About

Taylor Wilson Burkholder is an associate professor of clinical emergency medicine at the USC Department of Emergency Medicine and serves as the Director of Academic Programs at the USC Institute on Inequalities in Global Health. His training includes emergency medicine at the Denver Health Residency in Emergency Medicine and a fellowship in global emergency medicine at the University of Colorado. Dr. Burkholder is a volunteer consultant for the World Health Organization’s Emergency, Trauma and Acute Care programme, focusing on health service innovation implementation and the governance of emergency care systems in low and middle-income countries. His academic interests encompass rights-based approaches to emergency care, the use of ultrasound in low-resource settings, emerging infectious diseases, and medical education.

Research topics

• Medicine
• Medical emergency
• Computer Security
• Intensive care medicine
• Psychology
• Surgery
• Finance
• Risk analysis (engineering)
• Nursing
• Business
• Emergency medicine
• Psychiatry
• Family medicine
• Economic growth

Selected publications

• Optimizing Trauma Team Activation: A Mixed-Method Analysis of De-escalation, Re-consultation, and Clinician Decision-Making at a Level I Trauma Center

  The American Surgeon · 2026-03-28

  article

  BackgroundTrauma team activation (TTA) optimizes trauma care but is resource-intensive. Secondary triage in-hospital with trauma team release (rTTA) improves resource allocation but may result in under-triage and adverse outcomes. This study aimed to assess the impact of rTTA on clinical outcomes, identify predictors of rTTA and re-consultations, and understand decision-making perspectives of trauma surgeons (TS) and emergency physicians (EPs).MethodsRetrospective analysis of TTA patients from 2023 to 2024, categorizing patients as TTA without release, rTTA without re-consultation, or Rcon (rTTA requiring subsequent re-consultation). Univariate and multivariate analyses evaluated differences in clinical characteristics and predictors of Rcon. A survey on TS and EPs was administered, and responses were analyzed via descriptive statistics and thematic analysis where applicable.ResultsAmong 2091 TTA cases, 617 (29.5%) were released, with 132 patients (21.4%) requiring re-consultation. Re-consultation was most triggered by new imaging findings. Only 3 (2.3%) Rcon patients required hemorrhage control interventions. Mortality was lower among Rcon patients (3.8%) vs rTTA without re-consultation (4.5%) and TTA without release patients (10.9%). Traffic collisions, psychiatric history, and age ≥70 years were independent predictors for re-consultation (ORs = 7.05, 3.77, and 1.89, respectively). Both TS and EPs identified the same leading factors influencing rTTA, but selection frequencies differed. Qualitative thematic analysis identified key themes driving rTTA decisions, including ED evaluation findings, prehospital-emergency department discordance, and limitations of TTA criteria in special populations.DiscussionRcon occurred in one-fifth of rTTA patients, but the low mortality suggests this secondary triage may be safe in selected patients, although variability in decision-making warrants further evaluation.

  PublisherDOI

• Effects of a pilot simulation training on interdisciplinary closed-loop communication and time to critical actions at an emergency centre in Burundi

  African Journal of Emergency Medicine · 2025-08-28 · 2 citations

  articleOpen access

  Emergency medicine simulation is an effective training modality in both high and low resource settings. We describe the authors’ experiences conducting a four-week interdisciplinary, in situ , simulation training series at an emergency centre in Burundi. Training emphasized effective closed loop communication, early airway, breathing, and circulation assessment, as well as time to vital signs, IV placement, and oxygen administration when appropriate. Six doctor-nursing teams participated in four training sessions as well as pre- and post-test simulation cases which were graded by an independent evaluator. The training resulted in a statistically significant improvement in closed loop communication as well as notable narrowing in standard deviation of times to critical actions after the training intervention. Although the small sample size and large variation of data limited their statistical significance, these results may indicate a short-term benefit towards early assessment, management and team communication when simulating management of critical patients. Additionally, we found that interdisciplinary, in situ simulation was a safe and likely beneficial option for training and team building in a resource-limited emergency centre. While this pilot study establishes feasibility of low-cost, interdisciplinary emergency simulation training in resource-limited settings, further research is needed to establish educational effectiveness on quality-of-care measures and its generalizability to other contexts prior to implementing similar trainings.

