Latest / Here to Serve - A United Regional Podcast / Trauma and Fall Team: Ben Beutel, Shari Craig, Travis Newberry, and Laura Pressler
Transcript
- United Regional: Welcome to Here to Serve, a UNITA Regional podcast. I'm your host, Ryan Graves. My favorite part of being the director of patient experience at UNITA Regional is the incredible people that I meet and work with on a daily basis. And I want you to meet them too. Join us to meet the people behind the badge and to highlight those who are here to serve. Guys, welcome to the Here to Serve podcast. We got a good one for you today. to quote Steve Harvey, we got a good one for you today, folks. I'm excited about this crew that's here. I wanna go around real quick and just get the lay of the land for anybody that's listening that doesn't know you folks. So Travis, would you mind kicking us off? Telling us who you are and what you do. Sure. My name is Travis Newbury. I am the director of rehabilitation, wound care and sports medicine at United Regional. I've had the honor to serve at United Regional for fifteen years. I've been a physical therapist by trade for twenty eight and I'm happy to be here. Now, Laura, that was all very official. Tell us why we actually bring Travis to these events. Well Travis is kind of the eye candy for our older population and he can speak their language, so that's why we bring Travis around. Because I'm old. And he has a and he has a lot of great information. He he is he is really he can work a crowd. He's pretty serious at work, but you know, he gets up there and he's like Pat Say Jack. He just turns he shines. It's I love it. Yeah, I I agree with all that. all of those things, especially the eye candy, but also that he's Travis, when I have I'll tell you right now, when I have any kind of physical ailment Travis is one of my first calls to go, hey, what do think about this? 'Cause he's he knows a lot about all sorts of things. So we're glad to have him. Tell us about you, Laura. Well, I'm Laura Pressler, I'm the trauma educator at United Regional. I do trauma education, injury prevention, in our whole nine counties, with the outreach. I've been at the hospital for twenty thirty eight years. Thirty eight years and thirty eight years, a long time, almost thirty nine, and in trauma for over twenty. So I get to I get to do a lot in all of our rural areas and and and I drag these guys with us and that's a little bit of what we're gonna talk about today. Yeah. One I had somebody visiting our organization this week from gosh, I don't remember where they were, New York, someplace like that. and they were just shocked at the tenure. Everybody they would meet is like, I've been here twenty years, twenty five, thirty. They were just blown away by the tenure. So it's such a such a blessing to have people with that many years of experience. and also, anybody that wants if you want a tour of the hospital t Laura can take you down to the basement and show you the hand prints of hers when they were where they're pouring the foundation, we put her hand prints on. I'm kidding. Sherry. Yeah. So I'm Sherry Craig. I'm the manager of Outpatient Rehab. Officially I'm a physical therapist. I have been a therapist for thirty one years and but I've been at United Regional for eight years and and I have to say that I really love it. I love the people I work with, the organization, you know, what they stand for. So Incredible. You guys have a great team. I'm I've been the beneficiary of y'all's team many times. it's and even recently I've spent a couple of months in there getting worked really hard. Yes, absolutely. But I'm not limping after I call into work you extract. Yeah, they you they listened, clearly listened. So shout out to that whole team. They were incredible. they worked they worked me really hard and made a huge difference for my my quality of life because I'm not limping around today. So we have a great team. Most of them are really shocked to know that I was born in the nineteen hundreds. So Yeah, no doubt. All right, tell us about you, sir. Ben Butel, I worked for the What you call Falls Fire Department as a firefighter paramedic and I work in our EMS division. So I work on teaching classes, teaching our new recruits and rookies before they go on the station and teaching our our current guys new protocols and things like that as they come through. Awesome. Well thank you. For all you do for our community and for being here with us today. We're gonna in a minute, we're gonna get into why you're here and how this all comes together. So just thank each and every one of you. And and let me just say at the outset of this, we could go to each one of you and talk about what you do day to day. And that could each of those could be its own multiple series episode because everybody here does so many different things. but the reason we pulled this group together is because you guys all work on something that People may not even realize is happening and may not even realize is in your necessarily in your job description, but it's something that happens outside these walls that's really cool. And that is a a tremendous amount of work going on in the community to prevent a very common, unfortunately, hugely common is false in our community. So Laura, would you tell us a little bit about w why you guys even decided to tackle that? How did that come