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Critical care RN answers call

Nurse springs into action after teenís severe hockey injury in suburban Boston

Monday March 11, 2013
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Janielle Monbleau, RN, and Brady Barron pose at a recent Boston Bruins game.
(Photo courtesy of Janielle Monbleau)
Janielle Monbleau, RN, BSN, has worked at dozens of high school sporting events as a certified athletic trainer.

Even after going back to school for a BSN at the University of Massachusetts-Lowell, Monbleau has continued to work per diem for school sporting events in and around Boston.

"As an athletic trainer, [I see] bumps, bruises, sprains, muscle strains," said Monbleau, who also works as a critical care nurse on a progessive care/step-down unit at Lowell (Mass.) General Hospital. "Concussions, dislocations and fractures are among the different things Iíve seen."

On Jan. 14, while working at a Methuen (Mass.) High School hockey game, she encountered one of the most unusual situations of her career, a player being severely cut on the left wrist by an opponentís skate blade.

While trying to exit the ice on a line change, Methuen junior Brady Barron collided with a player from the opposing team, Gloucester.

"I didnít even think there was an injury at the time," said Monbleau, who was stationed at the door to the ice near the Methuen bench. "Scanning the ice ... there was something off about the way he was moving toward us. I noticed there was some sort of anguish and pain on his face."

Monbleau said she first looked for a facial injury or a nosebleed when she noticed Barron after the collision, then checked for "my worst fear," a skate blade injury to the neck, which has been the cause of several high-profile and life-threatening pro hockey injuries.

Monbleau flung open the door and got to Barron in seconds, she said, because the player was "luckily 5 to 10 feet away from where I was. For an unfortunate situation, it was the most optimal situation."

She noticed blood when Barronís glove moved. "Thatís when the artery started shooting blood everywhere," she said.

Monbleau immediately put pressure near the wound and was assisted by a Gloucester parent, who arrived on the ice and announced himself as an EMT.

"I said, 'Just grab pressure,í" Monbleau said. "He knew and he just reacted when I said it."

Monbleau, who quickly was joined by other EMTs, said her nursing instincts kicked in when caring for the severity of the injury and the possible rapid blood loss.

"Normally you think of an injury and you apply pressure almost to the direct wound," she said. "I work on a cardiac floor, so we have a lot of cardiac catheterization patients. Usually if the site is leaking, you always apply pressure above the wound."

In Barronís case, she and others applied pressure to various sites.

"I grabbed more proximal to his body, closer up on his arm, as well as grabbing his brachial artery in his bicep just to apply more pressure to a bigger artery that was delivering blood flow to those arteries," Monbleau said. "Being an artery [that was cut], you can lose blood much more quickly than if it was a vein."

Monbleau said she and the EMTs raised Barronís left arm above his head.

"You figure, use gravity to your advantage," she said. "It has to make the heart pump harder to get to that area and eventually helps [blood flow] slow down."

After emergency surgery to repair the cut, Barron asked a physician about the severity of the injuries. Barron was told, "If she hadnít gotten to you, you could have bled out in two minutes," Monbleau said.

While doing TV interviews in the days after the incident, Monbleau said she was able to talk with Barron and his father, Scott.

"[Brody] was very grateful," Monbleau said. "His father was extremely grateful and very emotional that first time meeting me."

Even as a college student, Monbleau was drawn to emergency situations.

"I really enjoy being in the critical care aspect," she said. "I think I work better under pressure. My father was a paramedic all my life. When I was at Springfield [Mass.] College for athletic training, I took an EMT class and passed my test. So I worked as an EMT at the same ambulance service as him.

"Iíve always had an emergent [care] background," she said.

Barry Bottino is a regional editor.


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