Global Emergency Medicine Fellowship Update April 2023
San Fernando General Hospital Campus; University of the West Indies Emergency Medicine.
Finally! After 3 years and a global pandemic, the long-planned return to San Fernando, Trinidad became a reality in March 2023.
The San Fernando Emergency Medicine Residency program and Department of Emergency Medicine is thriving despite the impact of COVID 19, in which not only patient volumes caused great uncertainty, but also in loss of staff and physicians to the disease. Our deepest condolences for their losses are with this resilient team of professionals.
Our ongoing projects that began back in 2018 in quality of care, department flow and triage processes have significantly improved patient care and throughput times and remain a mainstay of the department care model and our collaborative projects continue to advance. Some adjustments had to made during the highest COVID volumes to keep respiratory/contagious patients separated from the nonviral population in controlling the spread of the disease, including outdoor ventilated triage and treatment tents, modifications to exterior doors to allow separating critically ill patients with COVID from exposing others for transport to advanced imaging areas and critical care needs. Their creative approach is truly inspirational given the fact the physical plant was built in the 1860s with updates along the way.
On this most recent visit, the department has successfully created an ED MD workspace next to triage that functions as a fast track/vertical care outlet with great success. They have also created a vertical care area that functions similarly to an urgent care center and is staffed by the ministry of health clinic physicians who see this population regularly. This has also freed up the ED MDs appropriately to attend the MTA and critical care areas.
Vertical Patient Care Station Next to Triage/Registration
Sandhya Springer, PA-C, who is a Trinidad native - born and raised - prepared a very well received presentation of triage processes, and a case-based demonstration of triage models. This was requested by the ED attendings, as this is a difficult area for the nurses because the ministry of health assigns hospital nurses and rotates them through different departments. The audience included nurses on all wards and areas of the hospital, and most had never been exposed to ED triage, but will be assigned. This was presented not only at San Fernando, but also for other regional authority hospitals and freestanding emergency clinics. Way to go Sandy!!
Sandyha Springer PA-C with Nursing Teams on ED Triage
Our EVMS EM home team also participated in this 5-day collaborative, with Zoom platform lectures for the residents and consultants on The Care of the Critically Ill Patient by Anya Cipi MD, Ultrasound in the Critically Ill Patient by Matt Jones MD, and The Care of the Critically Ill Child by Dr. Alexandra Leader Pediatric Emergency Medicine. These were well attended and exceptionally well received! One resident shared a selfie with his 3-year-old daughter on his lap, participating in Dr. Leader’s PEDs lecture- next generation of EM Docs coming in! Thanks to all!
The transition from paper records to an electronic medical record has been a challenging situation that is currently underway at San Fernando General. I specifically worked with the administrative and physician interest team to identify areas where the existing electronic medical record could be streamlined to be more user-friendly for the physicians and this collaborative effort is ongoing remotely.
The leadership of our San Fernando colleagues, Dr. Rico Narayansingh, Dr. Reeta Moonsar, Dr. Saleem Varracchia, Dr. Robin Sinanan, Louann RN, Susan RN, and ED Manager Krystal Richardson is strong and steady.
Overall, together we were able to identify and address many needs of the ED team on the ground in San Fernando, and is as is the usual case, we all learned much more from each other than we could ever teach. These opportunities truly reignite the joy of emergency medicine!
Carol McCammon, MD, MPH, FACEP
Program Director, Global Emergency Medicine Fellowship
Associate Professor of Emergency Medicine