medical issues, or the loss of a spouse,” she says. “I hear about it and I get to be part of it. And I get to help that woman through it. This isn’t a job for me; it’s a life.”

    MedStar Harbor Women’s Care offers its services in three locations: on the MedStar Harbor campus, in Federal Hill in Baltimore City, and in Pasadena. The same scope of medical care is available at each location, and providers rotate between the three offices, giving patients flexibility and options when it comes to scheduling and managing health care.

    “Many patients utilize two locations because they live close to one and work close to another,” says Barett. “They appreciate that convenience and the fact that it makes it easier to get an appointment quickly.”

    The practice is currently accepting new patients. Appointments are available at any of the locations by calling 410-354-0800.

    For more information, please call

    410-354-0800

    MedStar Harbor Women's Care
    MedStar Harbor Hospital Outpatient Center, Ground Floor
    3001 South Hanover St.
    Baltimore, MD 21225

  • January 15, 2018

    By MedStar Health

     

    You know the drill. You’re in your physician’s office and one of the first things that happens is someone checks your blood pressure. While you may be familiar with this simple test, you may not understand why your blood pressure is so important.

    “Knowing your blood pressure is a critical part of managing your health,” says Kerunne Ketlogetswe, MD, MHS, a cardiologist at MedStar Harbor Hospital. “If it’s high and you don’t know it, or if it goes uncontrolled, you may be at greater risk for heart attack, heart failure, stroke, or kidney disease.”

    High blood pressure—also known as hypertension—can damage the arteries that carry the blood through your body. As blood moves through the arteries, it puts pressure on the artery walls. This pressure goes up and down depending on several things, including physical activity, diet, and medication. 

    Kerunne Ketlogetswe, MD

    A person has high blood pressure or hypertension when the pressure remains elevated over a period of time. But many people don’t know they have high blood pressure until something bad happens. That is why hypertension is sometimes called the silent killer—a person may have no symptoms even when their blood pressure is dangerously high.

    “Most people don’t realize that they can’t feel hypertension,” explains Dr. Ketlogetswe. “The only way to know your blood pressure is to have it checked. Having it checked regularly will help you and your healthcare provider manage it if it is too high. We have many safe and effective medications to control hypertension.”

    Experts consider optimal blood pressure to be lower than 120/80. Blood pressure readings of 130/80 or higher indicate hypertension.

    “Blood pressure tends to rise with age,” Dr. Ketlogetswe notes. “People who are obese, who have medical problems such as diabetes, or who take certain medications, are at higher risk for developing high blood pressure.”

    There are things you can do to prevent and/or control high blood pressure:

    • Don't smoke
    • Maintain a healthy weight
    • Eat a heart-healthy diet
    • Be physically active for at least 30 minutes every day
    • Watch your salt and sodium intake

    “Blood pressure readings can be confusing,” adds Dr. Ketlogetswe. “They don’t have to be. Talk to your healthcare provider. Knowing your numbers and what they mean is an important step toward staying healthy.”

    Location Information

    For more information, please call

    410-350-2106

    MedStar Harbor Hospital
    3001 South Hanover St.
    Baltimore, MD 21225

  • January 15, 2018

    By MedStar Health

     

    By John Irwin, MD, MedStar Harbor Pediatrics

    Every year, thousands of children and young adults are diagnosed with juvenile diabetes, also known as type 1 diabetes. Type 1 diabetes is an autoimmune disease that prevents the body from producing insulin, a hormone you need in order to survive.

    It’s important for parents to know the signs and symptoms associated with type 1 diabetes, and take their child to see a physician, if these conditions persist. Some of the most common early indicators include:

    John F. Irwin, MD
    • Increased thirst
    • Frequent urination
    • Extreme hunger
    • Unexplained or rapid weight loss
    • Fatigue
    • Irritability/mood swings
    • "Fruity" breath or odor
    • Blurred visition or inability to focus
    • Repeated yeast infections (girls)

    Learning that a child has diabetes can be devastating. However, know that the doctor will develop a comprehensive treatment plan that will emphasize health, wellness and the ability to selfmanage the condition, so your child can live a long, healthy life.

