Nurses, med techs get burn training at UC Davis

  • Published
  • By Merrie Schilter-Lowe
  • 60th Air Mobility Wing Public Affairs

TRAVIS AIR FORCE BASE, Calif. – “Gruesome, but a good experience,” is how Airman 1st Class Taylor Boone, 60th Inpatient Squadron critical care technician, described his first time in the burn center at the University of California, Davis, Medical Center in Sacramento. 

“We don’t see burns so this was completely different to me,” said Boone.  “One patient was burned so badly, she had to have skin grafts and will probably be in (the burn ICU) for months.”

Boone’s experiences are one reason DGMC signed a training assistance agreement allowing its 35 active duty ICU nurses and 44 medical technicians, who are certified emergency medical technicians, to train at UC Davis before they deploy to a combat area. 

“It’s very traumatic for a nurse or tech to see a burn patient in the ICU for the very first time without having the opportunity to prepare for that,” Lt. Col. LoriRose Hindman, 60th MDG clinical nurse specialist in the critical care flight said.  “To have to scrub the patient for the first time when you haven’t had the opportunity to prepare for that, it’s very traumatic.”

Active-duty physicians, surgeons and ICU nurses usually go to the Center for Sustainment of Trauma and Readiness Skills for pre-deployment training in St. Louis, Missouri, or Baltimore, Maryland.  However, a recent readiness directive requires ICU nurses to get 72 hours of trauma training annually.

Burn training indirectly falls under that umbrella.

“C-STARS covers trauma and burn training, but not everyone may get to see a burn patient during their two weeks there,” Hindman said.  “That’s why we want to capitalize on burn training at UC Davis.”

Burn treatment can be a lengthy and sometimes painful process for patient and caregiver, according to Hindman.  But Air Force ICU nurses typically get burn dressing and treatment training only if they are in the Critical Care Fellowship Program at the Institute of Surgical Research at the San Antonio Military Medical Center in Texas.

SAMMC operates the only Department of Defense Burn Center Level I trauma center, which is the highest level of care trauma patients can get. 

UC Davis also is a Level I trauma center and, like SAMMC, is accredited by the American Burn Association and the American College of Surgeons as meeting requirements to provide optimal care to burn patients.

In 2018, the UC Davis burn center treated 430 inpatients, said Len Sterling, UC Davis burn ICU case manager. 

“We don’t get burns every day, but the burn center has never not had patients,” he said. “Since the advent of meth and hash oils and the crazy wildfires, the number of patients just about always exceeds the number of beds we have, which is 12.”

While U.S. service members who suffer traumatic burns are transported back to SAMMC for care, that’s not the case for nationals or coalition force members. 

“They don’t have the resources, so we become the chronicity of their care,” Col. (Dr.) Rachel Hight, 60th MDG trauma surgeon embedded full time at UC Davis said.  “This is not something you just muscle through for a day or two days, but for days.”  

Burn patients usually spend one day in the hospital for every 1% of body surface burned, Sterling said. Putting this in perspective, he said the hand grip (outstretched palm and fingers) represents about 1% of total body surface.

The National Institutes of Health reports that burns exceeding 30% of the body can be fatal. Burns kill by damaging tissue and by allowing the body to leak fluids and salts. 

 “Burns are one of those specialty areas where, unless you do this a lot, you really don’t know if it’s serious or not,” Sterling said.  “A small, deep burn on the hand can heal in a way that leaves a lot of scar tissue and the hand becomes non-functioning.” 

A 2006 research study looking at burns sustained in Iraq and Afghanistan showed that of the 274 burn patients treated, about 80% suffered burns to their hands and 77% to their faces.

But it’s not just seeing a burn patient for the first time that’s disconcerting, according to Master Sgt. Jason Carrico, 60th MDG critical care flight chief.    

“I did 10 years of aeromedical evacuations and four years at Landstul Regional Medical Center in Germany,” he said.  “I learned that I was not mentally prepared for the smell, sight or severity of the trauma I witnessed.  It was, and still is, haunting.  I know we can do a better job of prepping our Airmen.”

Burns vary in depth based on temperature and time of exposure to the burn source, so even patients with small surface damage can have deep burns that cause tremendous pain, require IV pain medications or a skin graft, Sterling said.

Burns also are one of the most misdiagnosed conditions in the civilian world in emergency rooms across the country, according to Sterling.

“This is probably why most burn patients are referred to a burn center,” he said. “We get experience with how to wrap parts of the body when you don’t know how to wrap it. I think this will be very valuable experience for your nurses and medics.”