I don’t see a pack in the pillar mounted box in the North Work area, the Cintas sign/date checklist for refill is 9/2/22 by AB
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@Team_Logistics – who communicates with Cintas? We used to get the packet that would stop bleeding, at least pre-pandemic. I know we’ve had a couple of folks get cut pretty badly in, oh, the last year or two. Maybe we used it and they didn’t replace? Of course, could be the usual litany nowadays – supply chain, shortages, etc., etc…
Is the Cintas item the same/best solution? This is a serious as it can get. We have several licensed medical providers as members. It might be smart to loop them into this instead of placing the burden on well meaning layman members and a Cintas sales rep. We never want to hear the phrase, if you only had of …
The “trauma kit” next to woodshop is, AFAIK, the only one (and I’m the person who inventoried the safety equipment long, long ago for the “map”). This was probably appropriate pre-expansion because all the dangerous tools were located in one place. IMO we should probably add another one on the north side, in the section formerly known as Suite 102.
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As far as I know, the Cintas bag only has hemostatic gauze. Hemostatic gauze is great until it isn’t. It’s much better than nothing but not nearly sufficient for really serious bleeds - you can lose >40% of your blood in 3-4 minutes from an arterial bleed. Your hemostatic gauze just isn’t capable of controlling that kind of situation.
At a bare minimum, I feel strongly that there should also be a tourniquet in there and everyone in the maker space should have the opportunity to learn how to use both. The woodshop is far from the only place where dangerous tools exist and I think we can all think of examples of times when people who haven’t taken woodshop basics are using dangerous tools outside the woodshop or in the vicinity of someone who is.
I’m of the opinion that this should be like CPR training - basic common knowledge with equipment readily available in an easily identified location with clear steps printed on it (like the AED).
We will contact cintas and see about getting this all updated.
What would be your recommendation for specific things we should have?
Also, do you have a recommendation for certified trainers? We could get some in for free classes for the members.
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A note, the North Flex area box does have a tourniquet in there on the top shelf.
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This kit has everything that I think we should have: Enhanced STOP THE BLEED® Stations | STOP THE BLEED® - American College of Surgeons. It looks like Cintas offers a similar product: Bleeding Control Kits and Products | Cintas.
UT Southwestern has a robust Stop the Bleed training program where they send trainers out to community organizations, companies, etc. I’d be more than happy to reach out to get details and/or make introductions
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So far I’ve only looked at the FA kit in the galley, but it had 2 different tourniquets. So this is clearly a supply issue if there aren’t any in the back FA kits.
And the advantage to us using Cintas is that they come by monthly and restock, without us having to know exactly what we need. Clearly this has gotten off track during the pandemic, but we should be able to get it back on track.
I’m sorry that I haven’t had a chance to check yet but appreciate that you did. Are the tourniquets like these?
If so, perhaps this is a training/organization/signage issue, not an equipment one.
I still like the idea of having the specifically marked and organized Cintas (or other) bleeding control kits separate and easily distinguishable from the rest of the cabinet. If you need a bandaid or ibuprofen it is fine to peruse the cabinet and pick it off the shelves, but if you need an AED or tourniquet, time is more pressing - which is why AEDs are in separately marked and easily distinguishable cabinets.
This is the Cintas product (it comes with a wall hanger) that I would love to see us have in at least the galley:
The Cintas product seems to be similar to the American College of Surgeons Stop the Bleed station:
I can only speak to what I did but it was a long time ago at this point I went to a woodworkers meetup who had a
ER doctor who talked about wounds common in a woodshop.
I met/introduced myself and asked him and others at DMS for suggestions as I wanted to create a Trauma Kit for DMS.
Fast forward I ordered the trauma bag and I believe I also had Cintas install the first aid stations all around the same year.
The trauma bag contained a couple of quickclot packets and other products designed to control heavy bleeding such as tourniquet that I got from the ER doc and other DMS members. I also had them install “locks that come on the fire extinguishers” to prevent people from rummaging the trauma bag so supplies would be there when needed.
I also had them install quick clot in the main medical cabinets in the workshop and kitchenette. We had a one issue of what I expected to be theft of the higher end equipment but it seemed to subsided. I would usually do quarterly audits right after we had Cintas come out to make sure we were being billed correctly and the “extras” I ordered continued to be resupplied.
On this topic I was also the one checking the battery of the AED and validating the trauma bag was locked. As well as check the oxygen tank.
BTW one project I never got to but was on my todo list was to get a print out of directions to the nearest ER and have the number to the ER nurse station to let them know you were coming. This would be worth doing.
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Also for some history this is not the first time I saw poor support.
LOL, Is that what the post shows as when linking or did you quote my comment.
