Verslaggeving 2011: "TOOLS and SKILLS"

Workshops Reports:
"Basic Trauma Life Support"

introduction
Mortality due to trauma is unacceptably high in Malawi. Appropriate and timely care given early 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. Upon completion of the workshop the participant will be able to identify what is potentially killing the patient and how to act in those conditions, following a strict but simple protocol.

Actual workshop
To this end the required theoretical teaching presentation on Power Point preferably given by one of the anesthetic or surgical Clinical Officers from Kamuzu Central Hospital Lilongwe, is 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 very much resembling reality. Each session 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. The difference in speed and directivity of identifying the life threatening conditions and treatment between the first and the last patient is striking and suggest very strongly that this approach might have the desired impact. 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. 3 years old child who fell in an open fire six hours earlier,  with 24% body surface burns
2. Female, 42 years, involved in a RTA (Road Traffic Accident), having been thrown out of an overturning minibus one hour ago. In shock.
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. Male, 40 yrs, reportedly falling off the back of a truck full of supporters returning from a football match. Multiple fractures and thorax injury.

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

Data workshops: Basic Trauma Life Support March / April 2011
1    try out workshop at Kamuzu Central Hospital,
14 workshops in District and Mission Hospitals in Central Region,
6 in Northern Region.

Coordinators: 2   (of which 1 Malawian)
Instructors: 9 (of which 5 Malawian)
Transport SIMAVI cruiser
- total kilometers (preparation + workshop visits): 6000 km

April 2011
Dr. J.J. Petit, Malawi.kom