Gina Duwe
Sean Marquis, associate EMS medical director for Mercy Health System, shows how and why to use a tourniquet.

Mercy takes classroom casualty kits national

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Gina Duwe
September 3, 2015

JANESVILLE—Tourniquets and other medical tools used to stop bleeding are increasingly becoming part of the school supplies in classrooms across the area.

The Casualty Care Kit program started by Mercy Health System, Janesville's police and fire departments and the Janesville School District is now set to expand nationally.

The hope is the items are never needed, but Mercy emergency physicians are working with school systems across the state and speaking at national conventions to spread the word about the kits and accompanying training. A federal agency also is looking into the program as a potential federal model.

“What's taught in this setting is to get them through the first 30 to 40 minutes until help can get there,” said Dr. Christopher Wistrom, emergency medicine physician and associate EMS medical director for Mercy Health System.

More than 3,000 school personnel have been trained on simple techniques that will stop a person from bleeding to death before EMTs arrive. While an active shooter is often top of mind, the techniques also could save people injured in tornadoes, explosions or other calamities.

Each kit contains gloves, pressure dressing, gauze, a tourniquet and an instructional card.

Nearly 100 personnel at Blackhawk Technical College have been trained, and the casualty kits have been added to first aid kits across the campus. Top security administrators for the state's technical college system also have talked with Mercy and bought kits for each of the 16 colleges to start an initiative across the system, Wistrom said.

Wistrom also will talk about the program at the upcoming Iowa EMS Association conference, EMS World Expo in Las Vegas and the Trauma Center Association of America in Louisville, Kentucky.

“We're trying to kind of blanket all ends of it,” Wistrom said. “It's an interesting initiative in that it is so collaborative.”

The program relies on law enforcement, fire and EMS departments, schools and medical professionals to pull it off. It was designed that way so local people would provide the training that accompanies each kit, Wistrom said.

The Janesville School District kicked off the program during the last school year, and others in the area have followed suit, including the Beloit Turner, Clinton and Brodhead districts. Every district in Winnebago County, Illinois, except for Rockford is part of the program.

A half-dozen other local districts are interested.


Darien Elementary became the first Walworth County school to receive the kits. Staff members were trained earlier this week.

The training brings to the forefront that “these things could really happen,” and you have to be prepared, said Tina Paschke, a reading specialist at the school.

“It's always nice to be armed with knowledge to know what to do,” she said.

Being able to practice on a mannequin made it more comfortable, she said.

Stephaine Krueger teaches 4-year-old kindergarten and is an EMS volunteer in Darien. She said the training is the most practical guidance they've received for such situations.

“I think it's cool as an EMS provider that I'm not going to be the only one that they look to for assistance because they now kind of know as well,” she said.

Safety is the top priority in schools, and if students don't feel safe and secure, it's hard for them to learn, Principal Kelly Pickel said.

“I think everybody would agree that none of us went to school thinking that this is what kind of training we'd be spending our first day back to class doing,” she said. “However, we just never know, and we want our people to feel as comfortable (as they can) so our students can be the safest they can be.”


The kit grew out of a tabletop exercise emergency responders did with the FBI in early 2013. While much of the active shooter training focuses on dealing with an intruder, none of it addresses what to do when someone gets hurt, Wistrom said.

“That was our goal,” he said.

They used research from the global war on terror about what kills people, drilling down to what kills people in the first hour, then what they could do to prevent death in the first hour.

“Boiling it down to that and trying to keep cost as low as possible, we developed the contents of that kit,” he said.

Mercy is not growing the program to make a profit, and it is selling the kits and education basically at-cost as a public service, Wistrom said. The kits cost less than $20 each and come with training DVDs and web links, including a survey that school staff take before and after the training.

The feedback has been incredibly positive, Wistrom said. One woman's comments hit home for him.

“She thought about quitting teaching because she didn't sign up to work in a hazardous environment,” he said.

About 20 or so teachers say they think on a “pretty regular basis” about what they would do during a shooting and worry about how they would react, he said.

“There's a lot of fear that we have resolved just with a little basic education,” Wistrom said.

Teachers have often asked about their liability, and their actions would be covered under the Good Samaritan law, he said.

“The empowerment is huge,” Wistrom said. “I think the peace of mind that it brings is used on a daily basis. The kit may sit on the shelf until it expires in eight to 10 years. That empowerment will remain, and that's something I'm pretty proud of.”

None of the kits already in classrooms have been used, partly by design, he said. They aren't intended as a “cut and scratch kit—there's purposely no Band-Aids in the kit,” he said.

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