Burn Unit Tested by Wildfires
SAN DIEGO — Shortly after 4 in the morning on Oct. 26, the doors of the UC San Diego Regional Burn Unit swung open, and the first of the San Diego wildfire victims was rolled into the intensive care unit. Flames had seared 60% of Rudy Reyes' skin, and the scalding, ash-filled air had smothered his lungs when he was caught in a firestorm while trying to flee his home.
Within minutes, a team of nurses and doctors began flooding the 26-year-old man's veins with dozens of liters of plasma and saline in a race to replace the vital fluids he had lost and hooked his damaged lungs to a ventilator. They intentionally paralyzed his muscles with drugs, sedated him and administered huge doses of pain medication.
"Burn survivors don't usually remember the ICU at all," said Ann Malo, the head nurse that Sunday morning. "Which is good. I wouldn't want to remember. It would be horrendous -- the pain."
In the two weeks since the Cedar and Paradise fires tore through San Diego County, killing 14 people and destroying about 2,400 homes, families and communities have begun the halting process of moving on.
For more than two dozen people, the journey back has begun at this university's nationally renowned burn center. Over the next few weeks, several will walk away with only slight physical reminders of what they endured. Others, however, face a much darker future.
Even for this elite burn unit at UC San Diego Medical Center, which treats more than 400 patients a year and trains for mass casualty events, the fires tested the center's limits. Nurses and doctors described a scene that grew increasingly frenetic that Sunday as patient after patient arrived.
Having exhausted the hospital's supply of new intravenous pumps, nurses at one point were forced to sterilize used pumps. Doctors had to use rooms elsewhere in the hospital when the eight ICU beds were filled.
The phones rang constantly with hundreds of people searching frantically for relatives.
"One girl called and said, 'My grandpa is 65 and has blue eyes. Is he there?' " recalled Laura Everett, an administrative assistant at the burn center.
To avoid being overwhelmed, Dr. Daniel Lozano, the center's director, made the early, tactical decision that only the most gravely injured -- those with burns over more than 30% of their bodies and lung injuries -- would be admitted. The scores of less serious cases would be treated at other hospitals. By that first Sunday afternoon, 14 people in critical condition had arrived at the hospital -- twice the number admitted on what had been the unit's worse day.
