{"id":23633,"date":"2013-01-08T12:50:14","date_gmt":"2013-01-08T11:50:14","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=23633"},"modified":"2013-01-08T12:53:41","modified_gmt":"2013-01-08T11:53:41","slug":"lifebox-q-and-a-el-salvador-education-education-education","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/08\/lifebox-q-and-a-el-salvador-education-education-education\/","title":{"rendered":"Lifebox Q and A: El Salvador\u2014education, education, education"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/08\/lifebox-q-and-a-el-salvador-education-education-education\/sandra_leal\/\" rel=\"attachment wp-att-23638\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-23638\" alt=\"sandra_leal\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2013\/01\/sandra_leal.jpg\" width=\"160\" height=\"130\" \/><\/a>A pulse oximeter in the operating theatre doesn\u2019t make surgery safer; it\u2019s the anaesthesia provider using the oximeter effectively who will save lives.<\/p>\n<p>For Lifebox, the <em>BMJ<\/em>\u2019s Christmas charity, provision of <a href=\"http:\/\/www.lifebox.org\/education\">education<\/a> is inseparable from donating equipment.<\/p>\n<p>That\u2019s why we\u2019re excited to share a recent conversation with Sandra Leal the <a href=\"http:\/\/www.medicosdeelsalvador.com\/Detailed\/Asociaciones_M_dicas\/Asociaci_n_de_M_dicos_Anestesi_logos_de_El_Salvador_-_AMAES_210.html\">president of\u00a0the association of medical anaesthetists<\/a> in El Salvador (AMAES\u2014Asociaci\u00f3n de M\u00e9dicos Anestesi\u00f3logos de el Salvador). \u00a0<!--more--><\/p>\n<p>Sandra Leal has worked directly with El Salvador\u2019s <a href=\"http:\/\/www.salud.gob.sv\/\">ministry of public health<\/a> over the last few months to deliver a series of Lifebox training workshops across 30 hospitals to nearly 300 anaesthesia technicians in the north, south, east, and west of the country. They reached almost every anaesthesia technician working in a government hospital.<\/p>\n<p>Next step: the ministry will distribute 87 Lifebox pulse oximeters donated thanks to last year\u2019s <em>BMJ<\/em> Christmas Appeal!<\/p>\n<p><strong>Lifebox: Congratulations to you, the ministry of public health and AMAES on such a successful series of workshops.\u00a0 Have you had positive feedback?<\/strong><\/p>\n<p>Sandra: People said thank you, but you know it wasn\u2019t just about the oximeters that are coming. It was the teaching.<\/p>\n<p>There are only about 100 anaesthetists in El Salvador, so we rely on technicians a lot\u2014but there\u2019s really no continuing education. This was a first for them, coming together at these workshops. I think it was cathartic.<\/p>\n<p>We used the clinical scenarios, and the technicians got to express opinions\u2014they really got to think.\u00a0 They saw what medicine, real medicine, is about.<\/p>\n<p>And for the first time they saw medical anaesthetists reaching out to really see what their needs were.<\/p>\n<p><strong>Lifebox: were you surprised by what you saw?<\/strong><\/p>\n<p>Sandra: I think I got a sharper education than they did. Going out into the country and talking to all these people\u2014I had heard of their need, but had not had to face it. Some basic hospitals, only have a blood pressure cuff and that\u2019s the whole of their monitoring system.<\/p>\n<p>It was scary\u2014maybe that\u2019s the best word for it. When you\u2019re used to working with certain standards, it\u2019s hard to visualise people working without even the basics.<\/p>\n<p><strong>Lifebox: are problems with equipment frequent?<\/strong><\/p>\n<p>Sometimes things aren\u2019t in perfect condition\u2014this brings problems too. You know it\u2019s not 100 percent functional, but what if it\u2019s an emergency, an urgent procedure? An appendectomy, or a c-section that can\u2019t be delayed\u2014it doesn\u2019t leave any choice but to get the procedure done.<\/p>\n<p><strong>Lifebox: Did you hear this frequently from the technicians?