to be? So as a trauma center, we pull lots of data and I gotta I gotta put a shout out to our trauma team because they do so much and they multiple pieces of every trauma chart they put in a registry and we're able to pull that data and that helps us figure out who's getting hurt and why they're getting hurt and even where they're getting hurt. We can see things all the way from, you know, how many falls do we have, all the way to what zip codes have the most falls. That's why we were in Burt Burnett last night because they have a significant amount of falls in Burt. So we try to drive or use our Use our data from our trauma patients that we pull to figure out what are we gonna do in the community. And falls we're just it's been outstanding for the last probably the last ten years, but in the last three years. So falls is the biggest the biggest yeah thing that brings people into the hospital for trauma. So yes, l falls are falls are leading cause of injury in the hospital. And I'll let Dumb talk about the fire department's numbers, but our numbers are in just incredible. We have so many patients that come in with falls and they're a lot of them are have some small injuries but then our level our activations are just increasing dramatically every year due to falls. And so it can be just a level two trauma that's just that that's got some injury but all the way to level one o traumas where it's it's a huge, huge cost to the patient. It's a huge cost to the family and it's a lot of trauma for the patient. So we try to do what we can to instead of ta we wanna take care if you're injured, but we'd rather Prevent the injury in the first place. What's the phrase ounce of prevention, pounds of cure. Yeah. Yeah. I mean, that's makes perfect sense. you mentioned the trauma levels. That's very counterintuitive sometimes to folks. So level one is Level one's the worst of the worst. What's the what what are all the levels? Level one, two, and three. So ones are the most significant injuries. They're usually the vital signs are altered, they have an altered level of consciousness. We may have to intubate them to breathe. level twos are the ones that are sicker. We're cautious, more cautious about them, but we're not, you know, it's not as acute right there. And then level three is those people that fall and maybe have a hip fracture that has to get admitted. And those level threes are just huge 'cause we do see a lot of people with hip fractures, shoulder fractures that aren't a trauma activation to bring out the whole team there, but it is significant injuries for these for our age group, sixty five and older. Yeah. Life altering. Life altering. Life altering. It can be life altering. Once you have one fall, your chances are greatly at trim increased to have a second fall or multiple. So anything we can do. So that's what that's the why you guys said. We looked at the data. This is the huge problem. So what where did you start? I feel it actually kind of feels overwhelming to me to go, Hey, we have three thousand. You said three thousand falls? Where did you guys even s how'd you decide where to start? The first thing we looked at was okay, who is falling? And it was seventies, seventy two was almo three years in a row was almost the highest number of the year. seventy two years old was the highest. But we have falls from the fifties all the way to the nineties. The nineties we don't have as many falls, probably because there aren't as many ninety year olds running around. but then we also we can see where did they fall? They fell in the bathrooms. Bathrooms are biggest. they fell on stairs, steps on the porch. and then Like what what is injured when they fall? So we're able to tell that. We have h head injuries that obviously are biggest, orthopedic injuries, upper extremities, lower extremities, those are some of our increased numbers of falls that we see. So what are some of the basic things that you guys are putting out to to the community that can prevent that? Like what do you so people fall, right? Humans fall down. Right. and then if you're that in that age bracket, your your chance of falling down and getting injured. goes up significantly. If I may. Please. So I guess it's a t it's a two part theory. So there's there's the thought process if we and adapt the environment, we can help prevent fall, which is perfectly fine. I think that's a very valid coin. So make the make the home environment less could less conducive to people actually triffing and falling. You can use rugs for example. Someone described to me as a rug is just a banana peel, just me. So environmental adaptation to help To help limit or mitigate the risk of falls. Okay. And that is very important. And then secondarily, it's the the physical performance of the individual. So as as people get older, usually they become more dehabilitated. They become less likely to be able to adapt to when a loss of balance occurs. So we try to focus on both things. So we try to teach basic home and safety. We also try to encourage a lifestyle that will promote better strength, better mobility. And I would I say better, better reactivation. when you have a fall. So you you your body's able to react more appropriately, more quickly. So when you lose your balance when you're younger, you ought you don't think about it, your body automatically adapts and you don't