The child on the gurney inside a brightly lit room in Cayman Islands Hospital emits ragged cries, his chest rising and falling quickly, as a monitor at his feet tracks his heartbeat and blood pressure and beeps ominously.
But this is no ordinary sick child. For one thing, he’s plastic.
The little boy is a dummy, one of several brought by a team of paediatric care experts from across the US who spent last week in Grand Cayman training and teaching local medical staff on the latest techniques, equipment and medications used in emergency child health.
“What we give is simulation training so, as opposed to giving a lecture or standing by a white board and writing, we use these,” said team leader Dr. Marc Auerbach, indicating the toddler-sized dummy on the gurney.
“We can put an IV in, just like we would an actual patient; the eyes open and close, we get the heart rate and blood pressure on the monitor, we can take the pulse … You can listen to heart and lung sounds with a stethoscope; you can make it cough,” Dr. Auerbach said.
The team trained doctors, nurses, emergency medical technicians, anaesthetists, paediatricians, surgeons and other medical personnel who deal with acutely ill and injured children in both the government-run Health Services Authority and the private sector. About 70 medical personnel from Grand Cayman and Cayman Brac took part in the training programme.
The team came to Cayman as part of a project with the R Baby Foundation, a US-based charitable organisation focused on saving babies’ lives through improving paediatric emergency care. The foundation’s founders, Phyllis and Andrew Rabinowitz, were prompted to set up the organisation after they lost their week-old daughter Rebecca in 2006 when she was wrongly diagnosed as having a common cold, but in fact had a life-threatening enteroviral infection.
Dr. Auerbach said initially the plan was to send medical staff from Cayman overseas to take part in the course, but instead it was decided that by sending this team of 11 professionals to Cayman, more healthcare professionals in Cayman could be reached.
“We take high-stakes, low-frequency situations, so we’ve done a drowning patient, a septic shock patient, a seizure patient, severe head injury patient … We do the types of cases that you might see once a year or once every few years and you get hands-on practice as a team,” he said.
Part of training is the teamwork, which emulates what happens in real-life situations in hospitals, “as opposed to sitting one doctor in a classroom or a group of doctors …” said Dr. Auerbach after the first day of classes last Tuesday. “It’s hands on and you see the interaction with the patient. You see [the learners] administer medication and working together trying to decide what to do next as opposed to sitting up there and talking at them. You can figure out what they know and get into their mind-set of how they approach a problem, how they think through something, and see any limitations there may be,” Dr. Auerbach added.
He said staff in Cayman said they saw many of types of cases simulated in the classes several times a year locally, but that most of their training involved the more common types of illnesses and injuries.
The team simulated scenarios involving young babies, older babies, toddlers and children in the course.
Dr. Todd Chang, from the Children’s Hospital of Los Angeles, for example, took one class through a case of a 4-week-old baby with repeated vomiting and stomach issues and the students needed to work out from the symptoms and monitor readings what was wrong with the child. The diagnosis of this case is a relatively rare condition that Dr. Chang says may be seen in larger children’s hospitals a few times a month, but in smaller community hospitals like the Cayman Islands Hospital, it would not present itself frequently. “You many only see it once a year,” he said, emphasising how a simulation course can familiarise physicians with rarer cases like this.
The physicians and nurses on the team come from some of the US’ most prestigious universities and hospitals, including Yale, New York University and the Children’s Hospital of Los Angeles, which is affiliated with the University of Southern California.
The R Baby Foundation became involved in Cayman after the Walkers Intertrust Foundation in Cayman made a contribution to the organisation. Walkers Intertrust got to choose the recipient of the donation and nominated the Health Services Authority.
Local companies, including Cayman Airways, Coconut Car Rentals, Casa Caribe and Comfort Suites, stepped forward to bring the team to Cayman, accommodate them and make sure they were mobile during their stay.
The training programmes were held at the Health Services Authority’s Cayman Islands Hospital in George Town from Tuesday to Friday, 14 to 17 May.