PALS Santa Rosa de Copan - Emory Department of Pediatrics

PALS Santa Rosa de Copan - Emory Department of Pediatrics

PALS Santa Rosa de Copan Central American Medical Outreach CAMO Hospital Regional de Occidente February 25-28, 2008

PALS Objective To teach Pediatric Advanced Life Support to a group of

medical professionals in Santa Rosa de Copan Students came from many areas of Honduras including Tegucigalpa, Gracias, Santa Rosa de Copan, and Cesamo San Jose Copan Map of Honduras

The Hospital Classrooms were housed in the Hospital Regional de Occidente Class list Group A

Clara Lainez, MD Instituto

Hondureno Seguro Social (IHSS) Thunia Fancinily, MD IHSS Alma Rodriguez, MD Hospital Regional Occidente ( HRO)

Yadira Carcamo, MD Hospital Gracias Nelson Penman, MD HRO Jorge Madunado, MD HRO

Hector Sandoval, MD HRO Class list Group B

Jeanette Flores, MD Cesamo San Jose Copan Gloria Cacenes, MD Cesamo San Jose Copan

Claudia Calix, MD Hospital Gracias

Sonia Delattibodier, MD HRO Marisabel Rivera, MD HRO Marco Rodriguez, Paramedico, Santa

Rosa de Copan Map of Honduras SRDC, Gracias, Teguciga lpa

The Faculty

Carlos Delgado, MD Emory University, Atlanta, Georgia David Goo, MD - Emory University, Atlanta, Georgia Alex Rogers, MD - University of Michigan, Ann Arbor, Michigan

Ricardo Jimenez, MD All Childrens Hospital, St. Petersburg, Florida The Faculty Faculty The Course

The PALS video was shown and

translated into Spanish, pausing the video while discussion and translation occurred Skills station checklists were checked off and signed by the instructors Shock lecture was given in Spanish Dysrhythmia lecture was translated into Spanish

Skills Stations Skills stations Skills Stations Skills stations BLS

1 person 30:2 2 Person 15:2 AED Airway Defibrillator Dysrhythmias

Presenting the Video Intra-osseous Lecture Intra-osseous station Where to decompress a pneumothorax?

Defibrillator Station Guest Lecturer Natalie (Anesthesiologist at Hospital Occidente)

DOPE Pneumonic En Espangnol Desplazamie nto Obstruccion Pneumotorax

Equipo Shock Lecture Assess-CategorizeDecide-Act Testing Scenarios

Las Drogas Teaching The Broselow Tape Working the Megacode

Megacode Clinical Testing All participants passed the

megacode. A few clinical deficiencies were identified and corrected. Thanks to the CAMO support staff

Organization of participants Course Manuals

Preparation of mannequins and all the many supplies for airway, BLS, AED, etc Copies of materials and tests Snacks, coffee, lunch Chicken legs for the intr-osseus skills station CAMO Organization of

Equipment CAMO Support Staff Lunch and Snacks The Written Test

Written Testing

Pre-test and discussion were translated into Spanish Actual test was in Spanish 7 out of the 13 passed on the first try (Passing grade of 84) 2 missed just one extra question (80) Most were with in two questions (76)

Remediation Remediation

Tests were graded and key points were reviewed without answering the actual questions on the test. Participants were re-tested and all passed successfully Lunch post testing

Graduation 13 Medical Professionals successfully finished the new PALS course

Continued objectives will be to return and in time teach instructors and have a sustainable PALS class here in Santa Rosa de Copan Success! Faculty Organization

Accomplishments

Four pediatric emergency medicine attendings from 3 different hospitals around the US successfully put on a PALS course in Spanish The trip was self funded with the cooperation of CAMO a large non-profit group in Honduras Faculty preparation and teaching time as

well as some equipment were donated to the course and hospital. In kind course donations Central American Medical Outreach

About CAMO

CAMO has been serving Central America since 1993. CAMO's founder, Kathryn Tschiegg, RN served as a Peace Corps volunteer in Honduras. Kathy returned to Honduras with a team of physicians and technicians from the United States in early 1992.