fall. as you get older, it's it's not that you don't have the strength, which sometimes you don't, it's just your body cannot respond fast enough and you lose your balance and you fall before your body even realizes it's a problem. Yeah. So by working on both aspects of it, we can help make them safer and more functional and hopefully have a better life and be happier. Because if they move better, they feel better and they don't fall down, they can be more active in the community. Yeah. So it's it's a holistic approach. You know, it's I love that. What are some of the you mentioned rugs. What are some of the other big offenders that people need to be looking out for in their houses? Electrical cords. Electrical cords. Well, some things y'all see. Auction tubing is a big one. yeah. rugs. Rugs happen a lot, cords for laps or little space eaters, pets. Pets is huge, which is very difficult, subject to breach because nobody's willing to get rid of a dog or a cat or things like that. steps, front porches, stairs, things like that. uneven as the ground shifts and things like that, uneven yards, sidewalks, anywhere. this time of year and also winter, it becomes an issue. Somebody falls outside. yeah. You know, they they may be out there an extended amount of time before somebody Finds them, sees them, so now you've got not just the fall and the trauma from the fall, but now you've got a a heat related MS or cold related injury or something like that as well. anytime we have an ice event or anything like that, you'll just be making neighborhoods without ever getting back to the station because people will go out on their porch or go to their car. And and never make it to wherever they're trying to go without going out, unfortunately. So you guys A big chunk of what you're doing, it's just going out of the community and educating, right? So tell you just had an event last night, right? And Burke. 'Cause it been and no, I think I thought it was really interesting. You pointed out we went to Burke because the data says Burke is having more falls than some of the other communities. Let's go to Burke, which I think is just so cool. So we'll get we'll get why Ben's here in a little bit, but that's kind of what I did. Just the what we did with for Wichita Falls, we did for Burke. I reached out to the fire department and said, Hey You guys go on these lift assists where you go help people get off the ground. And a lot of people, they go and they go to pick them up off the ground and they put back to bed and the families don't even know that they fell last night or the ner home health doesn't know they fail last night. We started give the with the fire department here, we started giving out flyers that says, Hey, here's some things you can do to keep your house safe and do kind of a home and then we have our phone number there that says, Hey, we'll we'll come and we'll do a walkthrough of your house and check it for safety. And so to be able to help them figure out how to become more safe. But I reached out to the fire department in Burke, their fire chief, and he was all for it. He got the mayor involved, he got the Mills on Wills people involved. And so a lot of people in their community came together and we had a health fair. Our lab came to draw metabolic panels to make sure, hey, there's probably a reason why they're falling, is because their sodium is low or things like that. So we do have metabolic panels. These guys do a fantastic job. they're there a lot of their staff came in the athletic trainers. to teach people, you know, to test people's strength and stuff, I'll let them talk about that. So Travis talked a little bit and so did Ben, but those are only affecting one person at a time. And we know some of the the things that are in common with the healthiest communities are intergenerational react interactions and also just healthy lifestyle activity built into their life. So to be able to access more people than just those one-on-one that are already having problems, we're going out into the community, drawing in those people, whether it be a church or a community group that's meeting, an agency. We're impacting groups of people at a time so that we can help prevent this on a larger scale. But as far as last night, we had a a a fairly good turnout in Burke. It was directed towards seniors and it's kind of four to seven PM So I always tell them, you know, that's the time that they're having dinner and they're about to go to bed. So we we have to be careful about when we target what generation. But yeah, they came out last night. We had a little 90 year old gentleman in his overalls and he was outstanding. You know, you look at I I saw some people in their fifties that didn't even compare to him. They had so many medical issues. He did all of our testing and just aced it. Living by himself, doing great, but he's active in his community. So it's not really just age. So the people I get older, I'm I'm I'm gonna become less active. This gentleman he he he did he skewed the bar. He was every test he did, he scored well below his age range. Yeah. Inverse that we had people who were fifty who could not even compare to him. Yep. And h his his philosophy is really simple. He's just really active. He walks every day. he he eats a good diet. We were talking about it. He he just has a very healthy lifestyle. Yeah. And and he and