Simulators to Combat Maternal Mortality in Sierra Leone

Simulators to Combat Maternal Mortality in Sierra Leone

One of the world’s most dangerous places to have a baby is the small African nation of Sierra Leone. Maternal mortality rates in Sierra Leone see 1,360 mothers dying per 100,000 live births. This is the highest maternal mortality rate in the world, with countries such as Finland or Greece at the other end of the scale only experiencing 3 maternal deaths per 100,000 live births. The causes of maternal mortality are many and varied but are mainly due to lack of skilled care during pregnancy, during childbirth or in the hours immediately following birth. The World Health Organisation has as one of its Sustainable Development Goals to reduce maternal mortality worldwide to under 70 per 100,000 with emphasis being placed on the countries in Sub-Saharan Africa which have the highest levels of maternal deaths. The recent gift of two medical simulators for spinal injection training by 3B Scientific to the Princess Christian Maternity Hospital (PCMH) in Freetown, Sierra Leone, will help to train the next generation of medical professionals and reduce maternal mortality as a consequence.

Medical simulators: what is an Epidural and Spinal Injection Trainer?

One of the Instructors advising the class how to use the Epidural & Spinal Injection Trainer

One of the Instructors advising the class how to use the Epidural & Spinal Injection Trainer

One of the main difficulties in training anaesthetists and doctors to administer epidural injections into the spinal cavity is that it’s an intricate procedure with a tiny margin of error. Get it wrong and the outcome for your patient could be far less than ideal. Sierra Leone has one small medical school in Freetown but it is poorly resourced, when compared with European and North American schools, and many students study elsewhere in West Africa or Europe. Teaching students to deal with new situations or how to carry out a new procedure is therefore challenging – more so in a part of the world where cadavers are not routinely kept and used for dissection and training. The 3B Scientific medical simulators and trainers solves all of these problems in one simple unit. The simulator is an ultra-realistic back model, which can be used in a variety of ways to train medical professionals working in different areas of Epurobstetrics.

3B Scientific Working with Saving Lives Initiatives

3B Scientific teamed up with the charity Saving Lives Initiatives to deliver training to the first group of anesthetists to use the simulators in Sierra Leone.

Identifying the anatomy of the spine.

On a basic level, the medical simulators can be used to teach anatomy of the spine to nurses, doctors and midwives and the students can poke, prod and touch the model as often as they want, unlike a real patient who is likely to complain. On a more advanced level, the Spinal Injection Trainer can be used to help anesthetists learn the correct epidural technique and this was what the Saving Lives Initiatives tutors taught the group in Sierra Leone. Having more than one simulator allows trainers to adapt their lessons to the needs of the individual group by combining group talks, individual one to one instruction, anatomy lessons and guided practice in whatever way achieves the best learning environment. Teaching with the 3B Scientific Medical Injection Trainer was more effective than other types of training, with all 10 people attending the course performing at an above average level for epidural placement after using the simulators.

Anesthetists learning Epidural Placement Techniques

Anesthetists learning Epidural Placement Techniques

 

 

Why Epidural Is Important in Reducing Maternal Mortality

In the developed world, we may think of epidural as purely a pain-relieving measure. However, there are many other circumstances in which an effective epidural can be lifesaving for both mother and baby.

One of the students receiving one-to-one spinal anatomy tuition

One of the students receiving one-to-one spinal anatomy tuition

Most emergency c-sections are carried out with an epidural or spinal block to manage pain, and the ability to quickly anesthetise your patient and get them into theatre is critical. Furthermore, there is evidence that using epidural in patients who are suffering from pre-eclampsia can reduce the risk of stroke and cerebral bleeding, allowing medics to plan the c-section procedure carefully rather than having to deal with it as an emergency.

In developing countries, where midwife and ante-natal care is patchy and a woman may not even be aware that she has pre-eclampsia until it reaches an advanced stage, this ability to use epidural to minimise risks could have an enormous impact on maternal mortality rates.

Between 1990 and 2015, maternal mortality rates worldwide dropped by 44%. Sadly, around 830 women every day are still dying in childbirth but skilled training with these advanced Epidural and Spinal Injection Trainers will help to deliver a reduction in maternal mortality rates even further.

 

 

 

 

Sources:
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html
http://www.who.int/news-room/fact-sheets/detail/maternal-mortality
http://www.cochrane.org/CD009540/PREG_epidural-therapy-severe-pregnancy-induced-hypertension-reduce-morbidity-and-mortality-mother-and

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