I was in support of having first aid at DMS as were many of the people commenting. The concerns were cost and availability. In the end, DMS never has consistent man power for any project. This is why items needing restocking effectively have to be staffed by outside services like Cintas and Parks Panty(or who ever does the snacks now).
After having Cintas, I’m not sure we kept any public log of how we were doing with their service and supplies. I’ve been lucky in my time at DMS to never need any supplies from the first aid cabinet outside of a splinter puller.
That all said, I still support having a restocking cabinet in an RFID locked room at DMS. But, I would reach out to Cintas to keep that room and the first aid boxes filled like they do now. That way there are options for restocking items by trusted members between intervals.
The stop the bleed training would always be great, the catch is how to get more members trained on it and carrying the equipment needed. Possibly make it a requirement as part of Wood Shop, Metal Shop, Automotive, and other training needed for access to tools. But, without training requirement, having the equipment available is a very small step that can be made.
Good luck with the project!
Was not trying to quote you I think it just snagged you was really trying to quote how it’s not the first time Cintas has gotten lazy about checking inventory.
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I was thinking of starting with making training available and making sure we have the equipment that we will hopefully never need on hand - I’m not sure how I feel about a training requirement and am sure that conversation is a totally different can of worms.
I’m going to reach out to the trainers (one is a trauma surgeon/emergency medicine physician/EMS medical director/trainer extraordinaire and the other is a fellow medical student) today to start that ball rolling (UT Southwestern Stop the Bleed training classes are always free).
Edit: I copied [email protected] on the email.
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That is a good first step Henry,
The reason I suggest mandatory is with out that requirement, the odds of a member being on site with training when it is needed is very low if only say 50 members have the training and are proficient in their new skills. What is it less than 15% of the membership even walks through the doors of DMS in a given month. At 50 Trained people 15% is only 7.5 of them walking into DMS in a 30 day period. If each of those members spent 3 hour at the space, that is 22.5 hours of trained people able to use the tools you are purchasing for the 720 hours the DMS is open. Better than nothing 100% correct, but how much better? In this example, about 3% of the time DMS is open in a given month, someone may be there with the training if you managed to train 50 members.
If you wanted the get more people on site with training another option would be incentivize the members that spend the most time at DMS into being trained. Possibly offer a discount on membership for members that spend more than 20+ hours a month at DMS with the training?
Not trying to be a negative Nancy on this, I support getting the equipment. I also support setting up the structure to have people able to use it when it is needed.
I had a chance to take a look in the “trauma bag” outside the woodshop when I was in the shop on Wednesday. It has a lot of stuff in it, but unfortunately too much of the wrong stuff and too little of the right stuff. Here are my concerns with that bag specifically:
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The zipper on top of the kit is broken. Things are falling out just while hanging on the wall, not to mention what might happen if a person tries carrying it somewhere.
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There are no instructions on/near/in the kit. In an emergency, it is good to have a really simple set of pictorial instructions so that people can focus on doing one thing at a time rather than trying to remember what to do next.
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The minimal organization system in such a large bag necessitates digging for whatever you’re looking for, which makes hard to find if in a state of panic. A tackle-box style kit like the ones above is easier to use. Paramedics come on scene with giant bags full of all kinds of things, but we’re not looking for paramedic-level aid and don’t have paramedic-level training. We’re looking for bystander intervention until paramedics can arrive - simple is the name of the game.
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A lot of the stuff in there is just clutter in any situation in which you might need the kit. Boxes of bandaids, 4 Ace bandages, antibiotic ointment, Ibuprofen? This is all detrimental in a bleeding emergency - it makes it harder to find the things you might actually need.
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The tourniquet is poor quality. It is the style of a belt (rather than the large velcro straps included in every Stop The Bleed kit I’ve ever seen, including the ones offered currently by Cintas) and does not have a sufficient tightening mechanism. While it may be better than nothing, in a situation where I needed a tourniquet for myself or someone else, I would not trust this one.
Let’s lay two scenes that might put a finer point on it:
A scene with a victim of an injury causing massive blood loss from the right arm in the machine shop featuring our current trauma bag:
Imagine a person in a panic hurriedly running from the Woodshop/Auto first aid column towards an injured person on the ground somewhere else in the space in a rapidly expanding pool of blood. Now imagine them carrying a large bag - difficult enough. Now add on that the bag has a broken zipper so they’re trying to keep things from falling out along the way.
Our good samaritan arrives at the scene of the injury in a panic and can’t remember what they were looking for. Doubt begins to creep in - did they drop it along the way? Are they even going to be able to do any good at all? What’s the first thing they should do again? They freeze.
Our good samaritan is panicking. There’s all this stuff and it just keeps getting in the way. They dump everything out of the bag.
