EHA

Emmanuel Hospital Association in hands with the Indian Navy Health Services, Andamans arranged a three days training program on Emergency Health Care. Two trainers authorized by American Heart Association from St.John’s Medical College, Bangalore along with one resident trainer from Ashasagar Project were the Resource persons. There were altogether 16 Doctors and 2 Nurses from Indian Navy who undergone this training. EHA envisions a healthcare community that is prepared for disaster of all types through effective training, education and continuous quality improvement. EHA believes that such training will enhance the capacity of healthcare providers by providing accurate clinical scenario which will ultimately result in improved delivery of care during times of surge and potential catastrophic events in the islands any time.

BASIC LIFE SUPPORT COURSE:
The Basic Life Support course on the first day contained the following topics.

• Adult Basic Life Support
• Choking
• Infant and Child Basic Life Support
• AED-Automatic External Defibrillator

Basic life support includes maintaining the live airway and circulation. When any disaster happens, usually the life threatening conditions are the stopping of breathing and circulation of blood. Brain cannot live without blood and oxygen for more than three seconds and hence indicating the necessity of the effective intervention to restore circulation and airway patency.

The technique includes:

• First making a danger free environment
• Checking for the response of the patient
• Calling or shouting for help
• Opening the airway by head tilt and chin lift method
• Checking for breathing
• If no breathing, giving artificial breathing through mouth
• Checking for pulse, carotid pulse
• If no pulse starting compressing chest by placing hands over sternum
• Compressing at the rate of 100 per minute
• Giving 30 compressions followed by two rescue breaths

The same technique is followed for children and infants. Chest compressions are done with two hands for adults, one hand for children and with two fingers in infants.
Continuing resuscitation till advanced help comes or the rescuer becomes tired or the casualty becomes normal.

Choking means something getting blocked in the airway making breathing difficult and when untreated or not handled carefully, leading to death. To relieve choking, practice the Heimlich maneuver for adults by standing behind the patient, placing the fist of one hand between umbilicus and breast bone and giving n compressive force inside. Same techniques apply to children except you kneel behind children to have correct height. In infants choking is relieved by consecutive five chest thrusts and five back blows. Continuing the procedure until the choking is relieved or the advanced care arrives or the casualty becomes unconscious. Then proceed with the cardiopulmonary resuscitation.

ADVANCED CARDIO VASCULAR LIFE SUPPORT:

The second two days were for the ACLS and the topics covered were:

• ACLS introduction, primary and secondary survey
• Respiratory arrest
• CPR competency
• Megacode,pulseless arrest, ventricular fibrillation
• Asystole, Pulseless Electric Activity
• Bradycardia
• Tachycardia
• Stroke
• Megacode test

Advanced cardiovascular life support is very much required in order to save the casualty. But the effectiveness always depends on the successful and effective basic life support. Assessment of the casualty plays a very vital role in the resuscitation of the casualty. Correct assessment followed by a well planned and well executed team work will determine the success of the patient’s recovery. ACLS deals with the same concepts of BLS and advanced life support management like drugs, monitoring, and advanced airway, defibrillation.

The line of management depends on the rhythm of the heart and the knowledge of the accurate drugs helps in saving lives. During the training, the line of action for various heart rhythms like pulse less arrest, tachycardia, Bradycardia, asystole, stroke were discussed and practiced with different case scenarios.
All the common conditions leading to life threatening situations were discussed in a systematic way and the participants were made to practice them in an effective way.

Feed Back:
The participants very much applauded the methodology used to impart the training. Most of the Participants wanted to share the skills and knowledge they acquired to their colleagues. Also, the need for follow up review trainings was mentioned by some of the trainees while the feedback was given. The participants greatly appreciated the efforts made by Emmanuel Hospital Association to make this training happen and thanked the project team for arranging it.