Three Years of EMSB in Indonesia: A J ourney in Standardizing and Escalating Burn Care in Indonesia (AUSTRALIA - NEW ZEALAND - INDONESIA) Lisa Hasibuan, M D Convener of EM SB Indonesia Indonesian College of Surgeons PRESENTED IN ANZBA ASM 2019, HOBART , 17 SEPTEM BER 2019
Managing severe burn cases is still a problem in many Managing severe burn cases is still a problem in many countries, including our country with population of 270 million countries, including our country with population of 270 million people people Burn care and prevention Need significant is a team activity change Training of staff is critical To achieve better outcome in managing burn injuries 1. SCHEELE F. The art of medical education. FVV IN OBGYN, 2012, 4 (4): 266-269 2. Potokar T, Ali S, Bouali R, Walusimbi M , Chamania S. Training of medical and paramedical personnel in burn care and prevention. Indian J Plast Surg Supplement 1 2010 Vol 43
EMSB I t ’s been st course in I ndonesia Since our 1 ( DECEM BER 2013 )
spesif ic T o insert EM SB course in National Curriculum for General Surgery and Plastic Surgery Training in Indonesia T o provide EM SB course as a Continuing Professional Development Program for practicing general surgeons in are able to perform EM SB standards ? Indonesia To provide 690 health work forces in 2020 who
HOW ARE WE DOI NG ???
EMSB Origin of Participants Institution These are only the institutions, the true origin of participants are almost from all parts of Indonesia
EMSB 1 st EM SB Course 1 st Independent Course (BALI) 2013 2017 2016 2018-now EM SB Course courses are held independently in various (InaPRAS1 st joined) regions of Indonesia INVOLVING 2 COLLEGES : (Bandung, Jayapura, Jogjakarta, dll) ICS & INDONESIAN COLLEGE OF PLAS TIC SURGEONS
EMSB 3 COURSES 5 COURSES 1 COURSE 2016 – August 2019 : (2 provider courses, 1 TtT) (11 provider courses) (16 provider courses) 2019-now 2013 2017 47 provider courses (1102 participants) 2016 2018 2 COURSES 5 COURSES 27 active instructors (2 provider courses, 1 TtT) (15 provider courses, 1 TtT) 9 coordinators
Number of Participants 450 384 375 400 350 300 250 200 261 150 82 100 50 35 0 2013 2016 2017 2018 2019
1102 TOTAL TOTAL P P ARTICIP ARTICIP ANTS ANTS doctors and nurses (until now) (until now) To provide 690 health work forces in 2020 who are able to perform EM SB standards
so we did a lit t le
UL TIM ATE GOAL To provide health work forces competent in early burn resuscitation in all hospitals all across Indonesia
ACE H (5) E AST KALIMANTAN W E ST SUMATE RA (2) (1) CE NTRAL SULAW E SI (1) SOUTH SUMATE RA (1) NORTH SULAW E SI (2) BE LITUNG (1) LAMPUNG (4) BE NGKULU (1) SOUTH SULAW E SI (2) P APUA (4) JAKARTA (4) W E ST JAVA (23) BALI (3) CE NTRAL JAVA (4) JOGJAKARTA (5) E AST JAVA (8) 70 responders of 511 questionaires distributed randomly to our EM SB participants
DISTANCE BETWEEN FREQUENCIES IN PARTICIPANT'S HOSPITAL TREATING SEVERE BURN TO THE NEAREST BURN INJ URY AFTER ATTENDING CENTER EM SB COURSE 1-8 hours 21% < 5 cases in 6 months Never 23% 1% >1 day 6% 5-9 cases in 6 months <1 hour 19% 73% >10 cases in 6 months 57%
ANY EXPERIENCE OF TREATING SEVERE BURN PATIENTS AFTER EM SB? No 18.1% Yes 81.9% In treating severe burn cases Yes No No cases yet Able to identify and manage inhalation 57 (100%) trauma Able to rescucitate 57 (100%) Able to identify the indications and 43 (75.4%) 2 (3.5%) 12 (21.1%) perform escharotomy Able to refer in SPAM and ISBAR format 45 (78.9%) 12 (21.1%)
Changes and improvement in treating severe burn cases after EM SB 40 37 (62,7%) 35 30 25 17 (30,5%) 20 15 10 5 2 (5,1%) 1(1,7%) 0 0 1 2 3 4 5 M ajor changes No changes at all
DIFFICUL TIES IN APPL YING EM SB PRINCIPLES IN PARTICIPANT’S HOSPITAL Anesthesiologist Problem 7% No Other 87% 13% M orphine 3% Too aggressive 2% Distance in referral 1%
Our GOALS To incr ease knowledge and skill f or sever e bur n management in t he f ir st 48 hour s
CONCLUSION EM SB is increasingly known and 1 practiced in Indonesia we have achieved beyond the expected goal The path has been started to have a 2 standardized and qualified burn care all over Indonesia Still many challenges to face : 3 - having every doctors participating in the National Burn Registry, - building a good Burn Referral System and - also educating the people about burn prevention
THANK YOU THANK YOU FOR FIGHTING TOGETHER FOR INDONESIA FOR FIGHTING TOGETHER FOR INDONESIA
Recommend
More recommend