In 1993 she founded CAMO to provide medical supplies, equipment and education to hospitals and clinics in Central America. CAMO

At present, CAMO serves over 67,000 people a year in Central America Receives over $2million dollars in donated

supplies, time and financial contributions. A distribution center was built in Honduras in 2003 and is now operated by CAMOs Central American counterpart Fundacin CAMO. Fundacin CAMO serves as CAMO USAs local partner and conduit to the community.

Equipment Each year has seen an increase in the size and the number of specialty teams and an increase in the amount of

medical equipment integrated into the public health system. All equipment provided by CAMO is technically sound and in good working order. This equipment would be or has been discarded in the United States. Sustainability

CAMO trains Honduran public health staff to use the donated equipment through the efforts of licensed medical professionals from the United States who donate their time and services to

Central American hospitals and clinics. These medical teams travel with the sole purpose of integrating medical equipment and technology into the daily workings of these facilities and training the Central American staff to use their new skills after the U.S. teams leave. CAMO Programs

Capital Improvements in Medical Facilities Dental Program Wheelchair Repair and Distribution

Surgical Development: Orthopedics, Plastics, Eye, and Urology Prosthetic Lab MMERV Program Medical Education

Technical School Research and Development Community Center/Gym Audiometry

Multidisciplinary Breast Clinic Eye Clinic Day Care Center Medical Education

Educational Programs Currently Running: Respiratory care and equipment Neonatal care & NALS ACLS & CPR OB/GYN

Laboratory and X-ray Emergency medical services Dentistry and orthodontics Mammography & related areas Now PALS Accountability

Where Does the Money Go? With the extensive network of volunteers and in-kind contributions CAMO is able to get $7 dollars worth of work and equipment out of very $1 donated enabling CAMO to give the money to those who need it

most. Volunteer Costs Time and $$

It costs about $1,000 per team member for a week in Honduras Medical professionals donate their time with the understanding that they participate in an ongoing program which might require a commitment of

1 -2 weeks per year for five years. PALS will probably take three to four trips to accomplish the goal of a selfsustaining course Hospital Grounds Surgery and Womens Surgery

Emergency Room Ambulance Area Old Pediatric Area Outside Old Pediatric

Ward Current Pediatric Ward Nursing Station Pharmacy

Enfermera Preparing Meds Penicillin Test Dose Rounding with the Pediatricians

Radiology and Chart Filing System in the Patients Bedspace (Chair) Reviewing X-rays Chest X Ray

? Pneumothorax Femoral Cutdown Femoral Cutdown

Done at bedside Pediatrician on call, covers ER, Nursery, and Inpatient wards

Used a 10 French feeding tube cut off at an acute angle and inserted into the femoral vein after nicking. Vessel then ligated and feeding tube tied in.

Intubated in General Pediatric Ward Mother with Ventilated Child

Hospital Occidente

18 month old female with a history of one week of eye swelling. No fever No history of trauma No pertinent past

medical history Hospital Occidente ? Bot Fly Pathology Ophthalmomyiasis refers to the invasion

of the lids, conjunctiva, cornea, and rarely the orbit or globe of the mammalian eye by fly larvae (order Diptera) .1 The human botfly (D hominis) is the most common cause of cutaneous myiasis in Central and South America, but few cases of external ophthalmomyiasis and no previous case to our knowledge of

1. Savino DF, Margo CE, McCoy ED, Friedl FE. Dermal myiasis of invasion have been reported.2 theorbital eyelid. Ophthalmology. 1986;93:1225-1227.

2. Wilhelmus KR. Myiasis palpebrarum. Am J Ophthalmol. 1986;101:496-498. ambergriscaye.com/pages/town/botfly2.html The Bot Fly Scientific classification Kingdom: Animalia Phylum: Arthropoda

Class: Insecta Order: Diptera Suborder: Brachycera Infraorder: Muscomorpha Section: Schizophora Subsection: Calyptratae Superfamily: Oestroidea

Family: Oestridae http://en.wikipedia.org/wiki/Botfly The Human Bot Fly Bot Fly Pathology