he and I brought it down to him, he just really enjoys what he does. Yeah. And because of that, it reflects in his ability to move around and and honestly he did better than me in some things. Yes. So I just want to hone in on that for a second. I've seen that myself. One is that I think it's tempting in all of life, but certainly in this area, as you age to just accept, Well, I'm aging, there's nothing I can do about it. But that's not necessarily true. I mean, we're all gonna age. We can't stop the aging process. However, we can slow it down dramatically. And then you can stay staying active, eating healthy. And then I think the one you I really want to hone in this for a second, you said a word I haven't heard before, but I loved it. Intergenerational interactions. So in April, we focused, we had a an activity here in Wichita Falls, and it was called Generations United. For that event, we kind of paired up seniors in high school. with their senior adult that's in their life. And we asked them both to come and they participated in all of the same activities, the blood draws, the the physical balance testing. It was nice to see them kind of compete against each other and see who could do better and who had the best blood work. But it caused that that interaction between multiple generations. And whether it's in the community, I know like Lions Club, they have Things that they host that are bringing in students. and it we have to focus on that intergenerational interaction in in our home with our families and also out in our community. Tot totally agree. There's a book I've been a couple of books I've been really into lately. One's compassionomics, the other one's called Wonder Drug. And there's that's the same authors. They're both doctors, and then the third one's about to come out and it's all about hope. But one of the themes through that whole book is Humans from a medical standpoint need other humans. It's medical. It's not. Yeah, we want to say it's social or psychological. And you can say it's those things for sure, but it is a medical need. And he makes the case from he's an intensivist who wrote this book. And he's and he as a self-proclaimed data nerd, but he said from every bit of data he can see, the number one killer is loneliness above smoking, above anything else, that he can predict how many relationships you have in your life. that affects your life expectancy. And so the the the just the encouraging people to get out and be with other people. And it's such a epidemic in our society because of many the whole host of things you could blame for it, right? But loneliness is a huge issue. So I love I hadn't even thought about that as part of this work that you're doing. That is so cool. of the intergenerational interactions. I'm gonna start using that word for it's a good word. I love it though. It's needed. It and and and both generations need it, you know. You look at other cultures, you know, multiple generations of families all live in one in one at least in a city, but sometimes in the same home. And they all have different jobs that they do, but it's all coordinated and it creates a better culture. And here in America we've we've learned to spread out and you sit you go over here in this city, you go over here in this house, but the more that we can come together. The better the interactions. Amen. could not agree more. And in I know our CEO Corey is is really looking into like blue zones and bringing some of that here. But but when you look at the blue zones, everybody expected it to be well, it's what they eat. And all their diets are not the same. And it's like, well, it's what they're exercising. And if you and they're they're all varied. Yeah. Get off the floor. Right. But thing between all of them is they have social a high level of social interaction with family and community and that is like a core theme across all these blue zones is is really interesting to me. I'm glad you brought the blue zones up because I've been preaching that for I've watched that a long time ago and I love it because I tell people if you fall, you've gotta be able to get up. Yeah. And that's that's a big thing. And and that's what the blue zone people in the in the One City, they all they slept on the floor. They ate on the floor. They were able to get up and down. They walk on an even pavement and so one of the biggest things is is they don't fall. and I and yeah, and t here in our city is the falls are just tremendous, but we have a really older population, I think, here in Wichita Falls. But when we pulled our data, I know I noticed the trend, so I reached out to the fire department. You wanna say a little bit about what y'all see? As far as the trends go on what we're seeing? Yeah, and and and the the the lift assist, why do you get called to the house? So we get called people people anything from they've slid out of their chair, maybe they have a power recliner that helps them stand up and they lost their footing with their slippers or didn't have on and they've slid down and they just strictly need help back up. Where they don't have the power to stand up to get to their walker. maybe they've been on the toilet too long and they their legs have kinda gone numb so they need help up off off of the toilet to get back back to the living room, back to bed. all kinds of various reasons that they call. When