KEY ACHIEVEMENTS
Below is a selection of my key achievements from the past few years:
- Front Line Resuscitation in LMIC In response to the frequent poor resuscitation outcomes for children in clinics and the transport setting, I created a several training programs. I created the materials and employed combinations of teaching methods, such as: lectures, group-work, practical demonstrations, videos and hands-on practice of skills for participants. Elements of competency-based simulation testing of staff in resuscitation teams (nurses, paramedics and doctors together) was incorporated. I have run pilot courses for frontline staff as well as Train-the-Trainers courses - for my own courses as well as others (e.g. WHO ETAT, India Pediatric Resuscitation & Emergency Medicine (PREM)). My goal has been to provide nurses, pre-hospital personnel and junior medical staff with practical clinical knowledge and skills, utilizing only the limited resources available to them. The aim being to help them safely manage critically ill children at lower levels of care, whilst they are awaiting transport (can take many hours).
- “Time = Brain Pathway” implemented for Hypoxic Ischemic Encephalopathy (HIE) – treatment for this devastating neurological condition in newborn babies is acutely time-sensitive: babies must receive brain-cooling therapy within 6 hours of birth. The pathway I introduced led to a reduction in the number of complaints about babies missing HIE cooling deadlines due to transport delays by the end of 2018. An active surveillance system was initiated in 2019 whereby cases of transport related delays to cooling of HIE babies would be reported for investigation.
- “Stop babies dying in ambulances” created critical care retrieval team Specialised Paediatric Retrieval Including Neonatal Transport ‘SPRINT’ team – in 2016 I was asked by WC EMS Director to ‘stop babies dying in our ambulances’. I developed a dedicated paramedic team, fought for world-class transport ventilators and monitoring equipment, initiated multi-modal training program and collaboratively created criteria for SPRINT callout. I also initiated non-invasive ventilation (nCPAP & HFNC) during transport of children. Driving development of data and service indicators not just for SPRINT but for all EMS child transports.
- Popular Paediatric Emergency Medicine Guidance & App – Passionate about need to provide clinical support for junior doctors in LMIC I have been the editor of a very popular PEM Guidance (PEMG) book & App for low-resource settings from 2010 to date. Hosted on hugely popular, "Essential Medical Guidance" - an award-winning free app, with over 32,000 users in Africa, with up to 3,500 views per week in the 2018-2019 period. The PEMGs are amongst the most viewed of all guidelines and are used by doctors all over Africa. See link below for data on PEMG usage.
- ETAT-SA - chaired the National Department of Health ETAT-SA Working Group which adapted the World Health Organization (WHO) Emergency Triage Assessment & Treatment (ETAT) guidelines for use in South Africa to produce ETAT-SA, the triage system used in many provinces of South Africa. [Reference: Emergency Triage Assessment and Treatment SA (ETAT-SA) Manual for Participants with SA Adaptations. Cheema B, Stephen C. 2014 ISBN 978-0 620-48904-1]
- P-SATS co-chaired (with Dr Michelle Twomey) the provincial technical workgroup that adapted the South African Triage Scale (SATS) child component. Two year process involved combining ETAT-SA with SATS. To produce revised Paediatric-SATS (P-SATS) - the triage system used in Western Cape province of South Africa. https://emssa.org.za/wp-content/uploads/2011/04/SATS-Manual-A5-LR-spreads.pdf
- WHO Pocketbook of Hospital Care for Children, South African National Department of Health Adaptation, 2016 - I adapted-authored Chapter 1: Triage & Emergency Conditions in the SA Adaptation of this WHO resource. See https://www.health.gov.za/wp-content/uploads/2023/04/POCKET-BOOK-OF-HOSPITAL-CARE-FOR-CHILDREN-2016.pdf