Finding PEEP In a Bottle (of Water): Thinking Outside The Box

As you read this I am flying to Honduras with International Relief Team on a head and neck surgery medical mission. I will attempt to post mission updates from the hospital compound, pending internet connections. Participating in a medical mission to the developing world is never easy.

Medical personnel trained in a high tech environment take for granted the complex monitoring devices, multiple choices of drugs, and plentiful support peronnel which simplify our job. When medical volunteers travel to the developing world they are often unprepared for the potential hazards produced by outdated technology, unfamiliar and sometimes poorly maintained equipment, poor sanitation, limited supplies, and a malnourished, often poorly educated population.

Let me give you an example of one rather exciting case from early in my volunteer experience in which I had to reinvent PEEP using some suction tubing and an irrigation bottle filled with water.
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Help! My Anesthesia Machine’s Not Working!

There is nothing quite as scary as being in the middle of administering an anesthetic and having your anesthesia machine fail. In my 36 years of anesthesia practice I’ve had this happen to me a few times. Knowing how to quickly troubleshoot your machine, and knowing how to protect your patient are important, potentially life-saving skills. It helps to have thought through the steps to rescue the situation before it happens to you. This article discussed the steps you should take if your machine fails. Read More …

Ventilate and Intubate But Don’t Forget Communicate

Many years ago I was participating in a volunteer medical mission to Kenya when I learned a valuable lesson in communication which I often share with my students. It involves a failure to communicate on multiple levels that almost caused some major problems. Read More …

Protect Yourself From Infection In The Workplace

There are several animal and avian viruses that show the potential of becoming easily transmissible to humans. MERS, H7N9 and H5N1 are already spreading in humans, although not easily. The last major jump from animal to human occurred with the 1918 flu pandemic where an estimated 40 million people died. Mortality from MERS is currently 330-40% in the Middle East and 10% in South Korea. As health care workers, how we approach infectious disease precautions will have a lot to do with how safe we and our patients are in the workplace. Read More …

Communication Is Everything

Given the difficulty of working with a volunteer team in the developing world, how do we take strangers and quickly transform them into a cohesive, well-functioning team in a difficult environment? Let’s look at some of the tools we use. Read More …

When The Power Goes Out In The OR

While power failures in hospitals in the United States are thankfully rare, they do happen. This discussion offers tips on dealing with power failure in the OR while working in the developing world. Read More …