They Keep Coming Back

Thursday, June 30, 2011

Tonight was the third day of the Los Erasos course. It’s going great. We have a fantastic mix of students. There are some teenagers, who can’t be in the brigade but are interested in learning emergency medicine. There are young parents. And there are old parents (grandparents!). All seem to be having a great time, since they keep coming back each day, some 60 plus of them. It’s impressive, to say the least. Tonight we focused on cardiac and respiratory arrest (i.e. CPR for adults, children and infants) and choking (i.e. indications and contraindications for the Heimlich).

Yesterday we met with Alex, a young nursing student. He’s wants to head up the brigade when it goes live. We talked to him about the governing structure of Los Erasos, which geographically covers a small area (a few hundred meters long, about a hundred meters wide), but has a population of about 5,000 people. It’s divided into three parts – the lower, middle, and upper portions – for the purposes of community governance. We discussed using this kind of structure to set up ‘guardias’ (shifts) for members of the brigade, but right now we’re learning towards a different system.

For an idea of some of the things we are debating and constructing, consider the alert system for an emergency. One possibility is that all members of the brigade are part of an SMS (text message) group, which has its own phone number. By sending a message to that number, all members of the brigade get the message, along with the number that sent it. The group number could be something like 274-4233 (BRIGADE), so people can remember it. The technological details and the service can be arranged by VeneTecnologia, a health technology business that is part of Grupo Venemergencia. Using this number, when a member of Los Erasos has an emergency, they can text the brigade’s text group their location, the accident and other details. Then everyone in the brigade gets a text with this information. The first few members to write back to the text (to the group, that is) can respond saying “I will be there” (Or, as we like to say, “Estaré a tu lado” ;) ) to the other members of the brigade, and everyone in the brigade receives this text, too. Someone in the brigade (likely the first person to respond) will also text the person who sent the text asking for help to say people are on their way. A member of Venemergencia’s crew will also be included in the group SMS, so that when the brigade stabilizes the patient and gets them to an acceptable point of transfer for an ambulance, Vene has paramedics waiting to complete the transport. Alex likes this idea for the system, and between all of our partners, we have the resources to put it in place. In short, it’s one of the ideas we’re discussing.

Tonight at the course we had some special guests. The president of the social responsibility division of VenAmCham (Venezuelan-American Chamber of Commerce) came to see how we’re working to improve public health in this community. Next week we hope to meet with her and some others from VenAmCham to learn more about international business relations and social responsibility collaborations like A Tu Lado.

Aside from the course and designing the brigade, we’ve been busy organizing other pasantías for our remaining 10 days here. Tomorrow the three of us are doing a 24-hour shift with Salud Baruta, which is similar to Salud Chacao, where we have ridden along with their ambulances and helped in their clinic. While Baruta and Chacao are both municipalities in Caracas, each have their own structures, funding and systems in place for emergency and definitive medicine. Since tomorrow is both weekend night and the end of the month (i.e. payday), there is a good chance we will get some interesting and exciting service calls. Our ‘guardia’ with their paramedics is from 9 am Friday morning until 9 am Saturday morning. We expect to learn and do a lot, then go straight to the Los Erasos course for a day of simulations and skill sessions.

Enough for now. Until next time…
-Terence