One of the arguments that the NFA in the USA uses to support their belief that every citizen has the right to bear arms is the statement "guns don't kill people, people kill people."
This week a visiting delegation from the states has turned this argument on its head from a medical perspective. Hence I have learnt that it isn't health care professionals that save patients lives - it a automated external defibrillator (AED).
This is awkward as for the last year I have been explaining to my hospital that in the UK only 20% of in hospital cardiac arrest are a 'shockable' rhythm (no one knows what the figures for Cambodia are) & that with out adequate post resuscitation care the chain of survival is still weak. I've argued for capacity building basic & essential emergency care - basic airway management, importance of vital observations, good history taking, following evidence based protocols etc. etc. etc.
Of course the hospital want state of the art, shiny, new medical equipment & I don't debate that they deserve it, but like Maslow's pyramid - heirachy of needs in humans there is, I believe, the same principle to providing adequate emergency medical care. There is no point having a defib machine when nurses fabricate observations & there is no real nursing care or doctors can't manage basic airways or follow a simple Asthma protocol etc. etc. etc. This concept is sometimes hard to convey in a country where it is all about status & money.
So ON my deputy director gave me physical goose bumps & caused me to be culturally inappropriate when unprompted he agreed with me. We were both at an emergency seminar where the resurrection abilities of the AED were being lauded.
Preparing myself for a very long conversation about AED I sidled up & asked him what he thought. "Well Esther - an AED is very expensive & we have many things to buy for the new ER with very limited budget. I don't think an AED is first our priority - we need to sit down & prioritize equipment based on need & cost, lets meet Friday after this course."
I hugged him.
This week a visiting delegation from the states has turned this argument on its head from a medical perspective. Hence I have learnt that it isn't health care professionals that save patients lives - it a automated external defibrillator (AED).
This is awkward as for the last year I have been explaining to my hospital that in the UK only 20% of in hospital cardiac arrest are a 'shockable' rhythm (no one knows what the figures for Cambodia are) & that with out adequate post resuscitation care the chain of survival is still weak. I've argued for capacity building basic & essential emergency care - basic airway management, importance of vital observations, good history taking, following evidence based protocols etc. etc. etc.
Of course the hospital want state of the art, shiny, new medical equipment & I don't debate that they deserve it, but like Maslow's pyramid - heirachy of needs in humans there is, I believe, the same principle to providing adequate emergency medical care. There is no point having a defib machine when nurses fabricate observations & there is no real nursing care or doctors can't manage basic airways or follow a simple Asthma protocol etc. etc. etc. This concept is sometimes hard to convey in a country where it is all about status & money.
So ON my deputy director gave me physical goose bumps & caused me to be culturally inappropriate when unprompted he agreed with me. We were both at an emergency seminar where the resurrection abilities of the AED were being lauded.
Preparing myself for a very long conversation about AED I sidled up & asked him what he thought. "Well Esther - an AED is very expensive & we have many things to buy for the new ER with very limited budget. I don't think an AED is first our priority - we need to sit down & prioritize equipment based on need & cost, lets meet Friday after this course."
I hugged him.
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