list of participants...ptc course karachi, pakistan november 2005 7 course instructors the course...

PTC course Karachi, Pakistan November 2005 1

Primary Trauma Care Foundation and Instructors Course Dow University of Health Sciences

November 11 to 13, 2005

Executive Summary

• The Vice Chancellor of the DUHS Professor Masood Hameed and the Incharge of the CME Dr Rana Qamar requested the PTC Sindh to organise the PTC course in DUHS. Professor Rashid Jooma and Dr Shariq Ali after discussion and detailed consultation agreed to organise this course.

• A joint precourse strategy meeting took place between PTC Director Dr Shariq Ali and the organising committee of the DUHS including Directors of Centre for Skills Development, Dr Khalid Siddiqui and Dr Salim Ilyas. Dr Rana Qamar and Dr Shams Alam Nadeem was also present during the meeting which took place in the CME room of DUHS.

• The Course Director, Dr Shariq Ali was briefed by Dr Khalid Siddiqui, Dr Salim Ilyas and Dr Shams Alam Nadeem, who was appointed as the Course coordinator for this DUHS course, about the selected 30 participants for the Provider course, consisting of surgeons and anaesthetists, mainly from the Civil hospital, Karachi. Dr Shariq expressed his concern about the larger than usual number of participants. The list of the doctors for the Instructors course was also finalised, from Civil Hospital, from Liaquat University of Medical and Health Sciences, from Abbasi Shaheed Hospital and from Aga Khan University Hospital, Karachi. Various matters with regard to the inauguration session and logistics were also discussed.

• A twoday PTC founding course, followed by a oneday instructors’ course were run.

• The Inaugural session of the course was presided over by the Vice Chancellor of the Dow University of Health Sciences, Professor Masood Hamid.

• It was a comprehensive session around the important issue of trauma. Session started by recitation of Holly Quran by Dr Saleem Marfani. Various speakers included Professor Masood Hameed, Professor Rashid Jooma, Dr Khalid Siddiqui and Dr Shariq Ali. The session was also attended by the MS of Civil Hospital Dr Kaleem But and many professors and students of DUHS, This session provided an opportunity to highlight the importance of trauma care providers training in front of the members of the media and a wider audience.


Purpose of the Course

• To introduce and teach the concepts and principles of PTC to the consultants and trainees of DUHS and to complete the Instructors day for the previous course participants from LUMHS, ASH and AKUH.

Background The present course at DUHS was the result of repeated requests by the DUHS officials to the PTC team at the level of the PTC Director and then to the Chairperson. PTC course calendar was then rescheduled after the advice of the Chairperson. Dr Shariq Ali as the Course Director visited the venue and met with the DUHS officials twice to ensure the practicalities and arrangements for the execution of this course.

Every effort was made to learn from the experience of the previous courses and to maintain the appropriateness of this trauma course in accordance to the needs of the DUHS. It was kept in mind that the level of course should not be an exhaustive exploration of clinical trauma but to remain focused on the ABCDE of resuscitation. The format and contents of the lectures, small group discussions and the skill stations were kept realistic with the appropriate models and equipments.

An effort was made with the help of frequent communication through emails to convince the hosts to recruit broad base and multidisciplinary interest with appropriate number of doctors on board. Unfortunately, on the day of the course, it was disclosed that the number of participants were more than twenty.

Key staff involved in PTC DUHS November Course

Dr Shariq Ali, the Course Director was actively involved with the Chairperson Professor Rashid Jooma and other members of the team to organise this course. Dr Shams Alam Nadeem, Dr Khalid Siddiqui and Dr Salim Ilyas of Dow University played an important role to make this course a success. It was attempted to involve mainly the DUHS instructors from the previous courses to instruct for this course. The Manikins, some of the equipment, IT support, venue, meals, refreshments and digital imaging facilities were provided by the DUHS. Manuals and other printed material including MCQs, Evaluation forms, Certificates, registration slips etc were arranged by both i.e. DUHS and PTC Sindh.

Dr Shariq Ali, kept regular contacts through emails with Professor John Beavis, the founder of the IDEALS, UK, as well as with Dr Douglas Wilkinson, The International PTC Chairperson based at Oxford, about this course and received regular encouragement and support for which he is thankful. Professor Rashid Jooma also contributed and was very actively involved in some aspects of the course. The support of these committed, high calibre and respectable figures to the Course Director was immense and remarkable.