we go on a lift assist, we we assume that it's somebody just needs help up. but unfortunately it it can be anything, literally. we've been called for lift assist, you know, it's hey, you know, my my husband fell down or my wife fell down. They need help up. We go over there well they they fell down because they've coded. or they had a seizure or a stroke. So It's it's our job essentially to without MRIs, X rays, labs, to figure out what is causing the fall and do they need to go to the hospital to get it corrected? Or is it something that we can kind of coach them on, hey, you know, cord, rugs, anything that that could be causing it, and we've got to do our our due diligence on assessment, get a full set of bottles and and really figure out what what's causing it to begin with. And I can add a little bit to that if I may. Yeah, please. I'd also have seen with some linticists is that the the patient does either slide to the floor, they don't really fall, they just get on the floor for whatever reason. And because of either they panic and they they waste what energy they have, they waste it with techniques that aren't gonna work to try to pull themselves up. So by having really poor techniques and they're not able to figure out how to get off the ground because no one's there to help them, they they waste what energy they have and they get stuck because they're exhausted. Which causes other problems. If they lay there long enough, other medical issues can c contribute. Yeah. So and then to figure out they're outside or the bad environment or whatever. Yeah. Well, we we've had people that are fallen and they've they've laid for so long that they essentially will end up in rhabdo because when we they've been laying for so long when we lift them, those toxic is toxins just go systemic. but even this time of year we'll have hypothermic patients. If you think of little Mima or You know, she falls on the kitchen floor on the tile and lays on that coal tile. It it's gonna drop her yeah, drop her body temp, even though it's a hundred and five outside. So yeah. all kinds of different things. We we deal with a lot of skin tears. Mhm. And then we get into the issue of how do we get them safely off the floor. You can't just you know, smay as a bad shoulder, you can't use that. So now how are you gonna get upright? You don't just want to grab them and pull on their arm and create more skin tears or more issues or anything like that. So getting them safely off the floor up to where they need to be is another yeah, another thing as well. Well, it comes back around it to the the prevention. Like it's nothing good happens when you fall. So what do we gotta do to prevent it? A lot of those are recurrent too. And and that's where they have done such a tremendous job is our fire department. So sh you you you might share the number of f of lift assists you do because I don't think anybody would I was shocked when I realized how many lift assists y'all do in a year. We were running just shy of eighteen hundred a year just inside the city limits here at Wichita Falls. we've been able to significantly decrease it with the program that we've been doing. we've had several the cases where we've been able to get a company or a It's a service to come out and go build a ramp to help somebody get up into their into their home better where they're not having to deal with stairs or a lot of our lift assists are people are in wheelchairs but their home isn't wheelchair accessible. So we help from their vehicle inside their home or help from their home to their vehicle so they can make it to rehab or get labs or various doctor appointments and things like that. That's incredible. I w and first of all that number's outrageous. but so tell me about some of the results. You guys have been doing some the work, I know. tell me tell me about some of the results of what you guys have seen from this. So I'll just tell you a patient story, which was pretty pretty nice. We they had a lady who fell and her husband had multiple falls and was always horrified to call the call for at lift assist. And he passed away and then she had her first fall and it was over a weekend and the fire department over by s over by City View, which shout out to which is the fire department, whatever that department was, that seven. So they they contacted me on Monday and said, Hey, this lady would like a walk through. We so I called Jimmy Young, his his partner, and we went and we walked through this home and and her living conditions is just you know, it's things that can be fixed and that was what the sad part is. So she she was basically trapped in her house because she couldn't get down her stairs as a further looking around. Her t her husband had her disassemble her f her smoke detectors 'cause she was a bad cook. And she'd set off all the time. So she didn't have any smoke detectors in a in her in her home. there was a lot of things that we found. She had towels in her shower because she was afraid to f because she kept sliding. So there was a lot of things we could fix. and so we set her up with her her primary care provider at her her her ass. She asked us we helped her with her primary care provider, got her rehab ordered, Her labs were off, so they they had to fix that. Jimmy and them did a great job. We they put smoke detectors and and things in her home. But also then