  PublisherDOI

• Implementation of a Package of Emergency Care Interventions and Clinical Outcomes

  JAMA Network Open · 2025-10-27

  articleOpen access

  Importance: Investments in emergency care systems are vital to ensuring universal health coverage and improving health outcomes in low- and middle-income countries. Objective: To assess whether a package of emergency care interventions is associated with improved patient mortality and clinical care quality. Design, Setting, and Participants: This pre-post quality improvement study was conducted at a single urban referral hospital emergency unit (EU) in Monrovia, Liberia, to assess clinical and educational outcomes resulting from the implementation of a package of interventions from January 1, 2018, through June 30, 2019. Final analysis was performed in November 2023. Data from a random subset of adult patient encounters were collected retrospectively for the 12 months and compared with all adult patient presentations to the EU during the 6-month program implementation. Interventions: Triage, standardized documentations, and clinical teaching via a formal curriculum and bedside clinical mentorship. Main Outcomes and Measures: The primary outcome was all-cause mortality within 24 hours. Secondary outcomes included mortality at 48 hours, in-EU mortality, and EU quality process indicators. Multivariable logistic regression models were constructed to compare the association between program implementation and all-cause mortality. Results: A total of 344 preimplementation patients were compared with 1073 patients enrolled during the program with largely similar baseline characteristics between the 2 groups (mean [SD] age, 41.4 [16.4] vs 40.1 [17.3] years: 178 [51.7%] male and 164 [47.7%] female vs 601 [56.0%] male and 472 [44.0%] female; and 163 [47.3%] vs 510 [47.5%] near a hospital). All-cause mortality at 24 and 48 hours was significantly different between the preimplementation and implementation periods (27 [8.3%] vs 40 [3.9%], P < .001, and 34 [10.4%] vs 52 [5.0%], P < .001, respectively). In-EU mortality was significantly different between the 2 groups (13.5% [44 of 327] vs 7.1% [73 of 1031], P < .001). In multivariable regression, the adjusted odds of death at both 24 and 48 hours among patients in the intervention period was half that of the preintervention period. Conclusions and Relevance: This quality improvement study provides evidence that a set of interventions is associated with improved emergency care quality and reduced mortality. The high rates of EU-based mortality suggest the critical need to include EC in all facility-based quality improvement efforts.

  PublisherDOI

• Building a framework to decolonize global emergency medicine

  AEM Education and Training · 2024-05-16 · 5 citations

  articleOpen access

  Background: Global emergency medicine (GEM) is situated at the intersection of global health and emergency medicine (EM), which is built upon a history of colonial systems and institutions that continue to reinforce inequities between high-income countries (HICs) and low- and middle-income countries (LMICs) today. These power imbalances yield disparities in GEM practice, research, and education. Approach: The Global Emergency Medicine Academy (GEMA) of the Society for Academic Emergency Medicine formed the Decolonizing GEM Working Group in 2020, which now includes over 100 worldwide members. The mission is to address colonial legacies in GEM and catalyze sustainable changes and recommendations toward decolonization at individual and institutional levels. To develop recommendations to decolonize GEM, the group conducted a nonsystematic review of existing literature on decolonizing global health, followed by in-depth discussions between academics from LMICs and HICs to explore implications and challenges specific to GEM. We then synthesized actionable solutions to provide recommendations on decolonizing GEM. Results: Despite the rapidly expanding body of literature on decolonizing global health, there is little guidance specific to the relatively new field of GEM. By applying decolonizing principles to GEM, we suggest key priorities for improving equity in academic GEM: (1) reframing partnerships to place LMIC academics in positions of expertise and power, (2) redirecting research funding toward LMIC-driven projects and investigators, (3) creating more equitable practices in establishing authorship, and (4) upholding principles of decolonization in the education of EM trainees from LMICs and HICs. Conclusions: Understanding the colonial roots of GEM will allow us to look more critically at current health disparities and identify inequitable institutionalized practices within our profession that continue to uphold these misguided concepts. A decolonized future of GEM depends on our recognition and rectification of colonial-era practices that shape structural determinants of health care delivery and scientific advancement.

