UNLV Medicine Newsletter

Volume 19 - June 22, 2021

TRANSFORMING HEALTHCARE

Friends & Colleagues,

Over the years medical advances have dramatically improved the prospects of patients following severe burn injuries, which represent the most severe model of trauma. Today, studies show that outside the extremes of age, most patients treated in a modern burn center -- the UMC Lions Burn Care Center is one of 128 in the nation -- should be expected to survive despite the severity of their injury. It is clear that the development of designated burn centers, where well-organized, multifaceted, patient-centered teams in areas of clinical care and research are on hand, has made a profound difference. In today’s newsletter, we focus on UNLV Medicine surgeon-researcher Dr. Syed Saquib, the medical director of the UMC Lions Burn Care Center. He leads a team of dedicated medical professionals who are currently dealing with a phenomenon unique to the desert environment -- severe pavement burn injuries.

Michael Gardner, MD, MPH, MMM

President & CEO, UNLV Medicine

Vice Dean of Clinical Affairs

Kirk Kerkorian School of Medicine at UNLV

Medicine By The Numbers

Burn Injuries

Clinicians measure depth of burns in degrees.

First degree burns are the mildest type of burn. They damage only the epidermis, the first layer of skin. They usually don’t get infected or leave a scar. They usually heal within 3-5 days.

Second degree burns are also called partial thickness burns. They damage the epidermis and the dermis, the second layer of skin. The damaged skin, which can appear red with blisters, usually grows back unless it becomes infected or the injury gets deeper.

Third degree burns are also called full thickness burns. They go through the epidermis and dermis and affect deeper tissues, which may also be damaged or destroyed. The injured area, often numb to light touch, can appear charred and may be black, white, or deep red in color. Third degree burns don’t heal by themselves, so skin grafting is often necessary.

Fourth degree and deeper burns destroy the skin plus fat, muscle and sometimes bone.

Source:

https://msktc.org/burn/factsheets/

Understanding_Burn_Injury

UNLV Medicine Surgeon Plays Critical Role Treating Burn Patients

Dr. Syed Saquib was the primary surgeon on call at UMC when the events of October 1, 2017 occurred. With a growing passion for trauma/burn/critical care, he is a team player, leader, and mentor.

Syed Saquib, MD

UNLV Medicine Surgeon

It is that time of the year again. UNLV Medicine surgeon Dr. Syed Saquib, the medical director at the UMC Lions Burns Center, calls it “Pavement Burn Season.”

Summertime and the livin’ ain’t easy in Southern Nevada if you fall on sidewalks, roads or other surfaces that a scorching summer sun heats to as much as 180 degrees Fahrenheit. Thirteen percent of the burn center’s serious burn injuries come from hot pavement, says Saquib, who notes that the burn center admits more than 300 patients each year and also handles thousands of visits in the burn clinic.

Saquib has co-authored many peer-reviewed publications that have demonstrated that patients with pavement burns have an increased hospital length of stay compared to other burns of similar sizes. They also require a substantial need for surgical procedures and those that come in with signs of heatstroke have an increased in-hospital mortality.

People who are hurt -- Saquib says they are frequently the elderly -- often are unable to get off the blistering pavement because they are unconscious after collapsing from dehydration, heatstroke, or another medical condition.

Pavement burns are also caused by falls caused by intoxication -- others are burned after vehicle crashes that leave them on the pavement.

Saquib says serious pavement burn injuries are unique to the desert environment, something he had never heard before moving to Las Vegas in 2016. His studies of the phenomenon now have national media outlets stretching from CNN to the Associated Press calling him for comment.

A study he co-authored found that once temperatures hit 95 degrees Fahrenheit, there is a rise in admissions at the UMC Lions Burns Center, with the numbers surging as temperatures rise above 100 degrees. Temperatures have already hit 116 degrees this year.

Pediatric cases seen at the burn center, Saquib says, are frequently the result of children running barefoot on hot surfaces before caregivers can pick them up. As part of the burn center’s outreach program, flip-flops are given out at public swimming pools to help protect youngsters’ feet and to other vulnerable populations such as the homeless.

“We also see cases where people with diabetes who have a loss of sensation in their feet don’t feel the burn damage in their feet until it’s too late,” Saquib says.

Saquib, who grew up in California, received his MD from The Ohio State University College of Medicine. He completed a residency in general surgery from the State University of New York at Buffalo, a surgery critical care/trauma fellowship from the University of Florida-Jacksonville and a burn surgery fellowship from Johns Hopkins University.

“I was fortunate to have mentors that taught me not just about medicine and surgery but also about life and career choices. So I feel it’s my duty to pass on what I have learned to the next group of doctors including the next generation.”

Syed Saquib, UNLV Medicine Surgeon

“After evaluating my experience during my time in medical school, especially during my third-year rotations, I knew I had to pursue a surgical career,” he says. “I enjoyed being in the operating room, often with complex cases, with the potential to improve and even save lives...I especially appreciate trauma/burn/critical care -- they often involve some of the sickest of patients -- and it’s so gratifying to take critically ill patients and...be able to rescue them and often discharge them back into society as close to their baseline function as possible.”

Saquib’s interest in medicine began early. He volunteered at a hospital in high school. His father is a physician, specializing in internal medicine. He appreciated that his dad could help people. “I remember how in the ‘90s, before cell phones, we’d be out and about and his pager would go off and we’d have to find a payphone to call in about a patient. We learned to have plenty of quarters in the car to make phone calls.”

On the evening of October 1, 2017, Saquib was the primary surgeon on call at UMC after a shooter opened fire on a crowd attending the Route #91 Harvest music festival on the Strip. He killed 60 people and injured 867. It was the deadliest mass shooting committed by an individual in modern United States history.

Dr. Saquib speaking at the 2019 American Burn Association National Conference on mass casualty events.

“It was an unforgettable night,” Saquib says. “I was on call but never alone...Fortunately, the day trauma team was still in-house trying to finish patient care from their day shift. Shortly after 10 p.m, we got a notification that there was a shooting on the Strip. Ten minutes later we had almost 50 patients show up at the trauma center and then over the next eight hours, 50 more people came along with a large burn case unrelated to the event...We started calling providers in on all levels…At its peak, we ran eight operating rooms running concurrently and many teams of providers caring for patients. Providers from Nellis (Air Force Base) also came to help out. We did about 20 operations in 24 hours. It was a night where everyone banded together to meet the challenge.”

Dr. Douglas Fraser, division chief of acute care surgery and burn surgery at the Kirk Kerkorian School of Medicine at UNLV, as well as chief of trauma at UMC, met Saquib while he was a trauma fellow and recruited him to Las Vegas.

“Dr. Saquib is very focused on making sure everyone has an integral part of the patient’s experience and truly focuses on having everyone’s opinions heard and acted upon,” Fraser says. “He is the definition of a team player, more specifically a team leader.”

In 2020, Saquib and his team got the UMC Lions Burn Care Center reverified as an official burn center by the American Burn Center and the Committee on Trauma of the American College of Surgeons. “It validates that we provide excellent comprehensive care from the point of injury to discharge and beyond,” Saquib says. “It demonstrates that we are committed to a rigorous improvement process so that we can continue to do better for our patients.”

Saquib, an assistant professor of surgery in the Kirk Kerkorian School of Medicine at UNLV’s Division of Acute Care surgery, enjoys teaching medical students and residents.