Burns, Human Trafficking, Concussions and More Dominate Discussions at Medical Symposium

The Concho Valley Workforce Training Center, at Howard College, was the site for the 16th annual "Gus Eckhardt Trauma Symposium" in San Angelo this Saturday. Shannon Medical Center hosted the event with an approximate 200 medical personnel in attendance. Most were from the immediate area, but some had traveled from places as far as Kerrville, Alpine, Midland/Odessa, Ozona, Sweetwater, Eldorado and Irion County. 

Melissa Melton, Trauma Program Manager, and Nicole Schwertner, Trauma Registrar, greeted participants as they filed in at 7:30 a.m. and handed out required paperwork for the course.  

Melton said, "Our 7-hour continuing education course is free for those wanting to attend to receive credits. The public is allowed to attend, but, as in the past, we have a pre-registration process, limiting space to 200 people." She added that there were 192 pre-registered for the training.

Burns

Six guest speakers, who were experts in their individual fields, spoke on a variety of topics. Dr. Emmette Flynn, who specializes in General Surgery, was the moderator. He introduced the first speaker, Dr. John Griswold, F.A.C.S, who spoke on "Burns."  

As he took the podium, Dr. Griswold recognized Dr. Gus Eckhardt, saying, "I am humbled to be in his presence." Dr. Eckhardt, now 102 years old, is a well-known General Surgeon and practitioner in the Concho Valley since 1947. He has mentored countless medical personnel in the area.

"Modern burn care probably started because of the Coconut Grove fire in 1942," said Griswold. He added that the site was Boston's premier nightclub during the post-Prohibition 1930s and 1940s. It was the deadliest nightclub fire in history, killing 492 people. Griswold provided the statistics in burn treatment back then, compared to now, with the advancements in health care and wound treatment.

"Today, 72 percent of burns occur around the home and 69 percent of those tend to be men," said Griswold. "With those who sustain burns working in the oil field, 75 percent of patients will have other types of injuries such as fractures, internal bleeding, and blunt force trauma, sometimes making burn treatment more complex."

The nearest Regional Burn Center is in Lubbock Texas, where Dr. Griswold practices and is the Medical director.  

"Between the Lubbock, Dallas, Oklahoma City, and Phoenix Burn centers, approximately 2,000 to 2,500 new burn patients are treated each year," said Griswold.  

Human Trafficking

Lindsey Speed, Director of "Traffick911," gave her presentation on "Human Trafficking." She said, "There are over 600 volunteers across the state of Texas who investigate and intervene in what is often referred to as modern day slavery."  

Speed also shared part of the documentary "A Path Appears." She said, "12 to 14-year-old children are the mean targeted age for predators. Our youth are lured into situations in many ways: may it be online, at bus stops, malls, parks, and many by people they even know and trust."

Sexually transmitted diseases, pregnancy, physical and verbal abuse, and forced isolation from "safe" havens are just some of the psychological effects victims will suffer for a lifetime once rescued.  

"Unfortunately, many go unfound or even die," Speed added. Traffick911 works in conjunction with law enforcement and Homeland Security, and Speed stressed, "It is a shame such things go on in America in this day and time."  

Respiratory Mechanics and Chest Tubes

In addition to these topics, Jordan Weingarten, MD, discussed "Respiratory Mechanics and Chest Tubes." His presentation outlined the basic anatomy and function of the respiratory system, breathing complications, pulmonary lab testing, and complications arising from injury regarding the torso and nasopharyngeal area.

"A flail chest is what you get when you have three or four rib fractures, causing pain, difficulty breathing, and various other intrathoracic complications," said Weingarten. “Chest X-Ray, CT Scan, and Ultrasound are some of the procedures medical personnel use to properly diagnose many respiratory abnormalities."

Concussions

H Hunt Batjer, MD, F.A.C.S, gave an update on "concussions." Not only is he a well-respected neurosurgeon, but he also volunteers his time with the NFL, where he is co-chair of its committee on head, neck, and spine injuries. He explained that the brain floats in cerebrospinal fluid in the skull, and when trauma to the head occurs, it is basically rattled back and forth.  

Dr. Batjer said, "There are three basic injury types: the first being cognitive, which may include contusion (bruising), amnesia, disorientation, slurred speech and/or drowsiness. The second is ‘somatic.’ Symptoms may include any, or all, of the following: headache, fatigue, dizziness and visual disturbances. The affective aspect will include: emotional liability and irritability."  

Above: Dr. Gus Eckhardt (LIVE! Photo/Holiday Bailey)

​ Regarding concussions in contact sports such as football, Dr. Batjer added, "It is advisable to have more than one person watching the athletes." New rules and regulations now require the NFL to have more than 20 spotters for each game to monitor behaviors and player movement after impact, as sometimes symptoms of concussion aren't immediate. 

The Painful Truth About Spinal Immobilization

John Puryear, NREMT-P, a former rodeo performer, spoke on his expertise which was Emergency Medical Service. Because he was injured many times in his former career, and experienced the "long back board rides," Puryear’s topic was a passionate one regarding "The Painful Truth About Spinal Immobilization."  He sited the definition of "heretic" as one who does not conform to an established attitude, doctrine or principle. He then pleaded his case.  

“Long backboards" and "rigid cervical spine collars" are a “sore spot" with him. As a 33-year veteran servant in the EMS role, Puryear said, "I have found, although the rules are clearly written to use such equipment for transport, there are some situations I do not agree with. In situations when the patient has been immobilized (head, neck, arms, and back), and all of a sudden, needs to vomit or has difficulty breathing, it's difficult to turn [him or her] fast enough, risking aspiration, or oftentimes, clearing an airway."  

He added that many patients only have soft tissue injuries, not spinal or orthopedic, that do not necessitate being strapped down.  

Puryear said, "Even if the correct c-spine collar is placed, with the exact measurements according to the manufacturer’s specifications, there still is a chance for further injury, including vertebral separation." Needless to say, on occasion, he said he has done what is right for the patient instead of what is written.

Snake Bites

Last to speak was Dr. Nicholas Hurst, Clinical Instructor in Emergency Medicine at the University of Arizona.  He showed and described many photos of various snakes particularly those in the "Viperidae" family. Regarding "Envenomation" (snake bites), he said, "Do not apply a tourniquet, cut, suck on, or electrify the wound; seek medical attention immediately and call the AAPCC (poison control center) at 800-222-1222. The patient may have one or three of the following categories of clinical effects: "local"(includes pain and swelling); "hematologic" (includes bleeding/clotting issues); and, "systemic," where they experience nausea, vomiting, and diarrhea, weakness, a metallic taste, and Myokymia (quivering of muscles)." If deemed necessary, "Crofab" is the antivenom of choice nowadays, and may require multiple doses until the arrest of progression and improved laboratory test results.  

The Benefit

Overall, the symposium was an informative event for the many healthcare providers, including doctors, nurses and student nurses, EMS, respiratory therapists and medical technicians. The "Gus Eckhardt Endowment Fund" was established 16 years ago. 

"We have always held Dr. Eckhardt in high regard throughout the medical community for his service and appreciate him to this day," said Flynn.

For more information on the following, please go to Shannon Medical Center at https://www.shannonhealth.com. For more information on human trafficking, visit "rescuefreedom.org" and www.traffick.com.