Dr. Murray Buttner of Unalaska has been recognized nationally for his work in bringing emergency training to rural communities in Alaska.
Buttner, family doctor and medical co-director of Iliuliuk Family and Health Services clinic on the island, has been appointed a 2021 community star by the National Organization of State Offices of Rural Health. The award was presented to a health care provider in each state.
âIt was a nice little price because I’ve worked in rural Alaska since 1997. And that’s what I consider myself: a rural family doctor,â Buttner said. âI loved the job in Anchorage, but I didn’t feel like I was. And then when I come back here, it’s like, that’s what I like.
Buttner received the honor for his work in organizing trauma training workshops statewide. Trauma is the leading cause of death among Alaskans aged 45 and under, and overall, Alaskans die of trauma at rates 50% higher than the rest of the United States
Buttner said the first 30 minutes after a traumatic event – like an ATV accident or heart attack – is crucial in treating this patient. But most health care providers do not receive the appropriate training to respond to early emergencies.
This is where the Comprehensive Advanced Life Support – or CALS – courses come in. The courses help train physicians and responders in essential life-saving care in the most remote and austere environments.
âThis course is kind of like a paramedic training boot camp for doctors and nurses who haven’t done much in those first 30 minutes,â Buttner said. âParamedics are trained in how to care for someone in the car, at home, by the river – all that early and quick stabilization work. And when you’re in rural Alaska, you end up being that person much more than if you were an internist in New York or an obstetrician in St. Paul, Minnesota. “
Buttner found himself in the position several times at Unalaska.
The island’s IFHS clinic, located 800 air miles from Anchorage along the Aleutian Mountains, sees a higher number of trauma cases than most clinics due to its remoteness, extreme weather conditions and busy commercial fishing seasons.
Buttner, who has worked intermittently in rural Alaska since the late 1990s, completed his CALS training in Lower 48 in the fall of 2019. Two weeks later, he was the first to arrive on the scene. of a plane crash on the Unalaska runway that killed one person and injured a dozen others.
âI was literally the first person to get on the plane,â he said. âAs everyone was jumping, I was hopping on it. Myself and three or four passengers tried to help the young man who was hit by the propeller, and run to the plane to get on the plane, then trying to help him during the The next 30, 40 minutes, it was like everything was sort of automatic based on what I had learned in the course. And there’s absolutely no way I could have done all of this if I hadn’t taken the course. Maybe I would have tried to help, but it would have been more comfort and to cry out for help. “
The CALS course helps responders stay methodical and calm by teaching a step-by-step process for knowing what to do in an emergency, according to Buttner.
âYou take the exact same approach with a newborn baby who has trouble breathing or a pregnant woman who is bleeding or someone who has been in a car accident or someone who has had a stroke so you stay calm,â remember the basic steps, then keep working with the algorithm, âhe said.
Unfortunately, he said, the reality is that although some people survive, in many traumatic situations the person does not. But taking a step-by-step process helps take the guesswork out of it.
âIf you’ve been taught what you’re supposed to do, and you do what you’re supposed to do, and you do the best you can, that takes away a lot of the ‘what ifs’. “What if I had known how to do that?” What if there had been someone else in my place? ‘ Said Buttner. âI think it’s important because that kind of work can really exhaust people. And many people end up leaving the field or the community they are in because of bad experiences, where they are traumatized or feel guilty.
After the plane crash, Buttner began coordinating with other organizations statewide, including the Alaska Association of Family Physicians, the State Rural Health Bureau, and the Alaska Trauma Review Board, to bring Midwest-based training to Alaska.
In May, dozens of healthcare providers in 16 rural areas of the state completed CALS training in Anchorage, and six providers in Alaska were mentored as instructors for future courses.
Now, said Buttner, he believes they are in good shape to teach a number of courses throughout the year.
âI think over time we’ll help modify the course to be even more relevant to Alaska,â he said. âWe’re going to have moose trampling, paralyzing shellfish poisoning, ATV crashes and snowmobile crashes – things we all see here that you might not see in the Midwest. “
Buttner said all of Unalaska’s providers have taken the advanced rescue course, as have two of the island’s nurses. He said he hopes to bring the training to the sub-regional centers to continue training providers, health aides and responders statewide.