How to Kill a Patient During Airway Management

Airway Management is just that…managing the airway upside down and inside out. Take a quick read of the PDF or listen to EM:RAP’s November MP3 audio podcast called Strayerisms: Fluid Filled Airway. It’ll float your boat.

Correct ET tube placement, but if you tube the esophagus, leave the ET tube in place and use it as a landmark.

According to Dr. Reuben Strayer MD, the author, there are four ways to harm your patient during airway management: failure to oxygenate; failure to ventilate; worsening perfusion; and aspiration. His suggestions are doable no matter where you practice or what resources you lack…remember…your greatest resource is knowledge.

 

 

 

Who Knew? Probably the oldest recovered boat in the world, the Pesse canoe, found in the Netherlands, is a dugout made from the hollowed tree trunk of a Pinus sylvestris that was constructed somewhere between 8200 and 7600 BC. This canoe is exhibited in the Drents Museum in Assen, Netherlands. (Not looking too seaworthy these days.)

 

 

Giving Tuesday

Napo River, Tena, Ecuador. Local means of travel for many doctors and nurses in the Amazon.

Tomorrow is Giving Tuesday…the kickoff to end-of-year and charitable giving.

Please consider making a donation to Techies Without Borders (TWB). Our current project, Continuing Medical Education on Stick (CMES), provides free continuing medical education to doctors and nurses in resource-challenged countries globally. You can donate here or here by clicking the green Donate button.
If you have previously donated this year consider sharing this information via social media and spreading the word.
With gratitude,
TWB Team

Meet Dr. Cristian Carreon, Santo Domingo, Ecuador

Dr. Cristian gives a thumbs up while using the CMES-Pi app to search for medical topics of interest.

Dr. Cristian is a full-time Family Practice doctor at the Centro de Salud Hombro a Hombro Clinic (CSHH) in Santo Domingo, Ecuador. CSHH was established in 2007 and partners with Timmy Global Health during brigades. The clinic has three medical exam rooms, dental room and services, an office and a pharmacy. This small but mighty clinic, staffed by two nurses, one part-time and Dr. Cristian, serves approximately 20,000 patients from the poor urban neighborhoods each year.

Centro de Salud Hombro a Hombro Clinic (CSHH) in Santo Domingo, Ecuador.

Dr. Cristian and his staff have few opportunities or financial resources to attend continuing medical education (CME) conferences in Santo Domingo or Quito. A CMES Raspberry-Pi device was installed in the clinic and using smartphone apps the doctors and nurses can access free CME at the clinic. Every month about 20 new topics are available in Spanish as PDF files.

Ecuador Gets a Slice of CMES-Pi

Dr. Debra Stoner departs this week to install CMES-Pi at two sites and dispense CMES thumb drives at two other sites in Ecuador, including Quito, Santo Domingo, Guangaje, and Tena.

The CMES thumb drives and CMES-Pi give rural doctors and nurses access to cutting-edge continuing medical education (CME). Timmy Global Health, a Techies Without Borders (TWB) partner, works alongside local health providers in Ecuador to provide healthcare in remote regions. The CME is provided free of charge by another TWB partner, Emergency Medicine Reviews and Perspectives (EM:RAP).

Visit TWB Twitter, Instagram and Facebook pages for more photos later this week.

Dataplicity

Dr. Manoj Thomas and Dataplicity Founder, Elliot Mackenzie, London, England May 2018.

Techies Without Borders (TWB) partners with Dataplicity. Dataplicity is the foundation for IoT remote support and provides TWB with a generous allowance to keep track of our Raspberry-Pi data.

IoT = Internet of Things…sounds like a scifi book but means using the “Internet” as the backbone of connectivity and the “Things” are your devices. Your things collect data and send it to the Internet. Put it all together and IoT converts a normal device into a smart device. TWB installs Dataplicty on CMES-Pis before it gets to the clinics and hospitals. With Dataplicity, we are able to manage and update CMES-Pi devices located in remote and hard to reach areas. This means we can monitor and fix any issues without long distance phone calls and walking non-technology users through diagnostics.