the we I had a community event that day at Mills on Wheels and I talked to APS, one of our A crystal at APS, and she said, Well just turn her over to us. And I was like, she's not gonna like that. And she said, We can help her. And that's the thing, is knowing what resources we have in this community, we have people that can build ramps. We have people that can put a grab bar in a bathroom, we have somebody that can make their home wheelchair accessible. So that's that's the cool thing. So we got her, you know, th these guys got her the ramp built. Texas Ramp Project came and did that. this was this was a while back and she had she had a s pretty significant illness after that and she's since passed. But you know, the cool thing was that the daughter their grand the family member wanted her to share to share that I mean that ramp was brand new, so let them know what they did with the ramp. Did you I didn't know if you knew or not. When she after she passed. After she passed, they're able to actually take it back down and and use it again with yeah, with other shrif. And be but because we went to that house and we were able to do that, that same neighborhood, there's actually three, I think, other homes who saw that happen and came out and asked, you know, what's happened? We explained it. And those three other homes now have ramps that'll help prevent future falls. So that's reaching one person, but it's also reaching that whole community. So that's what was pretty cool about it. I love I just wanna the go ahead, please. No, she she touched on resources. That that's a big part because when people hear APS, they immediately get worried or they get mad and the thing that, you know, they're not able to take care of themselves. And that's a that's a big thing we run into is people are worried, you know, hey, if I f I fell, now somebody's gonna put me in a nursing hole. Assisted living, something like that. That that's not at all what we want. If we want them to live healthy, long lives in their own home independently. So by leaving our flyers, you know, like Laura said earlier, they're they're not telling people that they're falling. Well now their their kids or their grandkids come and visit, you know, and they say, Well, what is this? You know, what happened? So now they're involved helping make it safer. They're installing grab bars and doing some of the things that we can't necessarily do. so that It's just a really great program while we're out. If somebody hears this and wants more information, w w what do they start? How do they how do they get in touch? They can just contact me at the hospital, Laura Laura Pressler, and I'm in trauma services and just call the main number there at the hospital and they they can find me, they know where I'm at. And but the big thing is we got a lot of work to do because that happened over the last two years. This year we fifty percent of our level one trauma activations were falls. So it's you know, we're making we're making progress, but we have a but we have a lot to do. So there they're the fire department's numbers went down about eighteen percent, but the things that we're seeing this the more critical people too. We're seeing a lot more of those. So we need to do more work. Yeah. What any P public service announcements, anything if you could ask the community for for something they could do, what do you guys got? and one of the things we didn't touch on today is, you know, we do go out to churches or we did a sorority alumni group and we're not focused on the blood testing at that point. We're going into that that group and looking at what level of function they have and we're giving them exercises and things that they can go home and work on so that we can reduce this this number of falls. See, that's not just exercises, we also really educate on perspective and mindset. So it's not just if you do these three exercises it'll help which it will, but we we talk about overall if you do more activity and you do some of these things at conjunction, your you're will have a better lifestyle, you'll be more independent and you'll maintain your independence, as Ben pointed out. So it's it's a it's a broad it's a broad spectrum of things we can do. So if your if your community church would like to have us come with you bingo, you can ask Blori and she'll send He would have all these fault prevention but nobody was coming. So he Let's build bingo and then it worked. But then we get the bingo. Yeah. So man, we have the bingo and we have prizes. It means something. You want to tell about the prizes. Yeah, so we focus all our prizes on things that they need. So if they have a fanny pack so that they can keep their phone on them all the time with they go outside, that's one thing that we see. They go outside, they don't have their phone, they lay there for too many too long. We talk to them about healthy eating, so we might take measuring cups or a cutting board. we take some exercise bands and kinda show them what they can do at home. So it's all about the entire lifestyle and not just one thing that prevents it. Well they play bingo. That's awesome. Is the eye candy there? Exactly. He's got the he's got the mic and he's he's he's revving up. We started with that, we'll we'll end with that. thank you guys for coming on today. We appreciate you very much. And that's a wrap. Yeah.