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Reports

Workshops Reports (April 2015):
"Basic Trauma Life Support"

introduction
Mortality due to trauma is unacceptably high in Malawi. Appropriate and timely care could improve the outcome of the injured significantly. The Basic Trauma Life Support Workshop as a derivate of the well known ATLS course aims to teach health workers, when confronted with trauma victims whose lives are seriously endangered, what to do to prevent loss of life.
In rural Malawi, and in many countries in sub saharan Africa for that matter, the time lapse between the accident and the moment of entering a hospital is usually quite substantial. Here, such a thing as “the golden first hour in trauma” simply does not exist. It might seem therefore, that urgent treatment in those circumstances is hardly required. Such a presumption is misguided. On the contrary, a speedy and adequate management of trauma patients is more than ever called for. Not to realize this might well be one of the underlying causes for the high mortality in trauma. Unfortunately, the training of health care workers in giving adequate support for the acute trauma patient is not included in most curricula in Malawi.
The BTLS course teaches how to identify what is potentially killing the patient, and how to act in those conditions, following a strict but simple protocol. The workshops are structured to make the trainees acquainted with the potential dangers of trauma and to train them in a short span of time in getting to grips with the life saving procedures of the ABCDE protocol.

Actual workshop
An interactive general teaching session precedes the required theoretical teaching presentation on Power Point, followed by a very practical and-near-to life hands-on workshop. In small groups the participants get to treat four dummy patients who all “present” with a variety of signs and symptoms resembling reality. Each station is supervised and closely monitored by an instructor, one for each patient. By means of a rotating procedure all trainees in turn are being confronted by all of the four cases. A pocket sized, plasticized handout supports the trainee in taking the correct decisions during the workshop and hopefully thereafter.
The “patients” were the following:

  1. Female, 42 years, involved in a RTA (Road Traffic Accident), having been thrown out of an overturning minibus one hour ago. In shock.
  2. Male, 40 yrs, reportedly falling off the back of a truck full of supporters returning from a football match. Multiple fractures and thorax injury.
  3. Male, 18 yrs, with head injury following assault with a machete blow the previous day. Sub comatose, bleeding scalp wound and one dilated pupil.
  4. 3 years old child who fell in an open fire six hours earlier, with 24% body surface burns.

Tools
In accordance with the set-up of the Tools & Skills project, some essential equipment was left behind. These included a blood pressure machine, one or two pulse oxymeters, a rigid adjustable neck collar, as well as Guedel airways.

Certificates were issued to all participants, enabling them to collect points in the ongoing CPD program of the Medical Council of Malawi.

Data workshops: Basic Trauma Life Support April 2015

date

hospital / institute

participants

mo

co

m-n

ma

student

other

 

 

 

 

 

 

 

 

 

 7 - 4

Lilongwe         MASM

23

1

2

12

 

 

8

 9 - 4

Embangweni   MH

23

1

4

16

1

 

1

13- 4

Chitipa             DH

54

2

13

18

8

7

6

14- 4

Livingstonia     MH

9

1

2

1

 

 

5

15- 4

Ekwendeni       MH

9

2

3

2

 

2

 

 

 

 

 

 

 

 

 

 

 

5  hosp / inst.

118

7

24

49

9

9

20


MO = Medical Officer
CO = Clinical Officer
M-N = Midwife - Nurse
MA = Medical Assistant

Instructors:      4         
Transport total kilometers:     3000 km

Many thanks are owed to all instructors for their efforts and active participation making the workshop as successful as it was. 

April 2015
Dr. J.J. Petit, Malawi.kom

 

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