It's 6:30 a.m. At Mulago Hospital in Kampala the shift on the ambulance has only just begun. The emergency call comes in from a hospital 330 km away from the city. They have a patient who needs to be taken to ICU urgently. She's having difficulty breathing. Proper care is no longer possible. The patient has to go to another hospital. Mulago Hospital is better equipped to deal with such a case. The ambulance has a transport ventilator that can be used to care for the patient en route. The rescue team is already familiar with such assignments. But this time everything is a bit more fraught. The patient is a young girl: Aminata. She's only 16 years old.
Not enough ventilators in Uganda
People who die at the scene of an accident. People who wait on help for hours. Such situations are part of everyday life in Uganda. It is one of the countries with the highest number of traffic fatalities in the world. One of the reasons for this is their prehospital emergency care. First, it has too few trained personnel. Second, there is insufficient medical equipment.. Above all there is a shortage of ventilators, with the need for them being particularly driven by the Corona crisis.
A problem that Dr. Annet Alenyo, an emergency response doctor and Technical Advisor for Emergency Medical Services, knows all too well: “During the second wave we had lots of patients who needed to be ventilated. Most COVID patients could be saved with CPAP ventilation. But there are only a few ambulances and hospitals offering such ventilation. This means that some patients have to be transported from one place to another for hours on end to have a chance of CPAP therapy. And that takes time, something many patients don't have.”
Efficient, versatile ventilation with MEDUVENT Standard
Given the lengthy transport times, the most important ventilators in Uganda are those which operate independently of oxygen. This allows the emergency medical services to ventilate patients even with long transport times. Dr. Alenyo and her colleagues have been using MEDUVENT Standard for around 11 months. Turbine technology enables them to ventilate their patients without an external gas supply, so reducing the risk of a lack of oxygen. The EMS team can easily administer medical or concentrator oxygen to patients via the low-flow supply. “Ventilators from WEINMANN Emergency are a huge help to us”, says Dr. Alenyo. “Above all the ease of use and straightforward application make ventilation simple for the user.
The oxygen connection is compatible with all emergency vehicles – this benefits patients who depend on constant ventilation during transport. For example, we had a patient whose condition showed a marked improvement after being ventilated with MEDUVENT Standard”.
Ventilators must be easy to understand
But it isn't just patients who benefit from mechanical ventilation, users do too. Dr. Alenyo's team quickly learned how they had to ventilate their patients with MEDUVENT Standard. “Many of the nurses hadn't ever ventilated a patient and were therefore afraid of doing something wrong”, she says. “They are meanwhile so experienced in this that other hospitals now even ask them for assistance.” In addition, they can already get started with ventilation before a doctor has arrived. This means the patient receives help quickly, and the doctor can immediately embark on other important examinations.
Hygienic reprocessing should not take too long
Ventilators need to be cleaned after every use, and users have to carefully treat the devices concerned, particularly if any infectious disease is suspected. “We naturally can't use the ventilator during this time. This is a problem that's not easy to solve. Hygienic reprocessing is an operation we can't dispense with”, remarks Dr. Alenyo. MEDUVENT Standard features an easy-to-replace hygiene filter to protect patients, staff, and the device from contamination by viruses or bacteria. “This lets us at least save a bit of time, since we only have to replace the filter after a ventilation period of 24 hours.”
Emergency care in Uganda must become better
Aminata made it. The ambulance brought her to ICU in Kampala with non-invasive ventilation. CPAP therapy meant she got enough oxygen so the doctors didn't need to intubate her. “This isn't a matter of course. We have far too few ventilators. If a patient is at the wrong place at the wrong time, things can then turn out quite differently. CPAP therapy would save many people's lives. Far more hospitals and ambulances in Uganda therefore need ventilators that make this type of ventilation possible”, is the wish of Dr. Alenyo.