Come Clean About Hand Washing

Handwashing station. (Photo from Wikimedia Commons)

There are no disputes washing hands after patient contact with human excretions or blood is necessary. But what about everyday habits such as wearing a white coat or tie? Do you clean your stethoscope? Do these common articles act as fomites for infection?

The EM:RAP podcast and PDF for October 2019: Handwashing by Dan McCollum MD discusses pearls for handwashing, common misperceptions and the concept of a habit loop. Which is better chlorhexidine or betadine? Alcohol foam/rinse or soap and water? Long or short-sleeved clothing? Take a quick listen or read to ramp up your germ-busting habits.

An engraved portrait of Semmelweis: a mustachioed, balding man in formal attire, pictured from the chest up.

Who Knew? Ignaz Semmelweis was a Hungarian physician and scientist who advocated antiseptic procedures in the mid-1800s. His concept of physicians washing their hands as a way to reduce the spread of infection from cadavers conflicted with the established medical society. He was committed to an asylum by a colleague, beaten by the guards and died two weeks later as a result of a gangrenous wound at the age of 47. It would be two decades later when Louis Pasteur confirmed the germ theory that Semmelweis’s theory was widely accepted.

 

 

 

Hemophilia: Stemming the Crimson Tide

Wikipedia

Blood: the red liquid that circulates in the arteries and veins of humans carrying oxygen to and carbon dioxide from the tissues of the body.

Hemophilia: the ability of the blood to clot is severely reduced, causing severe bleeding from even a slight injury.

The prevalence of Hemophilia A varies by country, with a range of 5.4-14.5 cases per 100,000 males. (Medscape)

Do you know the three major forms of Hemophilia or the most common emergency department presentations? Take a listen or read EM:RAP’s October 2019 podcast: Hemophilia by Anand Swaminathan MD and Nilesh Patel MD to refresh your knowledge.

Who Knew? The first medical professional to describe the disease was Abulcasis. In the tenth century he described families whose males died of bleeding after only minor traumas.(Wikipedia)

 

 

 

Digital Divide: Closing the Gap

The Raspberry-Pi is a small computer installed in an Emergency Department or clinic and allows access to up-to-date medical education through smart-phone apps.

Can digital technology help fill the medical education gap? The World Health Assembly in May 2018 agreed on a digital health resolution that urged member states to prioritize the “development, evaluation, implementation, scale up and greater utilization of digital technologies as a means of promoting equitable, affordable and universal access to health for all.”

The recommendations focus on areas such as improved access to care, technical support for developing digital systems and improved health-care delivery systems. The TWB team were encouraged to note there is also mention of; “developing guidance for digital health…including through the identification and promotion of best practices, such as evidence-based digital health interventions and standards…”.
Our Continuing Medical Education on Stick (CMES) and CMES-Pi deliver continuing medical education digitally to doctors and nurses in resource-constrained countries through a novel IT solution that doesn’t depend on a constant source of electricity or Internet, making it ideal in countries with under-developed infrastructure. It allows them access to up-to-date medical information and treatment plans.
More about how CMES affects a doctor’s everyday practice with a story from Fiji to be posted next week.

Meet Abinash: TWB IT Team

Abinash Adhikari is from Nepal and is currently doing a Masters in Information Systems and Technology from Claremont Graduate Univesity, California. He completed his Bachelor’s degree in Computer Science from Waseda University, Tokyo and worked at  Rakuten in Tokyo as a full-stack web application engineer during his early career.

Abinash has hands-on experience in building distributed systems using REST web APIs and managing web servers and IT infrastructure. He brings industry-standard expertise and knowledge in all aspects of web technologies like frontend, backend and server deployments to Techies Without Borders projects.  He is highly self-motivated and always looking to hone new skills and take on new challenges. We welcome Abinash to the TWB IT team.

Who Knew? A full stack developer is a web developer or engineer who works with both the front and back ends of a website or application—meaning they can tackle projects that involve databases, building user-facing websites, or even work with clients during the planning phase of projects.

 

Calling All Doctors, Nurses, Medics and Health Providers

Are you connected globally in the health field? Techies Without Borders (TWB) needs your help identifying our global colleagues for the Continuing Medical Education on Stick (CMES) Project. Help give a doctor, nurse, medic or health practitioner free cme by contacting us at the email below.

Dr. Aloima from Tuvalu Island.

Dr. Dare from Ekiti Teaching Hospital, Nigeria.

Dr. Carmen (2nd from left) from Xela, Guatemala.