    If your child is diagnosed with type 1 diabetes, several medications may be prescribed to control and manage the condition.

    You will be taught how and when to measure blood glucose levels and urine ketones, how to document them, and what to do if your child has a low blood glucose reaction.

    Balanced, nutritious meals will become increasingly important in your household. And, most doctors will also suggest that you spend some time talking with your child about short and long-term goals. This is important, as it helps you understand what your child values most.

    Then you can determine what steps can be taken to assure your child can achieve those goals, despite the disease.

    We are happy to consult with you to answer any questions you may have, provide education and resources, and point you in the right direction, if your child needs specialty diabetic care and treatment.

    If you have concerns about childhood diabetes, or feel that your child may be at increased risk, take some time to talk with your existing pediatrician or call MedStar Harbor Pediatrics at 410-350-2253.

    Location Information

    For more information, please call

    410-350-2173

     

    MedStar Harbor Pediatrics
    Outpatient Center, Ste. 108
    3001 South Hanover St.
    Baltimore, MD 21225

  • January 12, 2018

    By Laura S. Johnson, MD

    Burn injuries are one of the leading causes of accidental death and injury in the United States. And while nearly 97 percent of people who suffer burn injuries survive, many will sustain serious, lifelong physical disabilities.

    We can turn these statistics around by following a few simple burn prevention tips and by knowing what to do if you or a loved one is burned. Unfortunately, we see a lot of mistakes because people simply didn’t know what to do in the situation or because they followed an old wives’ tale.

    Despite all the best prevention efforts, burns can happen. If you find yourself faced with a burn wound, whether it’s on you or a loved one, make sure you know what not to do. Let’s take a look at some of these more common mistakes, and talk about what should actually be done.

    Struggling with a burn wound? Request an appointment at our Burn Center.

    Request an Appointment

    5 mistakes people make when treating a burn wound

    1. Icing burn wounds

    Fight heat with cold, right? Wrong, at least when it comes to burns. Using cold water or ice on a burn is one of the biggest mistakes we see people make. I know it probably feels good at first, but it may end up doing more harm than good.

    Don’t forget that frostbite is as much a thermal injury as a burn caused by fire. They both damage tissue. You don’t want to add a cold injury on top of a heat injury. Also, you don’t want to lower your body temperature too much, as it can impair your physiologic response to stress. Instead, if it’s a small burn that doesn’t require immediate emergency care, run the wound under room-temperature tap water for 10 minutes. Then, apply a first aid burn cream or petroleum jelly and a bandage.

    2. Using home remedies

    Speaking of first aid burn cream, don’t try making your own. Mayonnaise, mustard, honey, butter—I’ve seen it all applied to burns. Toothpaste may have been my favorite because they smelled so minty fresh! While these products may not necessarily make a burn wound worse, they may impede healing by trapping the heat. And if they are contaminated in any way, they can lead to infection.

    So save the butter for your toast. Instead, use an over-the-counter, nonperfumed, antimicrobial moisturizing agent. You also can take an over-the-counter pain reliever, such as ibuprofen or acetaminophen for pain control.

    3. Popping burn blisters

    If your burns are severe enough to blister, you should probably be seen at a Burn Center. The providers can drain the blisters and provide dressings to protect the skin underneath.

    Related reading: When to seek treatment at a burn center

    4. Asking for antibiotics 

    “Is it infected? Do I need antibiotics?” This is a common question we get from burn patients. Antibiotics generally are not needed in the early management of burn wounds.

    There are a couple reasons for this. First, there’s no way to completely sterilize burn areas, since our normal, healthy skin has bacteria living on it on a day-to-day basis. Antibiotics prescribed to take by mouth will disrupt the normal balance of bacteria in our bodies.

    Second, as antibiotic resistance has grown over the years, we’ve become much more careful about how we administer antibiotics. The topical agents we put on burns are anti-microbial, which provide an antibiotic action, but it’s targeted to the specific area. This way, we can avoid impacting a person’s entire body.

    5. Underestimating burn wounds 

    Burns can be deceiving. Unless you see burns all the time, it can be easy to be fooled into thinking one isn’t as bad as it actually is. I would much rather you overestimate how bad a burn is and come in than wait too long and face long-term consequences, such as amputation or loss of function.

