Editor’s note: This story includes graphic descriptions of a serious injury and may be disturbing to some people.
58-year-old Zeferino Garcia was working on stilts at a construction site when it happened.
“The pressure of the blood, it reached the ceiling of the apartment I was working in,” Zeferino recalls.
A vein had torn out of his lower leg, likely due to varicose veins, and caused a significant amount of bleeding. Zeferino managed to drive himself to Atrium Health Urgent Care Belmont, but to make matters worse, it was during a storm that knocked the power out moments before he arrived.
“In all my years I have never seen that type of injury,” Dana Wolfe, nurse practitioner, says. “He was on stilts working and the stilt was rubbing against his leg and it broke down the skin and ruptured the vein. I have never seen that kind of blood.”
By the light of cell phones, Wolfe and the rest of the urgent care team scrambled to “stop the bleed.”
“When they took off my boot and then there was a lot of blood,” Zeferino recalls. “I was starting to black out, my body felt numb and I felt dizzy.”
Wolfe recalls the urgency of the situation, “I removed his shoe, and the blood was just shooting across the room into the hallway.”
Fortunately, just two weeks before Zeferino’s injury, the nurses had participated in Stop the Bleed training, a collaboration by the American College of Surgeons Committee (ACS) on Trauma to take hemorrhage control education out into the community.
“Our urgent care teams are incredible at what they do,” says Scott Wilson, Atrium Health regional trauma coordinator. “But they felt that they were seeing more drop offs or drive-by patients that were severely injured and they didn't feel like they had the appropriate equipment to take care of them. It could be as dramatic as a gunshot wound or a stabbing or even a construction accident. If you recognize a life-threatening hemorrhage, you need to act now. The Stop the Bleed simple steps we teach include applying direct pressure, using a tourniquet and wound packing.”
According to the ACS, one in five traumatic deaths could be prevented with the right equipment and the right education.
“We have noticed a growing number of these patients coming from urgent cares,” Dr. Britt Christmas, trauma section chief at Atrium Health Carolinas Medical Center. “I believe the reasons are multi-faceted. The number of urgent cares within most hospital systems has grown exponentially over the last five years. Previously, these patients would have presented directly to a hospital emergency department. The name ‘urgent care’ implies to the community that these facilities are equipped to care for trauma patients, which we know isn’t the case. There are distinct differences between urgent cares, EDs and trauma centers that the general community doesn't even realize. Concurrently, we have also seen an increase in our penetrating trauma rate throughout the region since 2015. This is a national trend as well.”
Your body has about 10 pints of blood and if you are bleeding to death, you can lose all your blood within three to five minutes.
Zeferino had lost just under a pint of blood.
“I called for my nurse who went and got the tourniquets from the Stop the Bleed kit,” Wolf remembers, “and she placed one and I could still feel the pulsating, so I told her to put another one on and that really slowed it down. Without it, we would have had to use a tourniquet they use for blood draws which would not have been as effective.”
Kirstie Millsaps, a registered nurse at Atrium Health Primary Care Belmont, assisted Wolfe, and says these type of wounds are rare.
“You would think it's an easy task,” Millsaps says. “But there's obviously different tourniquets and different ways to use them. I had never applied a tourniquet like that, let alone two. We just didn't have the reason to. It probably saved his life.”
Every urgent care within Atrium Health is now equipped with Stop the Bleed kits.
“I’m very grateful and I appreciate each and every one of the nurses that helped me,” Zeferino says. “Thanks to them I can say I’m still here.”
Atrium Health has urgent care facilities in North Carolina and South Carolina. Patients can also skip the wait and reserve a spot online. Video visits are also available. If you’d like to learn more about Stop the Bleed, please reach out to Scott Wilson.
