EMS doctor helps raise level of care

Dr. Todd Burgbacher had a “childhood passion” to work among the fire trucks and ambulances responding to an incident.

Now, he is doing it as a physician and helping to train others who will help lead and direct those responses. And he and others at Georgia Regents University will continue to apply new knowledge that helped save lives on the battlefield.

Burgbacher recently completed an Emergency Medical Services fellowship at the University of Texas Health Science Center at San Antonio and is helping to start a program at GRU. He will also serve as assistant medical director for Gold Cross EMS and respond to calls in a special GRU vehicle.

“I always got a big kick out of seeing the big red truck with the lights on go through intersections,” said Burgbacher, who worked as an EMT in college. “I was planning on being a medical director of an EMS agency way before I even knew they had fellowships.”

The GRU Department of Emergency Medicine is also beginning an EMS fellowship of its own that will help build on the department’s international reputation, said Dr. John G. McManus, the program’s director and a professor of Emergency Medicine.

Having a physician in the field will help raise the level of care overall, Burgbacher said. Rarely did he actually perform medical care that the EMTs could not do. He was there more as a resource for them to ask questions and to help direct care.

“We are trying to bring hospital-level care to the pre-hospital arena,” Burgbacher said. It is also to learn how to handle multiple agencies in big events, and more everyday tasks like buying the right equipment, setting policies and even handling the politics of the position, he said.

“You don’t really do the fellowship to learn about medicine,” Burgbacher said. “It was more about how to deal with all of the extra stuff involved.”

The fellowship and associated credentialing just codifies what people have learned on the job and makes sure they are receiving the right training and doing things the right way, McManus said. The recent response to some big disasters has clearly been wanting, he said.

“Our federal response to certain instances was inappropriate, understaffed, under-prepared, under-resourced,” McManus said. “That’s where our training is going to come in where your job may not only be a medical piece but a logistical piece on how to interact with all of these different agencies and bring in licensed providers and provide better care.”

That better care is being informed by trauma care performed during recent conflicts and aided by some of the lessons learned there, said McManus, a retired colonel who was Chief Medical Officer of the last Combat Support Hospital in Baghdad. Early on in the Iraq War, when a patient died from what seemed like preventable causes, they would do autopsies to try and get at the root cause of the problem, he said.

“We actually performed real-time research and concentrated on things that we thought we could do better, like hemorrhage control, hypothermia prevention, etc,” he said. The result was at least a 94 percent battlefield survival rate for injured soldiers, McManus said.

“We had an equal or better survivability rate in theater as we do here,” he said. With the use of field tourniquets and other measures, there were very few deaths due to soldiers bleeding out from an extremity wound, for instance, McManus said.

“That’s almost unheard of,” he said.

Now they must turn their attention to internal injuries, which are a big cause of civilian deaths, McManus said.

“That’s the next focus,” he said.

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