    If the burn is bigger than the palm of your hand or there is blistering, seek help. You also should seek medication attention if you have a persistent fever or redness that extends beyond the border of the burn injury, as these may indicate an infection.

    You also may want to consider seeking treatment at a specialized Burn Center like ours. The American Burn Association recommends you receive treatment from a burn center if you have:

    • Burns that involve the face, hands, feet, genitals or major joints
    • Third-degree burns, which can appear whitish, charred or translucent with no sensation in the burned area when pricked with a pin
    • Burns that cover more than 10 percent of total body surface area
    • A pre-existing medical condition that can complicate recovery, such as diabetes

    While it’s always good to know how to treat a burn wound, we hope you’ll never actually need to use that knowledge. You can reduce your burn risk by avoiding a few common mistakes.

    5 mistakes that can increase your burn risk

    1. Not wearing safety gear

    It’s not always appealing, but safety gear can save your life. This can include goggles, gloves and shoes. It may seem like common sense, but you’d be surprised by the number of people we treat who were burned because they weren’t wearing oven mitts to pick up a hot item in the kitchen.

    A few years ago, we treated a number of patients injured in unexpected laboratory accidents. While they did suffer burns, the injuries could have been much worse had they not been wearing safety goggles.

    2. Not being aware of your environment

    Stop for a moment. Do you know where the nearest exits and fire extinguishers are? Along with preventing a fire in the first place, it’s important to think about protecting yourself and escaping from a fire as well. A little pre-planning can go a long way. Make sure everyone in your household knows how to escape various rooms in the house, and establish a plan for where to meet up at a safe distance.

    3. Not knowing how to put out a kitchen fire

    When a pot or pan catches fire in the kitchen, people tend to want to throw it in the sink or outside. This can lead to a burn while picking it up or to the fire spreading as it’s moved.

    Instead, if there’s a fire on the stovetop, cut off the oxygen that feeds it by covering the pot or pan with a lid. If this doesn’t work, pour baking soda on it or grab the fire extinguisher. Don’t try to smother the fire with a towel unless it’s soaking wet.

    If something catches fire in the oven, shut the oven off and back away. The fire should eventually die down on its own. Once it’s cooled, you can open the oven and clean things up.

    If a fire doesn’t die down within a few minutes or begins to spread, call the fire department immediately.

    Related reading: Tips to avoid burns in the kitchen

    4. Not using sunscreen or checking the temperature of bathwater

    These are two basic burn prevention methods that too many people don’t take seriously enough. A first-degree sunburn, while maybe not life-threatening, can be exceptionally painful. Use a sunscreen with an SPF of 30 or higher and reapply every two hours or after swimming or sweating.

    And while most people tend to think of checking the temperature of their child’s bath, they often forget when it comes to our elderly loved ones. Temperatures that healthy adults might be able to tolerate can be enough to cause burns on the fragile skin of the young and old.

    5. Not following instructions

    Before you throw a turkey into your new deep fryer, have you read the manufacturer’s instructions? Most appliances and electronics carry a risk of fire, especially if not used as directed. I’ve seen it all, including burns from e-cigarettes exploding .

    We often can prevent fires and burns by following a few simple tips, and we can keep burn injuries from becoming more serious by avoiding common mistakes. If you or a loved one suffers a burn injury, seek immediate treatment at a Burn Center. Even if you don’t think the burn is “that serious,” we can make sure you receive appropriate care to prevent infection, reduce scarring and lower the risk of long-term complications.

  • January 10, 2018

    By MedStar Health

    Top 5 Blog Posts of 2017

    From a solar eclipse with potential vision threats to a shift in long-standing heart health guidelines, 2017 was a remarkable year for health care. Through it all, we’ve provided breaking news and health tips on the Center View blog to keep the D.C. area informed.

    We reviewed our 137 healthcare news stories of 2017 (which were read by nearly 510,000 readers!) and selected the following as our top five healthcare news stories of the year. Best wishes for a healthy and happy 2018 from all of us at MedStar Washington Hospital Center!