Our good samaritan is still trying to remember Step 1. Now they’re surrounded by heaps of medical seeming stuff. They’re becoming overwhelmed by the amount of stuff and none of it says when or why to use it on the package. “I didn’t go to school for this,” they think to themselves, “I don’t have any idea what I’m doing.” They’re getting overwhelmed - a normal physiological response to this type of stress that is nonetheless detrimental to rendering quality first aid. Doubt is increasing - similarly unproductive.
Our good samaritan has found the tourniquet in the heap. They have a surge of confidence and try to put it on the other person’s right arm, which is rapidly gushing blood. The victim is starting to look paler and seems to be having trouble breathing. The good samaritan pulls the tourniquet as tight as they can, but just can’t get it any tighter. The bleeding has slowed a bit but won’t stop. The tourniquet simply can’t be pulled any tighter. The good samaritan sits with the victim until paramedics arrive several minutes later.
The paramedics thank the good samaritan for doing what they can and quickly apply a high-quality tourniquet above the one the good samaritan put on. The bleeding slows, but the victim is very pale and taking only shallow breaths. The paramedics rush our victim off to the hospital and we hope for the best possible outcome.
Or, a scene featuring the same victim, the same good samaritan, and a bleeding control kit (from Cintas, the American College of Surgeons, or another vendor):
Imagine a person in a panic hurriedly running from the woodshop/auto first aid column towards an injured person on the ground somewhere else in the space in a rapidly expanding pool of blood. They’re carrying a plastic box about the size of a large lunch pail. It is securely closed and they just focus on getting back to the victim.
Our good samaritan arrives at the scene of the injury in a panic and can’t remember what they were looking for. Doubt begins to creep in - did they drop it along the way? Are they even going to be able to do any good at all? What’s the first thing they should do again? They freeze.
They decide to open the box. There is a clear sheet of instructions, like the ubiquitous choking poster, on the inside of the lid. It says to put on gloves and cut off the victim’s clothes around the wound.
Our good samaritan looks at the box, dons the gloves that are right on top and grabs the trauma shears. They cut along the now blood-soaked sleeve to reveal a large, gushing wound. Our good samaritan takes a deep breath, suppresses their oncoming feeling of nausea and looks back to the instructions.
“Step 2: apply pressure with gauze,” our good samaritan reads aloud to themselves. They grab the large package of clearly marked gauze, tear it open, and press down on the wound. The bleeding won’t stop. They panic but look back at the instructions. “If the bleeding does not slow, apply a tourniquet as follows,” they read aloud, relieved to have such clear instructions with pictures.
Our good samaritan quickly identifies the bright orange tourniquet. They follow the printed steps as well as they can, slipping the tourniquet over the victim’s arm before fastening it with the velcro as tightly as they can. They begin turning the rod to tighten it more. It gets harder to tighten but they keep going, as the instructions say, until finally, the bleeding slows to a trickle before stopping completely. Our good samaritan isn’t exactly sure what to do now that the bleeding has stopped - the instructions have ended - so they sit with the victim until paramedics arrive several minutes later.
The paramedics thank the good samaritan for doing such a good job controlling the bleeding and rush the victim off to the hospital. Our victim makes a complete recovery, left only with the scar on their arm from their nasty accident. After several weeks to months they return to DMS, where they teach classes on Stop the Bleed and the proper use of a vice for securing the work down to the mill. It really does pay to double-check that the material is secure, even if you’re absolutely certain that you tightened the vice all the way…
Both scenes are obviously dramatized for effect. Everyone on this chat and at DMS is obviously acting to the best of their knowledge and ability to keep everyone safe, I just think that it is worth thinking through some possible outcomes. The current trauma bag is almost certainly there as a result of someone looking out for everyone’s safety, thinking that see might need more trauma-type equipment, and making it happen, and it is certainly better than not having the current trauma bag at all. In fact, I’m glad that it is there today. I just think that we can do better. There are lots of ways to resolve what I think are a few issues with it, I’m just proposing one.
While we’re still working on the equipment side, I just heard back from Dr. Miller about Stop the Bleed training. She’s on board and we will have a call next week to begin planning.
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@Robert_Davidson … Those were very important things to do, IMO. Thank you for doing those.
I did something like that. It’s laminated and posted (or at least it was) in the galley next to the first aid kit. The “Call back number” should probably be updated since we no longer have a telephone in the Space.
If someone wants to update this I’m glad to provide the original.
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Just to clarify, I’m very thankful for all that @Robert_Davidson did - they were all the right steps. The tourniquet I found is probably not the one that he got - it is in a box from Cintas.
I wanted to just make sure that I don’t sound like I think anyone is (or has) done anything even approaching worthy of blame - I just see a possible way of building on/improving the status quo and am thankful for all those who worked hard to get us to where we are.
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