Former Patient Trains in Burn Care at Shriners Children's Northern California

When she was a teen in Mexico, a kitchen accident left Nahomi Barragan-Carmona with burns that nearly killed her, but after treatment at Shriners Children’s Northern California, the accident put her on a trajectory to become a life-saving physician herself.

Nearly two decades after her care at Shriners Children’s Northern California, Nahomi Barragan-Carmona, M.D., recently returned to the world’s leading pediatric burn hospital to learn more about advanced skills in burn treatment from the medical team that saved her life.

Local Hospital Lacked Burn Expertise

Nineteen years ago, when Dr. Barragan-Carmona was a teenager, she was in the kitchen at home when something unexpected ignited, leaving Nahomi with burns over 70% of her body. While the details of the accident remain a blur, Nahomi remembers the shock of realizing her own injuries and witnessing her mother’s burn injuries as well.

Her father rushed her and her mother to the nearest hospital in Rosarito, where they transferred her to the main hospital in Tijuana. There doctors told her father that they could not save his daughter’s life. Luckily for her family, Nahomi’s uncle was a firefighter who connected her father to the burn center at Shriners Children’s Northern California. To get her there, her family hired an ambulance to take her to San Diego, and from there she was flown to Shriners Children’s in Sacramento.

Worldclass Burn Care at Shriners

Nahomi’s uncle understood that the burn center, now called the Neil Reitman Pediatric Burn Institute at Shriners Children’s Northern California, was one of the world's leading pediatric burn research and treatment programs. While he didn’t have all the details, he understood the center offered all aspects of burn care – from initial management, critical care and wound coverage – to rehabilitation, inpatient care and reconstruction.

When the young Dr. Barragan-Carmona arrived with her father, not only were they embraced by the team at the most advanced pediatric burn center in the West, they were met by one of the world’s most preeminent burn physicians and researchers, David Greenhalgh, M.D..

Dr. Greenhalgh, who was then Chief of Burns at Shriners Children’s Northern California and is now Chief Emeritus, told her father, “Don’t worry, she’s going to be fine, we treat burns more severe than this and we are going to take good care of her.”

The teenage Dr. Barragan-Carmona was a patient at Shriners Children’s Northern California for about three months, where she received multiple skin grafts, intense physical therapy, and custom-made pressure garments to support healing. She also worked with a child life specialist who helped her grapple with what had happened to her.

Her father kept a diary during her recovery, recording many details of what happened. What came through was the patient-centered, whole-child, multi-disciplinary approach to care that his daughter received at Shriners Children’s.

One diary entry said, “The physical scars don’t even matter if you know that your child is alive, and she is healthy and she is emotionally healthy. Here, they take care of everything.”

No Longer a Patient, but a Physician

After her experience as a Shriners Children’s patient, she wanted to be a burn surgeon, like Dr. Greenhalgh. However, there are no dedicated burn centers in Mexico and Dr. Barragan-Carmona realized that in Mexico, the emergency departments are where improvements in burn care need to be made.

ER and Burn Care

Dr. Barragan-Carmona said that in Mexico, many burn patients die in the emergency department because personnel are not well trained in the unique needs of burn patients.

For example, individuals who are severely burned lose a great deal of fluid. The body’s intense response to a burn causes the capillaries to leak, which causes fluid to flow out of the circulatory system and eventually the body. The individual’s blood pressure drops as a result, and the body does not get the oxygen it needs, which can cause the patient to go into shock.

Patients with large burns need to have their fluids replenished to prevent shock, but this is a complicated process that requires calculating the person’s weight and the size of their burn, monitoring urine output, pulse rate and swelling.

Dr. Barragan-Carmona spent a month at the Shriners Children’s Northern California burn center to gain expertise on this and other treatment protocols, which she will share upon returning to Mexico.

“I will bring this knowledge back to my hospital and try to train everyone there and maybe build our own burn center one day,” she said.

Tragedy Leads to Purpose

Despite the scars she bears, Dr. Barragan-Carmona has a positive outlook about what happened to her and why. She credits the accident with focusing her on the path to becoming a doctor, and to staying committed to achieving that goal.

Dr. Barragan-Carmona said she has been able to achieve her goal of becoming a physician because Dr. Greenhalgh, who saved her life when she first came to Shriners Children’s, has been a steady presence and mentor during her journey.

“Dr. Greenhalgh created the world’s leading burn center at Shriners Children’s Northern California,” Dr. Barragan-Carmona said. “He’s inspired me to be a leader in providing more burn care in Mexico.”