    1. Tips to make colonoscopy prep more bearable

    Colonoscopy Prep liquids

    Patients often say the worst part of getting a colonoscopy is the prep before the screening. The liquid diet, the bowel-clearing fluids, the newfound relationship with the bathroom—unfortunate necessities for this lifesaving screening. Our readers submitted personal tips for making colonoscopy prep a little easier, and we compiled them in this March 2017 blog article. Learn more.

    2. Changing blood pressure targets frustrate patients – and doctors

    Doctor Measuring Patient's blood pressure

    Different health organizations have varying opinions on what constitutes high blood pressure. Then, in November 2017, new hypertension guidelines mean that nearly half of adults across the country are now considered to have high blood pressure. Dr. Allen J. Taylor discusses challenges with research and shares blood pressure management tips. Read more.

    3. Knee replacement alternative relieves pain, retains mobility

    Female medical provider examines athlete's injured knee

    If you’re facing knee replacement due to arthritis, you might feel like you’re caught between a rock and a hard place. Being active is painful, but being inactive while recovering or giving up high-impact activities like running, jumping and skiing sounds awful. Dr. Evan Argintar, an orthopaedic surgeon, discusses alternatives to knee replacement that can ease your pain and keep you active. Discover your options.

    4. Five tips to protect your eyes during the solar eclipse

    solar eclipse resize thumbnail

    The first coast-to-coast solar eclipse since 1979 crossed the skies on Aug. 21, 2017. People in the Washington, D.C., metropolitan area were treated to about 80 percent coverage of the sun that afternoon. Solar eclipse frenzy gripped the U.S., with people traveling hours to catch a glimpse. However, even a small amount of direct sunlight can damage the sensitive tissues of the eyes. We shared an article by Dr. Namratha Turlapati, an ophthalmologist, on how to enjoy the solar eclipse without damaging the eyes. Relive the solar eclipse excitement.

    5. How do colorectal cancer screenings measure up?

    Colorectal screening sign

    The gold standard for colorectal cancer screening is colonoscopy. It’s an accurate, effective test that may reduce the average person’s risk for getting colorectal cancer by 40 percent. But preparing for a colonoscopy can be a hassle, and some patients would rather have an alternative to this test. Dr. James F. FitzGerald discusses alternative colon cancer screenings and whether they’re as effective as colonoscopy. Learn more.

    Click the image to see the full-sized infographic.

    Top 2017 Blog Posts

  • January 09, 2018

    By Jack Sava, MD

    Imagine you’re walking to the bus or train when you spot a person lying on the ground, blood pooling under their leg. What do you do?

    The first instinct for many people is to freeze. Unfortunately, that response leads to avoidable deaths. Massive blood loss (hemorrhage) is the cause of death for more than 40 percent of people who die within 24 hours of sustaining a traumatic injury. Even when a person has the presence of mind to call 911, the victim could bleed to death by the time emergency responders can get them to our Level I Trauma Center. The luckier victims who make it to the hospital often are unconscious and need emergency surgery within minutes of arrival.

    While our trauma team is specially trained for these emergency situations, bystander intervention can help us save many more lives. In other words, it’s just as important for regular people in our community to learn how to stop a stranger’s blood loss as it is to learn CPR. And that’s why my team and I are actively involved in the Stop the Bleed campaign, a national movement to teach bystanders how to help people with bleeding wounds.

    LISTEN: Dr. Sava discusses how bystanders can stop blood loss in this Medical Intel podcast.

    What is the Stop the Bleed campaign?

    The Stop the Bleed campaign was started in response to mass shootings in the U.S. The general premise is that first responders, specifically police officers, should be able to stop bleeding with direct pressure, appropriate dressings and tourniquets. But we realized quickly that this doesn’t just apply to police officers and mass shootings—it applies to all our lives.

    An adult can die in less than five minutes from a bleeding wound in a critical area. Some areas, such as the neck or groin, can be very hard to control, even by expert medics. Other smaller wounds may stop on their own without much help. Stop the Bleed focuses on the broader middle ground—people who have severe bleeding and who need quick action by others within the hour after injury to save their lives.