  PublisherOA PDFDOI

• Symptoms: Anxiety, Dyspnea, and Cyanosis

  Emergency Medicine News · 2024-03-01

  article1st authorCorresponding
  PublisherDOI

• 81 A rapid-cycle application of the Consolidated Framework for Implementation Research allows timely identification of barriers and facilitators to implementing the World Health Organization’s Emergency Care Toolkit in Zambia

  Journal of Clinical and Translational Science · 2024-04-01

  articleOpen access1st authorCorresponding

  OBJECTIVES/GOALS: Implementation science evaluations are often too time-intensive to provide actionable feedback during implementation, suggesting the need for more agile methods. We present an evaluation of the World Health Organization’s Emergency Care Toolkit implementation in Zambia using rapid qualitative methods to provide timely feedback. METHODS/STUDY POPULATION: We evaluated the implementation of the Emergency Care Toolkit in eight general and referral hospitals in Zambia in 2023 using a rapid-cycle, qualitative template analysis approach grounded in the Consolidated Framework for Implementation Research (CFIR). We gathered qualitative data from operational field notes, focus groups, and key informant interviews of administrators, clinicians, nurses, and support staff in all eight hospitals in Zambia. We parsimoniously applied CFIR constructs and tool-specific codes, focused on barriers and facilitators, to allow for rapid but comprehensive cross-case analysis. The results were used to generate a matrix of stakeholder-relevant, plain-language barriers and facilitators for each tool. RESULTS/ANTICIPATED RESULTS: We completed eight site visits with focus groups and interviews following initial implementation in September 2023 to gather firsthand knowledge related to implementation of the Toolkit. The CFIR-focused coding accelerated analysis by centering on barriers and facilitators for each tool while maintaining a comprehensive evaluation framework. Summary tables of barriers and facilitators were easily interpreted by lay stakeholders. Visualization in tables allowed for identification of common themes across tools and hospitals, making comprehensive recommendations to the implementation and dissemination process quickly possible. We anticipate the study findings will empower implementing partners to make timely, actionable improvements. DISCUSSION/SIGNIFICANCE: Rapid-cycle qualitative implementation evaluations allow for rigorous yet timely feedback on the implementation process compared to traditional methods. This efficient strategy is particularly important in resource-constrained environments where inefficient implementation wastes limited resources and create delays that cost lives.

  PublisherOA PDFDOI

• Symptoms: Persistent Fevers, Malaise, and Rash

  Emergency Medicine News · 2024-09-25

  article1st authorCorresponding
  PublisherDOI

• Governance and legal considerations supporting prehospital emergency care in low and middle-income countries—For the Special Series on Prehospital Care in LMICs

