The first week of classes has been both exhilarating and exhausting. I have been writing lesson plans, running scenarios, and of course, working on endless documents that will be needed for the flight service. The students are enthusiastic, chiming in with their knowledge (which can be profound—there are practicing doctors and paramedics of 20 years who are taking this course), and arguing over the best way to perform procedures. I am deeply impressed by the students, and have found this to be much more of a learning experience than anticipated. Still, in teaching about pulse oximetry and altitude, or reviewing the procedure for back boarding a patient with a spinal injury, it is also clear that we have a lot to offer. Prehospital medical services are completely unstandardized here in Bolivia, and doctors who are well trained in hospital procedures are not prepared for emergencies in the field. Good to know we are proving useful in some way! If you want more details on the course, check out the A Tu Lado blog (news.atulado.net)
One of the essential parts of the project here is setting up a system of patient records and flight records. Hopefully this record system will serve several purposes, including improving patient care after hand off to hospital staff, providing a way for the organization to make informed decisions on how to improve the service, and helping to develop an epidemiological profile of the region. I have been working on setting up the run sheets that the emergency service is going to use. These will document each encounter with a patient, and will be one of the main sources of data for the retrospective analysis, as well as being part of a patient’s permanent medical record. There are plans to have the entire system digitalized by August. A lofty goal, but through our collaboration with a team of OpenMRS (open source medical record system) experts called eHealth Systems in Santiago, Chile, I think we have a good shot.
In the meantime, I’ve restarted conversations with the pilots in the flight service about what they want to see out of the mapping initiative. I have been working on a few maps since first coming to Bolivia in February. We had initially imagined these maps would show the normal and emergency runways with pertinent information for navigation. Turns out the pilots had begun to use Google Earth since our conversations in February, and had already figured out a rough system to plan flights using the open source software and their GPSs. Although I was initially dismayed at having been left out of the loops on this, I am feeling really positively about this unexpected development. I have already begun working with the pilots to make their system more streamlined and to use the information from ArcGIS to enhance their data on Google Earth. ArcGIS will still play an important role in helping with the retrospective analysis of flight patterns and resource usage, as well as displaying geographically any epidemiological trends that emerge from the emergency flight records. We have also begun conversations on how to improve the flight record system, so I am looking over how they currently do their documentation. Amazing how far a working knowledge of Excel will get you!