    I’ve seen footage of crowds of people standing around a person on the ground, watching them bleed to death. They’re frozen, not sure what to do or scared to act. As a trauma surgeon, it’s torture to watch people who are well-intentioned but don’t have the training and preparation to do a couple simple things to save a life. Bleeding control, in many cases, can be easier—and more successful—than CPR.

    A person can bleed out in < 5 minutes from a bad wound. Don’t hesitate—apply pressure and call 9-1-1. bddy.me/2mO19wT via @MedStarWHC
    Click to Tweet

    What to do if you see someone bleeding

    If you find the victim by yourself, your primary objective is to put pressure on the wound, then call 9-1-1 when you can. If another person is with you, one of you should call 9-1-1 while the other person puts pressure on the victim’s wound.

    To apply pressure and stop the bleed, you first must find the actual wound. This sounds obvious, but if a person’s entire pant leg or shirt sleeve is covered in blood, the source might not be easy to identify. You might have to roll up, tear away or cut off the person’s clothing to find the wound.

    The next step is to press on the wound—hard. This may cause the person more pain, but applying hard, continuous pressure is the only thing that will stop the bleed. Protect yourself with gloves when you can. It’s OK to use a shirt or bandage when you apply pressure, but it’s not critical. In fact, using too much cloth or gauze actually can spread out the pressure, making your efforts less effective. Use your hands or kneel directly on the wound, as military medics are trained to do in the field. Don’t worry if your hands or shoes are dirty—the risk of getting germs in the wound is meaningless if the person bleeds to death.

    Additional steps may require some simple equipment. If any emergency responder arrives, or if you have access to a Stop The Bleed kit, you will be able to use hemostatic dressings, or a tourniquet. Hemostatic dressing is a type of gauze that is coated with special substances that help stop bleeding. The hemostatic dressing is placed directly on the wound and have continuous pressure applied until the bleeding stops.

    The tourniquet is an ancient tool that has recently become very popular, especially with the new, easy-t0-use designs. A tourniquet is a device that’s similar to a belt—you can place it around a wounded limb and tighten it to stop blood loss. These devices have been around for a long time, and one of the goals of Stop the Bleed is to make them readily available, just like defibrillators are available in public places for cardiac resuscitation.

    The key thing about a tourniquet is that it must be placed above the wound—upstream of the blood flow, if you will—rather than directly on the wound or below it. So, if you find a person with a bleeding wound right above their knee, you should place the tourniquet around the thigh (above the knee) and pull it tight to block blood flow to the wound and stop the bleed. A tourniquet can be left on for a few hours if necessary while awaiting medical care before the risk of permanent tissue damage from lack of blood flow would become a concern. Tourniquets can be highly effective for traumatic injuries to the legs or arms. However, if the wound is in the groin, armpit or another area of the torso, direct pressure is a more effective method to stop blood loss.

    Over the past decade, we’ve seen more emergency responders putting on tourniquets in the field, and citizens commonly use them as well. We’ve seen patients in our trauma center who suffered a workplace accident and someone applied a tourniquet. Often, these individuals arrive awake and alert when, without the tourniquet, they likely would have arrived soaked in blood and perhaps near death.

    How to get Stop the Bleed training

    The Stop the Bleed campaign team has developed course materials with simple messaging around the importance of bystander intervention, bleeding wound management and more. We use a simulation mannequin leg to teach pressure application skills during our one- to two-hour education sessions at local organizations.

    We’ve started to present Stop the Bleed sessions in middle schools, which have raised an interesting discussion nationally: What’s the appropriate age for kids to learn about bystander intervention for bleeding wounds? Across the country, middle and elementary school students learn basic first aid skills and CPR. However, many people consider bleed management to be too scary to teach to children. I disagree—I’ve been educating my kids about it from the time they were 4 or 5. If I got a minor cut on my finger while working around the house, I’d call the kids to me and show them how to stop the bleed.

    If you’re interested in a Stop the Bleed course for your family or your community organization, visit StopTheBleedTraining.org to find courses online or contact our Level I Trauma Center or a trauma center local to you. There are many certified trauma providers in our community who want to help equip you with the skills to potentially save a life one day. While bleeding wounds might be scary, safe blood loss management is vital for all of us to learn to keep each other safe.

    infographic for first aid bleeding treatment