When Leann Krayenhagen saw the man in front of her fall from his bicycle, she knew she had to act quickly. She jumped off her own bike and shouted to a nearby father and son — panic evident on their faces — to call 911. She then knelt by the unconscious man and began pounding on his chest.
UCHealth is working to educate as many Coloradans as possible on how to stop uncontrolled bleeding in emergency situations. The skills learned in these interactive workshops are simple and could save a life. Monthly classes are available at UCHealth locations.
Find a workshop that works with your schedule by going here and searching “stop the bleed.”
The free 90-minute Stop the Bleed workshop was designed for anyone age 12 and older. Interested participants younger than 12 may attend at the discretion of a parent or guardian.
Or, bring the training to your workplace or organization by contacting Kerry Borrego, trauma outreach and education program manager for UCHealth in northern Colorado, at Kerry.firstname.lastname@example.org.
Her CPR training saved that man’s life. Six years later, the tables turned and Krayenhagen found herself alongside the roadway relying on others to decide her fate.
It was June 3, 2017, and Krayenhagen, a certified registered nurse anesthetist for 13 years with Northern Colorado Anesthesia Professionals, was going to enjoy a few days off with her husband, Scot, and friends, and travel to Steamboat Springs to celebrate her best friend’s birthday.
As a new motorcyclist, Krayenhagen rode second to last in the pack, just in front of her friend, as they took Colorado State Highway 14 up Poudre Canyon. Rounding one of the curves past the historic landmark Mishawaka, Krayenhagen went to point out a deer on the side of the road when, at the same time, a truck and trailer rounded the corner from the other direction.
“I’m not quite sure…” Krayenhagen’s said, her voice fading, “I was in his lane, and his front passenger tire and my leg collided. It somehow threw me, but the bike went under his truck. It was almost like God picked me up and laid me back down.”
Krayenhagen lay head down on the embankment, just feet from the Poudre River, on a dirt patch between two large rocks. Her leg was mangled and almost severed below the thigh. She was bleeding profusely, but she was conscious.
By her side almost immediately was Dr. Gabe Green, an emergency room physician at UCHealth in northern Colorado, who had been driving with his family behind the truck that collided with Krayenhagen. Green’s wife immediately pushed the SOS button on the emergency transponder they always travel with in the mountains, and then she and her kids headed down to the nearest emergency roadside phone to call for help.
“I saw Leann out of the corner of my eye shoot off to the right, down the embankment,” Green said. “I thought I was going to have to watch someone die.”
But when Green realized Krayenhagen’s injuries were largely isolated to the leg, which had taken the brunt of the impact. He said he was instantly relieved and thought to himself, “We can deal with this.”
A few vehicles behind Green was Ben Irvine, a certified trauma and critical care registered nurse, who was headed to work at UCHealth Medical Center of the Rockies. Green directed Krayenhagen’s friend to stabilize Krayenhagen’s head and neck — Krayenhagen’s helmet remained on — and Green immediately put pressure on her groin, above the wound. But the bleeding wasn’t stopping quickly enough, he said. By this time Irvine was there and the two looked at each other in agreement: “We need a tourniquet.”
Stop the bleed training
Uncontrolled bleeding is the number one cause of preventable death from trauma. But unlike CPR, Stop the Bleed training has not been mainstream — until recently.
The movement to train bystanders in bleeding control began after the 2012 shootings at Sandy Hook Elementary School, where many victims died because of wounds to their extremities. That training got momentum with the release of the “Hartford Consensus,” which resulted in the national Stop the Bleed awareness campaign and call to action launch in October 2015 by the U.S. Department of Homeland Security. The campaign’s intent: To cultivate grassroots efforts that encourage bystanders to become trained, equipped and empowered to help in a bleeding emergency before professional help arrives.
“It can happen anywhere at any time to anyone,” said Kerry Borrego, trauma outreach and education program manager for UCHealth in northern Colorado. “There are some injuries that are not survivable, but ones to the extremities, if you can stop the bleeding within the first five minutes, you can save lives.
