JACKSON, Miss.—Moments after a patient arrived at his burn center, Dr. William Lineaweaver was on the clock. “They come in on a helicopter, and we settle them into an ICU bed,” he said. “We start by going through the airway, checking the cardiovascular status, ensuring the intubation tube is in the right place.”
Lineaweaver related the story of a patient burned in a house fire in the years after the Joseph M. Still Burn Center moved to Jackson’s Merit Central Health in 2013. The patient inhaled smoke; severe burns snaked up their forearms, chest and face. “They were having increasing facial swelling. The fire department arrived, ambulances too. They offered some initial bandaging, and intubated them to protect their airway,” he recalled in an interview.
The first responders then sent the person straight on to JMS Burn Center, the only dedicated burn ward for nearly 200 miles in any direction from Jackson. What came next was a flurry of assessments. “(The patient) had a chest X-ray, looking for progressive lung damage, a bronchoscopy to examine damage to the airway,” he said in a Dec. 12 interview.
Resuscitation was next to restore circulation to vital organs to protect the functions of kidneys and lungs. Lineaweaver’s team tested the patient’s blood for carbon monoxide, while an IV helped replenish fluids. Sharp cuts in the burns helped relieve the pressure of constricted skin, restoring blood flow to extremities at risk of expiration. Then a catheter: Healthy urination is a measure of safe fluid retention.
The job of Lineaweaver and his team at JMS Burn Center was to manage the delicate chaos of a body in a state of breakdown. They maintained pressure and pulse, and washed the patient’s wounds as they prepared for the long phase of repair and recovery ahead.
Less than two hours had passed from the minute of injury to the first moment of calm, as the survivor was wrapped in antibiotic dressing. “At this point,” Lineaweaver said, “the first part of treatment was now established.”
Today, to get this level of treatment, the same patient would need to be