Overall Timetable

Friday 11 th November Inaugural session and 1 st day of PTC foundation course. Introduction of PTC to medical students, health officials, media and most senior specialists

Saturday 12 th November 2 nd Day of PTC Foundation Course. Sunday 13 th November PTC Instructors Course for LUMHS, DUHS, Abbasi Shaeed

Hospital and AKUH.


Although there were a large number of audience present during the inaugural session but 30 (unfortunately more than usually recommended) registered senior doctors attended the two days of the Foundation PTC course. On the third day, it was a mix of 31 doctors from DUHS, LUMHS, ASH and AKUH who attended the instructors’ course with great enthusiasm. There was a balanced mix of anaesthetists and surgeons of various specialties. These had been selected by the course organising committee of DUHS. The names of the participants are listed in full below.

List of Participants 11th & 12th November 2005 (Providers Course)


13 th November 2005 (Instructor Course)


Course Instructors The Course instructors were: § Professor Rashid Jooma, Professor and Head, Neurosurgery Department at JPMC, Karachi,

Pakistan. § Dr Shariq Ali, Asst. Dean & Consultant Plastic Surgeon, Ziauddin Medical University,

Karachi, Pakistan. § Dr Saeed Minhas, Asst. Professor & Consultant in Orthopedic Surgery, JPMC, Karachi,

Pakistan. § Dr Noor –ulHaque, Asst. Professor and Consultant Anaesthetist, ASH, Karachi, Pakistan. § Dr Shams Alam Nadeem ( DUHS Coordinator), Assistant Professor of Surgery, DUHS,

Karachi, Pakistan. § Dr Jamil Akhter, Consultant in Anaesthesia, DUHS, Karachi, Pakistan. § Dr Safia Zafar, Consultant in Anaesthesia, DUHS, Karachi, Pakistan. § Dr Bushra Shirazi, Asst. Professor and Consultant General Surgeon, ZMU, Karachi,

Pakistan

Contents and Venue of the Foundation Primary Trauma Care Course The subjects which were presented during the founding PTC course are outlined in the program. Course content was similar to what is advised in the PTC manual. The instructors used different styles of lecturing and different audiovisual aids, like PowerPoint, whiteboard and group discussion.

The venue in DUHS Centre for Skills Development was a comfortable, airconditioned lecture hall, with excellent audiovisual aids like a digital projector, an overhead projector (not used), a whiteboard and a cordless microphone. The hall was large enough to accommodate all the participants. Besides, we could make use of several spaces on the same floor for scenarios and workshops.


Course Program PRIMARY TRAUMA CARE

2 Days PTC Provider and 1 day Instructors Course

Day 1 November 11, 2005

TIME TOPIC INSTRUCTOR ( SESSION OPEN TO ALL)

9:00 a.m. Bismillah & Welcome Dr Khalid Siddiqui

9:05 to 9:20 a.m. Opening Remarks Prof Masood Hameed, VC DUHS

9:20 to 9:35 a.m. Faculty Introduction & PTC in Pakistan Prof. Rashid Jooma

9:35 to 9:45 a.m. PTC, Course Overview Dr Shariq Ali 9:45 to 10:00 a.m. Local Trauma Perspective Prof Younus Soomro

10:00 to 10:25 a.m. ABCDE of Trauma and Primary Survey Dr. Shariq Ali

10:25 to 10:40 a.m. Demo. Scenario and Q&A Dr.Shariq, Dr. Nur, Dr Shams

10:40 to 11:00 a.m. BREAK (SESSIONS FOR REGISTERED PARTICIPANTS ONLY )

11:00 to 11:25 a.m. Airway and Breathing Dr Jamil Akhter 11: 25 to 11:50a.m. Circulation & Shock Dr.NurulHaq

SKILLS STATION 1. Basic Airway Dr Safia Zafar / Dr. Nur 2. Advanced Airway Dr Zahid Selod / Dr Jamil 3. Radiology of C Spine Dr Shariq Ali

11:50 to 1:10 p.m.

