Mass shootings prompt Nashville school nurses to get 'Stop the Bleed' training

Anita Wadhwani | The Tennessean

Three dozen Nashville public school nurses practiced pressing gauze into gaping wounds gouged into fake limbs.

In a mass casualty situation, they were instructed, apply pressure for two minutes then ask conscious victims to apply their own pressure before moving onto the next victim.

Taking temperatures, dispensing medication and responding to endless complaints about stomach aches have long been the typical duties of school nurses.

But Wednesday's "Stop the Bleed" training added a more weighty responsibility — turning all 100 Nashville public school nurses into first responders in mass school shooting events.

CPR being replaced by 'Stop the Bleed' training in the wake of mass shootings Mass shootings prompt Nashville school nurses to get 'Stop the Bleed' training

"Given our current state of affairs with school shootings, we need to teach everyone to stop the bleed just like we taught everyone CPR and how to stop choking," said Christopher Brown, a critical care paramedic at Vanderbilt University Medical Center, who led the training.

"It's definitely a sign of the times," Brown said. "We've had all these shootings in our backyard — the Antioch church shooting, the Waffle House shooting — and we need everyone to be prepared."

In April, a mass shooting occurred at a Waffle House restaurant in Antioch, killing four people and injuring two. In September, a gunman opened fire at the Burnette Chapel Church of Christ in Antioch, killing one person and injuring seven others.

The average response time for EMS is six to eight minutes, Brown said. A person can bleed to death in less than three minutes. An immediate response by nurses on school campuses can save lives, he said, and CPR is useless on a victim who is dying from blood loss.

The Stop the Bleed campaign is a national program to train workers at schools, churches, businesses and large event venues how to administer immediate trauma aid in the event of a mass casualty event.

Four months after 26 people were killed at Sandy Hook Elementary School in Newtown, Connecticut, in 2012, the American College of Surgeons convened a summit to determine how to respond to mass shootings.

"It all started after Sandy Hook," said Melissa Smith, trauma program manager at Vanderbilt University Medical Center, which spearheads the program in Tennessee. "A lot of those kids bled out."

Many of the victims of the Sandy Hook shooting and the Pulse Nightclub shooting in 2016, which claimed the lives of 53 people, died of blood loss before emergency responders could save them.

Locally, Stop the Bleed training sessions have been held with staff at large venues including Ascend Amphitheater, Music City Center and the Schermerhorn Symphony Center.

The training has also been given to high school and college students. Last year, Hillsboro High School students were trained to be able to render aid to fellow students in the event of an active shooter. Vanderbilt University students received the same training.

Wednesday's training was the first for Metro school nurses.

The nurses practiced putting tourniquets on one another with a caution: For a tourniquet to be effective, it inflicts more pain than the wound it is intended to staunch.

"It's going to be difficult because you are all compassionate people, especially with children, which is who you might be mostly dealing with," Brown said. "But remember, even if you don't have the heart for it, you are saving a life."

Chest, neck and abdomen wounds require deep finger pressure inside the wound, but Brown cautioned the nurses that gunshots often shatter bones and can lead to sharp protuberances inside the wound.

After the Boston Marathon shooting, where many bystanders improvised tourniquets out of clothing or belts to aid the wounded, first responders found that many of the improvised tourniquets weren't adequate and had to be replaced.

All of the nurses received a kit containing a military grade tourniquet, gauze, gloves and scissors. The kits were paid for by a foundation grant, and Vanderbilt hopes to distribute 1,500 of them, focused mostly on schools and large events such as CMA Fest.

But the nurses were instructed that tourniquets may not always be the best option for young children suffering gunshot wounds.

Their "tiny limbs" make tourniquets difficult to apply, Brown said.

Nieka Fink, a nurse at the Harris-Hillman School, which provides services to student with disabilities age 3 to 21, said she had mixed feelings about the need for the training.

"Oh, my goodness, it's very serious and scary with all the school shootings," she said. "It's good to be prepared. Hopefully I will never have to use it."