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医学公平与全球健康倡议(IMEGH)复苏培训项目:非洲复苏培训课程的一个典范

The initiative for medical equity and global health (IMEGH) resuscitation training program: A model for resuscitation training courses in Africa.

作者信息

Tuyishime Eugene, Irakoze Alain, Seneza Celestin, Fan Bernice, Mvukiyehe Jean Paul, Kwizera Jackson, Rosenberg Noah, Evans Faye M

机构信息

Department Anesthesia, Critical Care, and Emergency Medicine, University of Rwanda, Rwanda.

Department of Anesthesia and Perioperative Medicine, Western University, Canada.

出版信息

Afr J Emerg Med. 2024 Mar;14(1):33-37. doi: 10.1016/j.afjem.2023.12.003. Epub 2023 Dec 30.

Abstract

In high-income countries, outcomes following in hospital cardiac arrest have improved over the last two decades due to the introduction of rapid response teams, cardiac arrest teams, and advanced resuscitation training. However, in low-income countries, such as Rwanda, outcomes are still poor. This is due to multiple factors including lack of adequate resuscitation training, few trainers, and lack of equipment. To address this issue, the Initiative for Medical Equity and Global Health Equity (IMEGH), a training organization founded in 2018 by 5 local anesthesiologists has regularly taught resuscitation courses such as Basic Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support in hospitals throughout Rwanda. The aims of the organization include developing a sustainable model to offer context relevant resuscitation training courses, building a cadre of local instructors to teach on the courses, as well as engaging funding partners to help support the effort. From October 2018 until September 2022, 31 courses were run in 11 hospitals across Rwanda training 1,060 healthcare providers (mainly of non-physician anesthetists, nurses, midwives, and general practitioners). Ongoing challenges include lack of local protocols, inability to tracking resuscitation outcomes, and continued inaccessibility by many healthcare providers. Despite these challenges, the IMEGH program is an example of a successful context-relevant model and has potential to inform the design of resuscitation programs in other similar settings. This article describes the development of the IMEGH program, accomplishments as well as lessons learned, challenges, and next steps for expansion.

摘要

在高收入国家,由于引入了快速反应小组、心脏骤停抢救小组以及先进的复苏培训,过去二十年来院内心脏骤停后的治疗效果有所改善。然而,在卢旺达等低收入国家,治疗效果仍然很差。这是由多种因素造成的,包括缺乏足够的复苏培训、培训人员稀少以及设备短缺。为解决这一问题,医学公平与全球健康公平倡议组织(IMEGH),一个由5名当地麻醉师于2018年创立的培训组织,在卢旺达各地的医院定期开展诸如基础生命支持、高级心脏生命支持和儿科高级生命支持等复苏课程。该组织的目标包括建立一个可持续的模式,提供与实际情况相关的复苏培训课程,培养一批当地教员来教授这些课程,以及吸引资金合作伙伴来支持这项工作。从2018年10月到2022年9月,在卢旺达11家医院开展了31期课程,培训了1060名医疗保健提供者(主要是非医师麻醉师、护士、助产士和全科医生)。持续存在的挑战包括缺乏当地的规程、无法追踪复苏结果以及许多医疗保健提供者仍然无法获得培训。尽管存在这些挑战,IMEGH项目是一个成功的与实际情况相关的模式范例,有潜力为其他类似环境下的复苏项目设计提供参考。本文描述了IMEGH项目的发展、成就以及经验教训、挑战和下一步的扩展计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0898/10805636/00ead77b062e/gr1.jpg

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