  Surgery · 2024-06-15 · 5 citations

  review1st authorCorresponding
  PublisherDOI

• Infectious Disease

  Emergency Medicine News · 2023-03-01

  articleSenior author

  Figure: tooth pain, swollen jaw, symptoms, edema, CT, Ludwig angina, submandibular abscess, laryngoscopyFigureFigureA 39-year-old man with no chronic medical problems presented with three days of tooth pain and swelling to his right jaw with associated chills. He reported no recent facial or dental trauma, and he had no difficulty breathing, speaking, or swallowing but said the pain had prevented him from eating that day. The patient was afebrile with normal vital signs. He had moderate right submandibular tenderness, edema, and erythema with a carious and tender tooth #31. He also had moderate edema to the sublingual space. He was speaking in full sentences with no changes in phonation. He had no trismus, drooling, or stridor at presentation, but the submandibular and sublingual swelling progressed over three hours in the ED while awaiting consultation by oral and maxillofacial surgery and a contrast CT of the neck. He subsequently developed a muffled voice and severe trismus, and his tongue was elevated. Labs were notable for a white blood cell count of 32,500 cells per cubic millimeter. The patient's CT revealed phlegmonous changes of the sublingual space with a large submandibular abscess. How would you manage this patient in the ED? Find a case discussion on the next page. Diagnosis: Ludwig Angina Complicated by Submandibular Abscess Ludwig angina is a life-threatening cellulitis involving the submandibular space and the floor of the mouth that can rapidly lead to airway obstruction. It is most often caused by disease of the lower molars, although less common causes include peritonsillar abscess, mandibular fracture, sialadenitis, and tongue piercing. The infection is classically polymicrobial, and causative organisms include oral anaerobes, Streptococcus, Escherichia coli, Enterococcus, and even methicillin-resistant Staphylococcus aureus and Klebsiella in immunocompromised patients. (Am J Emerg Med. 2021;41:1; https://bit.ly/3WppSp4.) Ludwig angina can progress to abscess or spread to adjacent structures including the parapharyngeal and retropharyngeal spaces and the mediastinum. Left untreated, it has a mortality approaching 50 percent, although a recent study reported that modern antibiotics, airway techniques, and surgical management have reduced fatalities to less than one percent. (Laryngoscope. 2019;129[9]:2041; https://bit.ly/3ZPpNhm.) Patients often present with pain and swelling of the jaw or neck, dysphagia, and drooling along with fever and malaise. External exam findings include symmetric, tense swelling, and induration of the submandibular space. Oropharyngeal exam may show edema and elevation of the oral floor with an enlarged, lifted tongue. Trismus and stridor are late findings signaling impending airway compromise. (Am J Emerg Med. 2021;41:1; https://bit.ly/3WppSp4.) Diagnosing Ludwig angina is clinical, but a CT of the neck with contrast can be useful in early cases or to assess for drainable fluid collections when safe to do so. Routine laboratory studies have limited utility in the diagnosis, but blood cultures should be obtained. The most important step for ED management of Ludwig angina is airway assessment. Patients with significant oral swelling, stridor, dyspnea, hypoxia, or other concerns for airway compromise should be intubated for airway protection. The optimal intubation technique will depend on resource availability and should be guided by a difficult-airway algorithm. Standard direct laryngoscopy has a high rate of failure in Ludwig angina because of oral swelling, so an awake, upright fiberoptic nasotracheal intubation with adequate topical anesthesia such as nebulized or atomized lidocaine is a common primary strategy. (Am J Emerg Med. 2021;41:1; https://bit.ly/3WppSp4.) A sedative agent may also be required. Preparing for possible intubation failure should include marking landmarks for cricothyrotomy if not too distorted by infection, and otolaryngology should be consulted for a potential emergent tracheostomy. Supraglottic airways are unlikely to be helpful because of anatomical distortion and difficulty inserting past the tongue. (Anesth Prog. 2019;66[2]:103; https://bit.ly/3GPtXx7.) All patients should be started on broad-spectrum parenteral antibiotics to cover oral anaerobes and gram-negative bacteria. Ampicillin-sulbactam or ceftriaxone plus metronidazole can be used in immunocompetent patients. Clindamycin monotherapy is no longer recommended for patients allergic to penicillin because of resistance, so levofloxacin should be added. Cefepime plus metronidazole or piperacillin-tazobactam can be used for immunocompromised patients. Vancomycin should be added for patients at-risk for MRSA, including patients with diabetes, those on dialysis, intravenous drug users, and residents of long-term care facilities. (Am J Emerg Med. 2021;41:1; https://bit.ly/3WppSp4.) Treatment includes IV steroids and inhaled racemic epinephrine in addition to antibiotics. The use of steroids—commonly dexamethasone 10 mg IV—to reduce airway inflammation and allow increased antibiotic penetration has limited evidence, yet is backed by expert recommendations. Inhaled racemic epinephrine is sometimes used to improve airway edema, although the extent of its benefit is uncertain. Early surgical intervention may reduce the need for intubation. (Am J Emerg Med. 2021;41:1; https://bit.ly/3WppSp4.) Consider prompt transfer to a higher level of care if otolaryngology or oral and maxillofacial surgery is unavailable. Our patient was started on IV ampicillin-sulbactam in the ED. His airway was still patent for transport, but he was quickly taken to the operating room because of how rapidly his disease progressed. The otolaryngologist successfully intubated him via nasotracheal route before the oral and maxillofacial surgery team performed an incision and drainage with washout, as well as dental extractions. The patient was extubated two days later and discharged five days after that. Share this article on Twitter and Facebook. Access the links in EMN by reading this on our website: www.EM-News.com. Comments? Write to us at [email protected]. Dr. Barrettis an emergency medicine resident physician at LAC + USC Medical Center. Dr. Burkholderis an assistant professor of clinical emergency medicine at the Keck School of Medicine at the University of Southern California. Follow him on Twitter@tayburkholder. Read past Quick Consult columns athttp://bit.ly/EMN-QuickConsult.

  PublisherDOI

• 217EMF The Impact of Health Insurance on Catastrophic and Impoverishing Health Expenses for Patients Seeking Emergency Care in Kumasi, Ghana

  Annals of Emergency Medicine · 2023-09-26

  articleOpen access
  PublisherOA PDFDOI

Frequent coauthors

• Lee Wallis

  University of Cape Town

  10 shared

• Julia Dixon

  University of Colorado Denver

  8 shared

• Margaret Sande

  8 shared

• Harveen Bergquist

  University of Cape Town

  6 shared

• Nee‐Kofi Mould‐Millman

  University of Colorado Anschutz Medical Campus

  6 shared

• Nicholas Risko

  Johns Hopkins University

  5 shared

• Reneé A. King

  University of Colorado Denver

  5 shared

• Timothy Hirsch

  Littleton Adventist Hospital

  4 shared