“What we have been learning from these disasters, shootings and accidents is that people are dying when there could have been things done to prevent it. We are realizing there is a knowledge deficiency. People are afraid to intervene, and also they don’t know what they should do.”
UCHealth is helping lead the charge in Colorado by providing Stop the Bleed training to staff and community members. The health system has held several free training events along the Front Range, and free monthly classes are now available at UCHealth locations throughout Colorado. Register here by searching “stop the bleed.”
“Stop the Bleed training is much like CPR. When initiated immediately, the chance of survival increases,” Borrego said. “What we are teaching people is that they can intervene and save a life if they do these few things; stop the bleeding and buy those patients time to get to the hospital.”
“Immediately when I looked at her I knew the injury to her leg was life-threatening,” Irvine recalled about that day in the canyon. “The amount of blood on the ground and pooling in the wound was pretty significant.”
As medical professionals, Green and Irvine knew they needed to act quickly to stop the bleeding, and after deciding on a tourniquet, Irvine ran up to his car and grabbed the gym bags from his trunk. Inside was a compression band.
“We discussed how we would do this, and together we helped elevate what was left of the leg and wrapped the band around her leg,” Irvine said. “Dr. Green had a great idea based on how tourniquets are designed with the device to twist to make them tighter.”
A commercial tourniquet has a wide, self-adhering band that has a windlass rod that can be twisted and then locked into place to hold the tourniquet tight. A tourniquet costs about $30.
“Direct pressure is often effective in the absence of a commercial tourniquet,” Borrego said. “If direct pressure isn’t working and you need to make a tourniquet, use a wide strap, approximately two inches, like a belt.”
Using a climbing knot, Green made a loop in Irvine’s exercise resistance band and fashioned a small, strong stick to the band to allow them to twist it and make it tighter. They secured it several inches above the wound.
Thirty years ago, teaching civilians how to use a tourniquet would have been discouraged as it was believed that the technique caused more damage to a patient than it helped, Borrego said. But more recent battlefield studies have proven that if applied early and removed in a timely fashion for a repair to be performed, a tourniquet actually has a significant role in preventing death from severe blood loss from an extremity injury, according to a March 2018 press release from the American College of Surgeons.
“It’s cheap, easy and requires very little training,” Green said about a tourniquet. He now has a commercial tourniquet as part of his traveling first aid kit. “Though it’s an easy thing to learn, if you have someone that really needs a tourniquet, it’s going to look like a lot of injury so that training piece is important. In the right scenario, you have to be willing to sacrifice a limb to save someone’s life.”
What if it was you?
The memory of the day of the accident is still crystal clear for Krayenhagen.
“Scot kissed me — I think he thought it was going to be the last time,” Krayenhagen said. “I kept telling them (first responders) I was going to die.”
And she might have if not for the bystanders who knew how to stop her bleeding and the UCHealth LifeLine helicopter that happened to be minutes away because a call to a nearby emergency had been cancelled.
Krayenhagen realizes how lucky she was.
“Not everyone is going to have an ER doc and an ICU nurse on them in seconds,” she said to 150 people attending a UCHealth Stop the Bleed training at Colorado State University’s campus. “You knowing — taking the time to learn these skills — can save a life.”
Irvine sure doesn’t need convincing.
“The only thing I was thinking in that moment is that we have to do everything we can to save this lady’s life; she needs every little bit of help,” Irvine said. “And once we put that tourniquet on, you could see less bleeding in the wound and less blood being lost.”
Once Krayenhagen was taken away, Irvine headed to his ICU shift at MCR, where Krayenhagen became his patient.
“I don’t know how to describe the feeling,” he said. “I couldn’t believe that what we did for her enabled her to make it to the trauma bay, the OR and get fixed up and start making a recovery. I got to see that.
“It’s something I won’t ever forget, and when there is a chance for me to help someone, it comes to mind. We saved Leann. It’s possible.”