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Building safer communities

Two people apply a tourniquet to a silicone leg
Sunnybrook’s Centre for Injury Prevention and Toronto Community Housing are teaming up to save lives

On one hot summer evening in Toronto, a young person was shot while walking home in an act of gun violence.

In the precious minutes before paramedics arrived, a young woman rushed to their side. She used her shirt to pack the wound and applied as much pressure as she could. Her resourcefulness and quick thinking prevented a catastrophic loss of blood.

A life was saved and further tragedy was averted.

This story is recounted with equal parts awe and pride by Diandra Greaves, a Toronto Community Housing (TCH) staff member, who has asked we protect the identities of those involved.

Luckily, the courageous bystander instinctively knew what to do, but not everyone does. Which is why Diandra and Toronto Community Housing are working in partnership with Sunnybrook’s Centre for Injury Prevention to give more people this life-saving knowledge through an innovative training initiative.

Taking control of uncontrolled bleeding

STOP THE BLEED® is a 90-minute course developed by the American College of Surgeons that provides members of the public with the skills and tools to stop uncontrolled bleeding in an emergency situation.

As the first and largest trauma centre in Canada, Sunnybrook was a natural fit for STOP THE BLEED® and became the first hospital in Canada to offer this training in 2017. In the years since, Sunnybrook’s Centre for Injury Prevention, Canada’s first hospital-based centre of its kind, has helped to bring the training initiative to schools, Toronto Community Housing and corporate groups, such as Toronto City Hall, Metrolinx, the Toronto Blue Jays venue staff, the general public and more.

We teach people how to stop life-threatening bleeding following everyday emergencies, natural disasters and mass casualty incidents. Anyone who does this training can help save a life,” says Corey Freedman, Manager of Trauma Services at Sunnybrook and a certified STOP THE BLEED® instructor.

In her role as Violence Reduction Program Community Services Coordinator at TCH, Diandra learned about STOP THE BLEED® while visiting the Centre for Injury Prevention’s website. She immediately recognized a valuable opportunity to empower people in communities that experience gun violence.

“A lot of folks, including myself, have lost friends and family members to violence. This one-time training can equip people with the skills they need to intervene and save a life,” explains Diandra. “I knew right away that I wanted to help bring it into the community to make it accessible to as many people as possible.”

By Fall 2021, 83 TCH tenants received training in the pilot program in northwest Toronto, and by word of mouth, many more people have asked for the life-saving training. TCH and Sunnybrook are ramping up efforts to meet the demand.

Says Diandra: “It has taken off like wildfire.”

Addressing inequity in injury

The partnership with TCH and other community organizations is part of a broader strategy in Sunnybrook's Centre for Injury Prevention to address inequity in injury.

“Injury is a disease that affects populations experiencing systemic disadvantage in higher rates than expected for population size,” says Corey. “Developing targeted interventions where they are needed is critical work.”

"If you are working in the field of injury prevention, we must go forward with the lens of equity on everything we do," says Brandy Tanenbaum, a certified risk manager who works as the Injury Prevention Coordinator in Sunnybrook’s Centre for Injury Prevention.

A person applies pressure to a simulated injury
This 90-minute course is providing the general public with the skills and tools that could save a life in an emergency situation.

Data shows that injury risk is affected by the social determinants of health, such as age, sex, race, gender, education, housing and income. The Public Health Agency of Canada notes that people living in the lowest income areas are 1.4 times more likely to die from unintentional injury than the highest income area.

The Centre for Injury Prevention’s team believes that addressing the social determinants of injury is the best way to reduce the number of injuries Sunnybrook sees on a regular basis.

The team’s long-term vision for STOP THE BLEED® is ambitious, including widely accessible training and public access to a specialized kit complete with tourniquets, gloves and gauze in areas such as community centres and schools. Donor support will be essential to helping realize the team’s long-term vision.

"We hope to make STOP THE BLEED® kits as ubiquitous as first aid kits in the GTA, especially in the communities that need them most," says Corey.

Brandy says that collaborating with TCH to direct information and resources is what is needed right now to empower communities deeply affected by violence.

“We need more prevention programs like STOP THE BLEED® that go beyond patching someone up. It's important for staff to get out of the Hospital and into the community to see how people live, where they go home to, and not just to see them as patients,” says Brandy.

Fostering successful partnerships

Brandy is quick to credit Diandra for making the partnership such a success. “We’re here to guide and support, but Diandra is doing the hard work to bring groups together and advocate for primary and secondary prevention in the community,” says Brandy.

Toronto has experienced a spike in violence over the past few years and Diandra admits that her role on the front line can be emotionally draining.

Learning that a STOP THE BLEED® trainee was able to implement their new skills and save a life is a powerful reminder to Diandra of the impact a single person can have, including herself.

"Even if I can help move the needle a little bit – just a smidge – in the right direction, then I'm OK with that,” says Diandra. “I feel like I have done my job to help make things better.”