<\/strong><\/p>\n<p>Sandra: Again and again. It\u2019s a major concern. They expressed over and over the stress that they work with everyday\u2014every single surgery, trying to make the best of what they have. It\u2019s exhausting.\u00a0 To be in the middle of a case and something just shuts down.<\/p>\n<p><strong>Lifebox: Those are difficult conditions for delivering safe surgery.<\/strong><\/p>\n<p>That\u2019s how accidents happen\u2014but they\u2019re not really accidents, are they? An accident happens when you\u2019ve taken all the precautions and something still goes wrong. When you don\u2019t have what you need, but you have to go ahead anyway\u2014that\u2019s not the definition of an accident.<\/p>\n<p><strong>Lifebox: Do you think the WHO Surgical Safety Checklist can make a difference here?<\/strong><\/p>\n<p>Sandra: We introduced it as part of the workshops. People really accepted it, and it made sense to them.\u00a0 They had the idea, they just didn\u2019t have the list, or all the equipment. The pulse oximeters will be a big help.<\/p>\n<p><strong>Lifebox: What are some other barriers to surgical safety?<\/strong><\/p>\n<p>Sandra: We have to break through the idea that it is going to work against them, that people are going to go after them like a witch-hunt. We have to get people used to the idea that the checklist, and the logbook are tools that will help them to do something better.<\/p>\n<p><strong>Lifebox: The ministry of health will shortly be distributing the donated Lifebox oximeters to ensure that all public government hospitals, which provide free care, have access to safe monitoring.<\/strong><\/p>\n<p><strong>Did you hear reports from the technicians about the sort of difference these will make?<\/strong><\/p>\n<p>Sandra:\u00a0 They had stories that didn\u2019t end well.<\/p>\n<p>Even for small cases, people were turning blue and that\u2019s the point when you know something\u2019s going wrong.\u00a0 The oxygen saturation (Sp02) is down to 60 percent, way, way too low to be admissible, and all of a sudden a small case becomes more complicated.<\/p>\n<p>We don\u2019t have enough anesthesiologists in the country to cover all of the hospitals, and the technicians are on their own.<\/p>\n<p>We got people excited\u2014and now they\u2019re ready. This is not the only thing we need, but it\u2019s a huge start. These oximeters are going to make a difference.<\/p>\n<p><em><strong>Sandra Leal<\/strong> has been an anesthesiologist for almost 20 years.\u00a0 She works at Hospital Nacional Zacamil, El Salvador, a public 240 bed, 2nd level regional hospital, in the outskirts of the capital city.<\/em><\/p>\n<p>Lifebox is the <em>BMJ<\/em>\u2019s holiday charity this year.\u00a0 For more information, or to donate, see this week\u2019s <em>BMJ<\/em> or visit <a href=\"http:\/\/www.lifebox.org\/\">www.lifebox.org<\/a>. The <em>BMJ<\/em> campaign runs until the end of January.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A pulse oximeter in the operating theatre doesn\u2019t make surgery safer; it\u2019s the anaesthesia provider using the oximeter effectively who will save lives. For Lifebox, the BMJ\u2019s Christmas charity, provision [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/08\/lifebox-q-and-a-el-salvador-education-education-education\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1871,263,224],"tags":[],"class_list":["post-23633","post","type-post","status-publish","format-standard","hentry","category-christmas-appeal","category-global-health","category-students"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Lifebox Q and A: El Salvador\u2014education, education, education - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/08\/lifebox-q-and-a-el-salvador-education-education-education\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Lifebox Q and A: El Salvador\u2014education, education, education - The BMJ\" \/>\n<meta property=\"og:description\" content=\"A pulse oximeter in the operating theatre doesn\u2019t make surgery safer; it\u2019s the anaesthesia provider using the oximeter effectively who will save lives. 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