The female botfly glues her eggs onto the abdomen of a captured mosquito or other common fly. When the carrier insect lands on a human, the larva, or bot, hatches, burrows into the skin, and positions

itself "head down" to feed, breathing through caudal respiratory spiracles. ambergriscaye.com/pages/town/botfly2.html Bot Fly Pathology The larva withdraws through a central punctum, falling to the

ground and pupating before emerging as a mature botfly.3 Chloroform or lidocaine to anesthetize the bot may facilitate surgical removal as does occluding the breathing hole

3. Lane RP, Lowell CR, Griffiths WA, with Sonnex ointment, TS. Human cutaneous myiasis: a review and report of three cases due to Dermatobia beeswax,

chewing gum, or pork fat.4 hominis. Clin Exp Dermatol. 1987;12:40-45. 4. Elgart ML. Flies and myiasis. Dermatol Clin. 1990;8:237-244.

ambergriscaye.com/pages/town/botfly2.html Human Bot Fly ambergriscaye.com/pages/town/ Human Bot Fly

ambergriscaye.com/pages/town/botfly2.html NICU Pediatric Interns in the NICU Premature Infant

Hospital Occidente

Macrosomia Edema Respiratory Failure Shock Breathing over ventilator

NICU Flowsheet

Dobutamine Albumin

Furosemide Hydrocortisone Ciprofloxacin Clindamycin Fluconazole Midazolam Fentanyl Albuterol/Atrovent

D10 NS Delayed Capillary Refill Time Post Bolus Improvement in CRT

Delivery Room Resuscitation Equipment Delivery Room Delivery Area - Nursery ONLY Breast Feed!

Breast Feeding Teaching Area Lecture to Pediatric Housestaff Benefits

Cultural exchange

Teaching Potential collaboration in the future Exposes us to the limitations of medical practice in other parts of the world Enlightens us about how our counterparts work internationally

Recently Viewed Presentations

  • Plastics Recycling - University at Buffalo

    Plastics Recycling - University at Buffalo

    Plastics Recycling Ryan Rose . Alphonse G. Mutsindashyaka 04/26/2001 . Objective To determine if why it is important to recycle plastics made from synthetic polymers - statistics - advantages - disadvantages - impact on environment Why Recycle Question arises about...
  • 1.2.1 Searech for Definition of Life

    1.2.1 Searech for Definition of Life

    Define the terms Metabolism Continuity of life * The Variety of Life All living things are divided into two main groups Plants Animals * The Diversity of Animals There are more than a million different species of animals on earth...
  • Your hospital room can make you sick! How

    Your hospital room can make you sick! How

    There is no direct correlation between RLU and microbial contamination, but "hygiene fails" determined by aerobic colony count and ATP do correlate1,2. Improve existing procedures. Fluorescent markers. Fluorescent material in the form of gel, powder or lotion can be applied...
  • Scaling and Fault Tolerance for Distributed Messages in a ...

    Scaling and Fault Tolerance for Distributed Messages in a ...

    Scaling and Fault Tolerance for Distributed Messages in a Service and Streaming Architecture Hasan Bulut [email protected] Motivation Videoconferencing systems; AccessGrid, VRVS, H.323 based systems (i.e. Polycom) Streaming media; client-server architecture. Client has control over the stream.
  • files.meetup.com

    files.meetup.com

    The Future Of Women Originally "The Future Of Gender Relations" Wayne Radinsky Boulder Future Salon July 23rd, 2011
  • Small Engine Operation - Mediapolis Community School

    Small Engine Operation - Mediapolis Community School

    Hole in the engine block that houses and aligns the piston in the engine block. Bore- is the diameter of the cylinder bore. Stroke- is the linear distance that a piston travels from TDC to BDC in the cylinder bore....
  • Bell Ringer - Watertown City School District

    Bell Ringer - Watertown City School District

    Pray 5 times daily towards Mecca. Charity for the poor. Fast during the month of Ramadan. ... Over time many of these stories are written down. The most famous collection is One Thousand and One Nights. This collection includes ....
  • The Impact of Available Learnscapes on Teachers' Pedagogies ...

    The Impact of Available Learnscapes on Teachers' Pedagogies ...

    Learnscapes as Pedagogical Tools: Understanding Teachers' Levels of Use. Keith Skamp Centre for Children & Young People School of Education Southern Cross University