Health providers such as Dr. Aloima, Dr. Carmen and, Dr. Dare in Nigeria depend on the CMES content for up-to-date monthly topics on Emergency Medicine, Primary Care, and Core Content.
Contact Dr. Debra Stoner: techieswithoutborders@gmail.com

Congratulations Ruxandra Zait, TWB IT Volunteer

Ruxandra was promoted at her state job to Senior IT Auditor after only one year of employment.
Ruxandra describes her job, “I am part of the Internal Audit Unit. It is only two of us that do IT-related audits. We check the systems that hold sensitive data to determine if adequate security controls are in place and if we are compliant with the applicable technical standards. We review everything from access management and data handling to systems and applications development including penetration testing and vulnerability scans. I get to work with people from all units and I truly love this.”


Despite her demanding job responsibilities, Ruxandra volunteers her skills and experience with TWB as the Conceptual Design Developer. Each month she processes and uploads dozens of EM:RAP MP3 and PDF files containing continuing medical education for 700+ doctors and nurses globally who use the Continuing Medical Education on Stick (CMES) and CMES-Pi content. Thank you, Ruxandra!

Itching to Understand Eczema

Photo from the website of Fondation Dermatite Atopique.

Eczema, also called Atopic Dermatitis affects 15-20% of children and 1-3% of adults worldwide according to a paper recommended by the National Center for Biotechnology Information (NCBI). The paper titled, “Worldwide variations in  the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood”, was originally published in J Allergy Clin Immunol. 1999 Jan;103(1 Pt 1):125-38.

Photo from Wikimedia.

This common recurrent or chronic inflammatory skin disease is characterized by dry skin with acute flare-ups of eczematous pruritic lesions. Vanessa Cardy MD, Adrien Selim MD and Heidi James MD offer bullet point clues to understanding, diagnosing and treating this disease which impacts not only our patients health but their psychosocial well being. Take a listen or read the August Right on Prime’s: The Generalist: Eczema.

 

Photo from Wikimedia.

Who Knew? The first dermatology textbook book, “De Morbis Cutaneis”, was written in 1572 by an Italian physician, Girolamo Mercurialis. Translated it means ““Of all skin diseases and waste treatment of the body.”

Blown Away

The EM:RAP July Introduction by Stuart Swadron MD and Jan Shoenberger MD talks about a case that will blow you away…pneumomediastinum presentation and causes. Can you answer these questions:

  1. Can pnuemomediastinum occur after forceful expiration?
  2. Can ECG findings be distorted due to the presence of subcutaneous air?

You will, once you listen to the MP3 file or read the PDF article.

 

Pneumomediastinum. Photo from Wikicommons.

Cultural Highlight: St. Lucia

While traveling to install the Techies Without Borders Continuing Medical Education on Stick Project (CMES and CMES-Pi) I have been invited to joined in local sports events…playing soccer in Ecuador with clinic patients…volleyball at the Himanchal Higher Education School in Nangi, Nepal…and receiving a cricket lesson in St. Lucia. Understanding not only the medical culture in a country but the cultural pastimes is important in bridging relationships.

Dominoes played in St. Lucia during work breaks.

One of my favorite games to simply watch is Dominoes played with great enthusiasm in St. Lucia. You know a hotly contested game is nearby when you hear the dominoes slammed down onto the table….quickly followed by cheers and groans.

 

Who Knew? Besides playing games, another use of dominoes involves standing them on end in long lines so that when the first tile is toppled, it topples the second, which topples the third, etc., resulting in all of the tiles falling. By analogy, the phenomenon of small events causing similar events leading to change is called the Domino Effect…we at TWB believe making CME available to all medical practitioners directly affects their patients and you don’t need a game face to make the win. (Photo Wikipedia)

Meet a Solar Power House from Nepal

Meet Sandeep Giri, Founder and CEO of Gham Power, a Nepali company providing solar based solutions for rural households, businesses and communities. Their solar micro-grid solutions are used where national gridlines are not available.

Bayalpata Hospital, Achham District, Nepal.

Gham Power enables TWB to provide the free Continuing Medical Education on Stick Project in remote areas of Nepal such as Possible Health’s Bayalpata Hospital in the far western Achham District. They installed the solar panels which provides the electricity to run the hospital and the Raspberry-Pi device. Doctors and nurses use smart phone apps to access up-to-date medical information on the Pi thereby decreasing their isolation and improving their knowledge base. Gham Power uses unique “pay as you go” financing and investors to help communities reach their potential with access to electricity. They also developed solar pump solutions for farmers.

TWB gives a three thumb drive salute to Gham Power for their global foresight, business model and technical ingenuity. Read more about them on our Facebook page.

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