Background In the presence of ischaemia, albumin undergoes changes resulting in the formation of ischaemia-modified albumin (IMA). Increased serum concentrations of IMA have been found in patients with myocardial ischaemia. The purpose of this study was threefold: to evaluate the albumin cobalt binding (ACB) assay for measurement of IMA on the Beckman Coulter LX-20; to establish a reference range for IMA; and to investigate the relationship between IMA and total albumin concentrations.
Introduction:St. Joseph's Mission Hospital, Nyabonda, Kenya is the site chosen for a new Trauma Response Center as part of a new national highway development scheme. This highway will significantly increase in traffic volume expected in the region. With increased traffic volume, there will be an expected increase in trauma presentations as well as medical presentations due to increased populations in the area. This center is expected to serve a population of four million people. To date, the majority of nurses, medical officers and doctors in the pre-existing facility received no formal post graduate training in medical and surgical emergencies.Method:Global Emergency Medical Skills (GECS) is a registered charity, with an aim to provide medical education for the management of both trauma and medical emergencies for both adults and children. GECS was invited to attend St. Joseph's Missionary Hospital to provide education to nurses, medical officers and doctors. A curriculum encompassing the management of medical and surgical emergencies through both didactic lectures, practical skills training and simulation based workshops was composed and delivered by a group of 11 faculty, crossing Emergency Medicine, Intensive Care, Anesthesia and General Medicine. This curriculum had 28 participants and was conducted over a five day period. A "train the trainer" model was employed to ensure the strongest candidates were chosen for further training on how to deliver course material and organized simulations for future colleagues in St. Josephs Trauma Center.Results:Questionnaires of both staff and students have highlighted the utility of GECS and its curriculum in preparing staff for the opening of this new trauma center.Conclusion:This program was the first of its kind undertaken in St. Joseph's Hospital and has provided valuable education to the staff of this new trauma center. This project has enabled the continuity of this knowledge through chosen trainers.
Introduction:In November 2022, a group of eleven Irish doctors traveled to St. Joseph’s Hospital, Nyabondo, Kenya with Global Emergency Care Skills (GECS), an Irish NGO. The group delivered a training course to healthcare staff in the hospital, in advance of the scheduled opening of a regional Major Trauma Center on site. This course incorporated didactic lectures, skills stations and simulated clinical scenarios and covered commonly encountered emergency presentations in low and middle income countries (LMICs).Method:A qualitative study was conducted using a free text questionnaire with faculty, exploring their experiences of education in a resource-limited environment. Responses were interpreted by performing thematic analysis to identify recurring themes.Results:All eleven faculty members completed the survey in full. An interrogation of the responses identified commonalities across the majority of faculty members. The main themes encountered were increased recognition of the lack of postgraduate training in LMICs, the challenge of devising material appropriate to a resource-limited setting, a growth in confidence and individual teaching ability, and a reaffirmation of the effectiveness of simulation teaching in medical education.Conclusion:This survey demonstrates the significant impact of teaching such a course on faculty members. Despite the challenges encountered, faculty members strongly felt that simulation training offered significant benefits. Survey respondents noted that moulage could be adapted to suit the needs of course participants without compromising on educational goals. In the absence of formal postgraduate education in LMICs, external agencies continue to play an important role in the delivery of structured training programs.
Introduction:Global Emergency Care Skills, an Irish-based NGO, provided a five-day intensive training course to 24 local healthcare professionals in Nyabondo, Kenya in November 2022, in advance of the opening of a new major trauma center which will serve the greater Kisumu region. The pre-participation knowledge, experience and skills base was surveyed. Following the completion of didactic, workshop and simulation-based training, the perceived acquired competence and applicability of skills were surveyed. The ability to provide ongoing teaching of skills acquired within local healthcare settings was evident.Method:Nine emergency medicine and two anesthesia doctors currently working in the Irish healthcare system traveled to Nyabondo in the Kisumu region in Kenya for one week in November 2022. A five-day course based on providing practical training addressing comprehensive trauma and acute deteriorating patient knowledge and skills was provided. This included extensive focus on the primary survey approach. A quantitative survey of 22 questions with binary answering options was used. 19 participants completed the survey, and qualitative data on the applicability of the training provided to the local healthcare resource environment was gathered.Results:Following surveying participants we found that the majority of participants had no previous experience or knowledge of simulation based learning. Further, a vast majority had no formal skills or educational training post completing their medical qualification.Conclusion:The overwhelming majority of participants felt that this training improved their confidence and competence in managing trauma and assessment of the critically unwell adult and child. 100% of participants stated they gained new skills and were confident in their ability following this training to deliver local training on an ongoing basis in their own healthcare settings.
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