The Disaster Medicine Project (DMP) was approached by Jenny Anderson, president of Snohomish County Council of the Blind (SCCB), following our Stop the Bleed class at Edmonds’ Westgate Chapel, which she had attended last February. With her faithful white Labrador guide dog, Nevi, lying patiently panting on the floor by her chair, what she asked took me completely by surprise. Could we design a Stop the Bleed training for her blind membership?
My politely-guarded reaction was we should meet and discuss this further. After all, training a blind person to recognize life-threatening bleeding, then pack with gauze these severe trauma wounds and to apply a tourniquet to stem potentially fatal blood loss seemed far-fetched at best to me. Right?
Over the next months, the Stop the Bleed for the Vision-Impaired mission came to life in collaboration with City of Redmond Emergency Management and Fire Department and SCCB’s Jenny Anderson, assisted by solid leadership from the Disaster Medicine Project.
It was launched on Oct. 13, 2018 for a community never before thought capable of responding to an emergency situation and saving lives.
We began with the premise shared by a blind SCCB member. What she said would shape our entire program:
The blind are not “dis-abled”; they are “differently-abled.”
From this simple observation, we set our priorities: to integrate multiple layers of sensory perception skills, to identify capabilities other than sight to assess scene safety and life-threatening bleeding, and to promote verbal declaration of their Stop the Bleed training, while enabling bystander recruitment, task delegation and direction through leadership-skill empowerment.
Over a three-hour time frame these abilities were honed, practiced and tuned: Touch, smell, hearing/sounds, leadership, thinking/assessment, motor/hands-on, repetition, verbalization, incorporation of calling 9-1-1 dispatch action steps.
Eight stations were built, supplied and utilized for training purposes. In an oval/series configuration, each station was connected by rope with knots in it. The number of knots in the rope-guiding, station-to-station connections reflected each station number… 1 knot = station 1, 2 knots = station 2, and so on. This enabled trainees to follow the series of tables using their hands to feel their way along. The station layout reflected the sequence of skill sets they would employ at an actual mass casualty incident.
Content of these eight stations consisted of elements of each of the following:
-Leadership and scene management/organization; these capabilities will play a major role in what all/any Stop the Bleed trainees bring to any event response
-Is it safe? Site/scene safety assessment
-Call 9-1-1: language and message delivery skills trained and practiced
-Assessment for physical injuries and life-threatening bleeding, number of victims, triage, need for first-aid and bleeding control, prevention of irreversible shock. “Wet” stations including hand-pump simulation were provided for arterial bleed realism
-How to find/determine whether a trauma kit or bleeding control tools are available and who can help?
-How to direct and describe for those who are “sighted” at the scene to locate AEDs and trauma kits if available
-Identify necessary tasks and manage assignments/roles if multiple “sighted” bystanders are present
-Apply direct pressure – Gauze, or articles of clothing
-Insert packing – Gauze, hemostatic gauze, or clothing
-Apply tourniquet if necessary
Note: The “sighted” bystander may be reluctant to step in due to the gory nature of an MCI scene. The blind/visually-impaired can remain calm in the absence of visual cues that may be disturbing to the “sighted.” They won’t freak out from what they see.
When the class was finally over, everyone gathering for the class picture, I’ll never forget the look on all their faces. I don’t know what it is to be blind, but I still understood how grateful they were. On that day nothing meant more than giving them these skills. My Disaster Medicine Project team did that. On that day we celebrated their achievement. Serving this visually impaired community was truly an honor and privilege.
— By Robert J. Mitchell, M.D., FACOG
An Edmonds resident, Dr. Mitchell serves as the Managing Director of the Disaster Medicine Project, a local non-profit service organization dedicated to community disaster-resilience building. In 2016, he joined the instructor team of Boston’s Beth Israel Deaconess Medical Center Fellowship in Disaster Medicine, as Director of Community Disaster Medicine.