Who Knew: Data geeks knew…there are a lot of data jokes on the web…one of my favorite.

 

 

Go Fund Me: Give a Slice of CMES-Pi Success

 

The Techies Without Borders team thanks everyone who donated, sent words of encouragement and shared our Go Fund Me page on their social media. We raised $2000 USD in two weeks.

The funding supports installation of CMES-Pi units in Mbarara University of Science and Technology and Makerere University Hospital, Uganda; Mount St John’s Medical Centre, Antigua; Victoria Hospital, St. Lucia; Timmy Global Health (TGH) partner clinics in Quito, Santa Domingo, and Tena, Ecuador; and USB drives TGH’s Guangaji Clinic, Ecuador.

Who Knew? TWB slowly formed as two university professors, Dr. Manoj Thomas and Dr. Yan Li, along with their graduate students worked on social-driven educational IT projects for their studies. A mutual friend invited Manoj to meet her mom, Dr. Debra Stoner. Over dinner…Manoj and Deb formed a friendship based on mutual respect and their passions to bring education to those with limited access…CMES was born and in 2018 TWB incorporated as a 501c3 nonprofit corporation. We are committed for the long haul.

Meet Dr. Samrat in Nepal

Dr. Samrat graduated from the Peoples’ Friendship University of Russia in Moscow and earned his post-graduate degree in General Practice and Emergency Medicine from Tribhuvan University Teaching Hospital in Kathmandu, Nepal.
After working in Patan Academy of Health Science and Kathmandu Model Hospital, he joined CIWEC Clinic and Hospital in Kathmandu a few years ago. CIWEC is a travel medicine facility that cares for patients with a variety of travel-related and general health issues. Dr. Samrat describes his practice: “We deal with common issues like common respiratory illness, gastrointestinal illness and also rare and complicated issues requiring prolonged hospital care or care in the intensive care unit. We look after both outpatients and inpatients.  We help people with their travel needs including vaccinations and recommendations for their specific travel plans.”
Despite having access at CIWEC to UpToDate, a point of care medical information site provided by his employee, he uses the CMES thumb drive to access up-to-date cme at home. He likes having this option because “…the CMES thumb drive has helped me a lot while dealing with these issues. This has also given opportunities to interact with colleagues for the improvement in the overall care of our patients.”
Who Knew? The national flag of Nepal (Nepali: नेपालको झण्डा) is the world’s only non-quadrilateral national flag. The flag is a simplified combination of two single pennons, known as a double pennon. Its crimson red is the color of the rhododendron, Nepal’s national flower, while the blue border is the color of peace.

Guatemala Gets a Slice of CMES-Pi

Dr. Manoj Thomas visited Timmy Global Healths partner Asociacion Pop Wuj Clinic in Xela, Guatemala this past March. Asociacion Pop Wuj is a collectively owned, non-profit, Spanish language school that promotes community development through a variety of programs including a daycare center, construction of safe stoves, reforestation and ecological education, a student scholarship program, and a comprehensive health and nutrition program.

Working with Dr. Carmen and Dr. Herman he set up a CMES-Pi at the Xela clinic. The regular access to up-to-date continuing medical education content for the staff is welcomed as travel to conferences is difficult and costly for the organization.

We welcome Asociacion Pop Wuj and there impressive work in the community.

The Pop Wuj team with Dr. Manoj Thomas (on right).

The Pop Wuj team tries out the CMES-Pi connectivity.

A Word…or Two…from Mel Herbert at EMRAP

Image result for emrap logo

Who and what is EM:RAP? Emergency Medicine: Reviews and Perspectives (EM:RAP) is our sponsor and source of the continuing medical education (cme) materials brought to you by the Techies Without Borders (TWB) program called Continuing Medical Education on Stick (CMES) and CMES-Pi. Listen to a free podcast by Mel Herbert MD MBBS FAAEM as he discusses the future of EMRAP here.

As a participant in CMES or CMES-Pi we wanted you to appreciate this is a company that goes beyond the mission of excellent cme. It makes a commitment to helping you be the best you can and embracing colleagues worldwide. We at TWB gratefully acknowledge EM:RAPs forward vision and passion.