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USAISR program training local first responders on advanced burn care

By David DeKunder | 502nd Air Base Wing Public Affairs | Nov. 29, 2019

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —

Paramedics and emergency medical technicians with the San Antonio Fire Department are being trained on the basics of advanced burn care through a new program and partnership with the U.S. Army Institute of Surgical Research at Joint Base San Antonio-Fort Sam Houston.

The program, Burn Strong, started in January and since its inception has trained and instructed over 800 paramedics and EMTs on advanced burn and trauma life support care. By the end of the year, approximately 1,000 first responders are expected to have gone through the Burn Strong program.

Coming up with the idea for Burn Strong is Brent Sabatino, USAISR Burn Center burn intensive care unit nurse, after he attended the American Burn Association conference in 2018. While at the conference, Sabatino said he learned that several burn centers worked with and had partnerships with first responders and firefighters in the cities they are located in.

When he returned from the conference, Sabatino said he felt USAISR – the sole facility within the Department of Defense caring for combat burn casualties, beneficiaries with burn injuries and civilian burn patients – needed to establish more of a community presence on the awareness, training and education of burn care by reaching out to first responders with the San Antonio Fire Department.

“I just thought it would be something beneficial to the city of San Antonio,” Sabatino said. “We’ve never really partnered with them before. Hopefully, it will improve patient outcomes with proper education of burn care.”

First, Sabatino presented his idea for starting a program focusing on awareness, training and basics of advanced burn care to USAISR leadership. Once USAISR leaders gave their support for the idea, Sabatino then talked to Dr. David Miramontes, San Antonio Fire Department medical director, who also backed the idea of having the department’s paramedics and EMTs instructed and trained on advanced burn care.

Sabatino said Burn Strong consists of three components: a two hour training and instruction presentation for paramedics and EMTs with the San Antonio Fire Department focusing on advanced and pre-hospital burn care; getting USAISR clinical staff the opportunity to take an Advanced Burn Life Support course in which they can attain certification; and a support group for burn patients at the USAISR Burn Center that started in the spring.

He is the instructor for both the training course for the EMTs and paramedics and the Advanced Burn Life Support course for USAISR clinical staff.

Sabatino conducts the two-hour training course/presentation for first responders with the San Antonio Fire Department once a week at the fire department’s training center. He said the class is part of a weeklong series of training and education classes the paramedics and EMTs must take each year to earn continuing education hours and credits.

He said the training and education provided to the first responders corresponds with the expectations set forth by Miramontes and approval by USAISR leadership. Sabatino said the presentation for the paramedics and EMTs includes the different types of burns they may see or have to treat, different reactions patients will have to burn injuries, the affects a burn injury will have on a patient and proper techniques for pre-hospital wound care.

Sabatino said other things that are covered in his presentation include how to estimate the total burn surface area on a patient, fluid resuscitation of a burn patient and what affects comorbidities, chronic diseases such as diabetes, high blood pressure and vascular disease, have on patients with a burn injury.

“It is a breakdown of burn care and things they haven’t seen or dealt with before, common and uncommon burn injuries and how to treat them,” Sabatino said. “Just getting that knowledge out there to them of things they may have not known on how to treat and handle burns before they come to us could prevent that patient from extending their length of stay or possibly saving their life or limbs.”

Sabatino said through Burn Strong 15 physicians and fellows from the City of San Antonio Office of Medical Director were able to take an Advanced Burn Life Support course at USAISR and obtain certification in advanced burn care. He said four of the people who took the course have become Advanced Burn Life Support instructors.

In exchange, the San Antonio Fire Department has allowed USAISR clinical staff members, on their own time, to do a ride-along in an ambulance. This has provided USAISR clinical staff an opportunity to observe what EMTs and paramedics do during an eight hour shift. Before going on the ride-along, USAISR clinical staff members must have taken the Advanced Burn Life Support certification course.

Miramontes said the Burn Strong program fulfilled a need within the San Antonio Fire Department of providing up to date advanced burn care education for paramedics and EMTs. With the knowledge the first responders gain from the two hour course, Miramontes said it will enhance their skills in treating burn injuries.

“It will provide more aggressive treatment in the field and will facilitate transport to the (USAISR) burn center,” Miramontes said.

In addition, Miramontes said the Burn Strong course educates first responders on the dangers and health hazards of smoke inhalation and the need for them to wear personal protective equipment. The course also informs paramedics and EMTs on the resources available to them at the USAISR Burn Center should they be exposed to smoke or have a burn injury.

“They’re more comfortable realizing that there are these advanced resources available to them at the burn center should they get a burn injury or be exposed to smoke,” Miramontes said.

Sabatino said he hopes the scope of the Burn Strong program can be extended beyond San Antonio and Bexar County to include a 22-county trauma service area of South Texas covered by the USAISR Burn Center.

“Our intention is to participate more in the community at health fairs, partnering with the (San Antonio) fire department at their functions, partnering with school districts and just expand our program to help USAISR be known of who we are and what we do,” he said.