School personnel reviews CPR, bleeding rules

Posted 8/8/18

The Walker County Board of Education held CPR and other emergency medical training Tuesday for school personnel from the county school system, ending with a major presentation about wound care from a …

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School personnel reviews CPR, bleeding rules


The Walker County Board of Education held CPR and other emergency medical training Tuesday for school personnel from the county school system, ending with a major presentation about wound care from a UAB official concerned about the aftermath of school shooting events. 

Margaret Guthrie, director of health services for the county school system, and Eric Pendley, the director of operations for of Regional Paramedical Services (RPS) oversaw the three-hour event at the Curry High School Gymnasium. The session involved about 150 coaches, band directors, cheerleader sponsors, physical education teachers and nurses in the county system. 

"They come here every two years," Guthrie said, saying it started about two decades ago. "We do CPR, AED and first aide training. We had Mayfield Armstrong here from Champion Sports Medicine who talked about sports-related injuries and concussions." 

She said RPS has helped in the program "since Day 1" to coordinate everyone coming in at the same time to do the training." 

Pendley noted RPS covers nine counties as a service area but noted this is the only venue he knows of to bring everyone together at one time, adding Guthrie and her staff do a great job with it. 

"It just works out well that way. I think they get more out of it because we do a lot of hands-on at the end, and that way they actually put their hands on a mannequin and use the AED in practice with it," he said. 

Automated external defibrillators (AED) are used to shock the heart back into rhythm, with portable versions available now at schools. Guthrie said some of the county high schools have as many as seven spread out on campus. 

Guthrie and Pendley noted how this and other means of first aide can be needed not just at normal school classes but even during athletic events, such as when former Dora High School head football coach Johnny Wright collapsed a number of years ago during a football game and needed defibrillation. He noted allergic reactions also sometimes happen on the school grounds. 

"We want to be proactive in taking care of any situation that comes through our doors at the school," Guthrie said. "And they can use this at home. It's not just for school." 

"Situations are going to happen," Pendley said, "and we just want to make sure when there is an incident that teachers and coaches are trained to do the right thing, that they don't panic and they've had the proper instructions." That way the person involved can know how to control the scene and respond properly. 

"We've seen it make a difference," in that the proper first treatment can help  increase chances for survival, he said. 

Pendley noted that not only does the board require RPS ambulances to be on standby during games, but before games the medics meet with athletic trainers so everyone knows what role each person plays that night in case something happens. 

After watching a training film, participants were divided into smaller teams grouped by their schools and got on the gym floor to receive instructions from RPS medical technicians on how how to give CPR and use AEDs, as well as giving other first response to other first aide situations. 

Oakman High head football coach Mark Hastings said during a break, "I think it is a great experience for our coaches to be exposed to this in-depth, covering all the things we are responsible for. Furthermore, the demonstration, the personalized instruction is very good. It's organized. We can get the whole staff done in one day, which is important. It is something in today's time has to be done and they do a good job making sure we get it." 

Hastings said the training is a state requirement for all coaches, but that it is something they would want to do anyway to handle emergencies.

Dr. Jeffrey Kerby, the director of acute care surgery at the University of Alabama at Birmingham (UAB), spoke at the end of the morning. He is also the medical director for the county school system's AED and emergency allergy reaction program, and is the medical director for RPS. 

Pendley said Kerby has been participating in the Stop the Bleed campaign, and he's going around different schools trying to put emergency supplies in schools in case a mass shooting occurs, so teachers and coaches can start treating the injured with their bleeding. 

The ABC's of bleeding is to be alert and call E-911, find the bleeding and compress pressure to the bleeding to stop it, he said.  He urged  people giving treatment (once they make sure they themselves are safe) to at least have clean cloths, towels or gauze  to apply pressure directly on it with both hands. 

Both hands are needed in such cases, and while it is uncomfortable, continuous pressure is needed to overcome pressure from the artery. "Don't be tempted to let up and peek" until first responders arrive, he said. 

They can also use a tourniquet. "The key is to put the tourniquet above the level from where the bleeding is coming from," Kerby said, tightening it until the bleeding stops, noting it will hurt for the victim. It can be kept on for up to two hours and doesn't mean that the limb is automatically going to be amputated, despite myths to the contrary. Pain medication can also be given once medics arrive. 

It should be 2-3 inches about the bleeding wound, higher on the arm or leg. "At least get it above the knee joint or the elbow joint," he said, and not over pocket items like keys or wallets. 

Kerby displayed a kit that is placed in classrooms, which has a tourniquet, gauze, compression bandages and gloves. He said the military's preferred tourniquet is a CAT tourniquet as it is easy and fast to use.

"There have been a number of mass casualty incidents across the country. A lot of these have been put in schools," he said. "I hope you never have to use this training in school but if you do, that is why we are here, to try to stop bleeding. If you look at the casualties that happen in those shootings, a lot of the preventable deaths result from controlled compressible hemorrhage," which can involve bleeding from the legs and arms. 

"That is real simple stuff, stuff people shouldn't die from," he said. 

Someone can die within 10 minutes from such wounds, he said, requiring immediate attention many times before an EMT can arrive. He also noted pressure can also be put on other areas that you can't use a tourniquet on, such as the groin, armpits, and neck area. Chest and abdominal injuries are not compressible areas, however, as those wounds can only result in taking the patient to the hospital. 

He said the same kits and training can be used well in other emergencies, such as car accidents. 

Kerby said that his office can arrange a free 50-minute training on bleeding to help schools, businesses, industrial plants, churches and other groups to treat bleeding, with time also included for on-hands practice with a tourniquet. He said he can also arrange to help that group to get kits at cost for about $25, although some private companies will sell them for $50 each. Anyone interested to have the training can call Holly Waller at UAB Trauma at 205-975-3034. Within the county school system, one can also call Guthrie. 

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