The heart rate increases, pumping blood throughout the body. The pupils dilate, letting light into the eyes. The breath quickens, ensuring oxygen reaches muscles and organs. This is the body’s response to stress during emergency situations, flooding the system with hormones that trigger the fight-or-flight instinct.
Calm while under this immense pressure, faculty in the Department of Emergency Medicine at McGovern Medical School at UTHealth work efficiently and with precision as they care for patients who find themselves in dire situations. Guiding this effort is Bentley J. Bobrow, MD, who joined UTHealth in 2019 to lead the department.
“Our mission is to improve access to emergency care for everyone with a focus on providing lifesaving care for emergencies like heart attacks, stroke, trauma, brain injury, and severe infections,” says Bobrow. “We have an opportunity to save lives and expand care from immediate emergencies to other areas—even continuity of care, public health, and prevention.”
Bobrow’s vision is to enhance emergency medicine care through the integration of evidence-based practices and public health policies. Faculty in the department conduct innovative, lifesaving trials and research inside and outside of the hospital, including assisting with opioid overdose mitigation—not just to save lives but to provide continuous, effective, integrated programs where patients get the care they need to prevent recurrence.This research is then applied to the patient care and community outreach programs.
“One of our goals is to develop a model to help people who need help but don’t necessarily need to come to the emergency room,” says Bobrow. “We are using what is called community paramedicine to do this.”
Community paramedicine is an emerging field where emergency medical technicians and paramedics operate in expanded roles, helping to manage chronic diseases, monitoring medication compliance, determining a patient’s risk for falls, checking on high-risk patients to prevent hospital readmission, and assisting with transports to reduce 911 calls.
In 2019, Bobrow and his team built TX-CARES, expanding the Cardiac Arrest Registry to Enhance Survival network to 9-1-1 agencies, emergency medical services agencies, and hospitals statewide as the first step to measure and improve cardiac arrest care and outcomes across Texas.
“There are about 60 sudden cardiac arrests each day in Texas,” says Bobrow. “Today, 60 people will die.Yesterday, 60 people died. Until we started TX-CARES, we did not have a statewide cardiac arrest registry.This allows us to collect data, analyze the data, and implement programs and initiatives.”
In the first year, Bobrow’s team collected data for over a third of Texas residents who suffer an out-of-hospital cardiac arrest.
The registry helped the team determine that there are enormous disparities between communities based on socioeconomic and racial factors across Texas. The most basic lifesaving procedure, CPR can triple or quadruple the chance of survival. Powered by this information, faculty in the Department of Emergency Medicine can address those disparities and design programs that aren’t just for populations that already have abundant resources.
“This is a new concept—demonstrating how important emergency care is,” explains Bobrow. “We work closely with all the other specialists to make sure these patients are optimally cared for. We really are the nexus of how patients fare in the hospital, and we can do more to help prevent them from needing the hospital in the first place.”