Your working at 5000 rpms as patient after patient after patient arrives at your Emergency Department for treatment. It’s a typical shift but this one never stops gaining momentum until you and the staff are at the breaking point. You think you can manage, but like any excellent racer…some days you can hit a wall, flame and die.
Take a listen or read the August 2018 EM:RAP podcast and PDF called; “Beating Burnout” by Annahieta Kalantari DO. It’s there for you to access using a CMES-Pi or the CMES thumb drives and it’s worth a listen. Even being retired, I was able to understand better why I felt the way I did and what happens to all of us as we deliver medical care.
Take care of yourself and your staff…it’s the only way to win the race.
Dr. Aloima is an Emergency Department Registrar at the Princess Margaret Hospital in Tuvalu. It is the only hospital in the country, and the primary provider of medical services for all the islands of Tuvalu.
She was a delegate at the DevelopingEM Conference held in Fiji in early December. As a regional delegate she networked with similar doctors struggling to introduce Emergency Medicine concepts and management into their Oceania countries.
Dr. Aloima trained on the CMES thumb drive and will share it’s content with her colleagues at the Princess Margaret Hospital. TWB plans to install a CMES-Pi at the hospital in 2019.
Who Knew? The food culture of Tuvalu is based on the coconut and the many species of fish found in the ocean and lagoons of the atolls. Desserts are made from coconut milk instead of animal milk. The traditional foods eaten in Tuvalu are pulaka, taro, bananas, and breadfruit. Food taken from the sea includes coconut crabs, fish and seabirds.
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.)
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.
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.
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.
EMRAP‘s YouTube channel has a plethora of tutorial videos and today’s recommendation will take less than 3 minutes to view. Take a quick review of how to rongeur a fingertip bone to facilitate skin closure. Added bonus…how to make a finger tourniquet from a glove. View here.
Who Knew? Think of a rongeur as a heavy duty forceps used to remove bone. The word is derived from the French noun meaning “rodent” or the adjective meaning “gnawing”.
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.
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 nationalflag 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.