4. CSpine control and Log Roll Dr Shams/Dr Saeed

1:10 p.m. to 2:15 p.m. JUMA PRAYERS & LUNCH BREAK 2:15 to 2:35 p.m. Secondary Survey Dr Shariq Ali 2:35 to 3:35 p.m. Primary Survey Scenarios PTC Team 3:35 to 3:50 p.m. Chest Injuries Dr Shams Nadeem Alam 3:50 to 4:00 p.m. Overview and Summary


Day 2 November 12, 2005

TIME TOPIC INSTRUCTOR

8:30 to 9:00 a.m. Burns Dr. Shariq Ali

9:00 to 9:15 a.m. Abdominal injuries Dr. Shams Nadeem Alam

9:15 to 9:35 a.m. Limb injuries Dr. Saeed Minhas

9:35 to 10:00 a.m. Head and Spinal Injuries Prof. Rashid Jooma

10:00 to 10:15 a.m. TEA BREAK

10:15 to 10:45 a.m. Disaster management Dr Shariq Ali

10:45 to 12:15 p.m. WORKSHOPS

Analgesia Dr. Nur/Dr Safia

Triage Dr. Shariq Ali

Trauma Registry Dr Saeed/ Dr Jamil

Transportation Dr Shams/Dr Zahid

12:15 to 12:45 p.m. LUNCH BREAK

12:45 to 1:15 p.m. Paediatrics and Obstetrics Dr. Saeed Minhas

1:15 to 2::15 p.m. SKILLS STATIONS

Pelvic Sling Dr Shariq/Dr Jamil

Chest Drain Dr Saeed/Dr Zahid

Extrication of Helmet Dr Nur/Dr Safia

Neurological Assessment Dr Shams Nadeem Alam

2:15 to 2:45 p.m. MCQ's

2:45 to 3:45 p.m. Secondary Survey Scenarios PTC Team

3:45 to 4:00 p.m. Provider Certificate Distribution VC DUHS / Prof. R. Jooma


Day 3 November 13, 2005 (Instructors Course)

TIME TOPIC INSTRUCTOR

9:30 to 9: 40a.m. Introduction and Objectives Prof. Rashid Jooma

9:40 to 10:00 a.m. How adults Learn Dr. Shariq Ali

10:00 to 10:15 a.m. Asking Questions Dr. Bushra Shirazi

10:15 to 10:30 a.m. Feedback Dr Saeed Minhas

10:30 to 10:45 a.m. How to Give a PTC Presentation Dr. Shariq Ali

10:45 to 1100 a.m. TEA BREAK

11:00 to 11:15 a.m. Discussion Group Dr Shariq Ali

11:15 to 11:30 a.m. Teaching a Skill Dr Shams Nadeem Alam

11:30 to 11:45a.m. Scenario Dr Saeed Minhas

WORKSHOPS

Discussion Group/Lectures Dr Shariq/Dr Jamil Dr Bushra/Dr Safia

Teaching a Skill Dr Nur/Dr Shams

11:45 to 1:30 p.m.

Scenario Dr Saeed/Dr Zahid

1:30 to 2:00 p.m. Lunch & Certificate Distribution

Vice Chancellor DUHS & PTC Chairperson


Centre for Skills Development

Dow University of Health Sciences, Karachi In collaboration with

PRIMARY TRAUMA CARE SINDH GROUP

Instructor course, Sunday 13 th November 2005 Following the 2 day PTC course selected participants from DUHS, LUMHS, ASH and AKUH proceeded to take part in the PTC instructor course, which was Directed and convened by Dr Shariq Ali. This used the recently finalised PTC instructor materials and a programme based on that in the Instructor manual, with presentations in the morning by Professor Rashid Jooma, Dr Shariq Ali, DrSaeed Minhas, Dr Shams Alam and Dr Bushra Shirazi. Following this the course split into four groups and did practical sessions ran by all presenters and Dr NoorulHaque, Dr Jamil Akhter and Dr Safia Zafar on giving a lecture, teaching a skill, leading a discussion group and running a scenario. The day finished with a feedback session. This was followed by a discussion on the practicalities of running further courses.

After the course

The course was closed by Prof. Masood Hameed, who thanked all the participants for their hard work and dedication. He thanked the faculty for their assistance in running the course. Following that the certificates were handed over to the participants by him alongside Dr Shariq Ali, Director PTC.

Notes on delivery of the Course and lessons learnt

• Unfortunately we did not manage to control the number of participants within the recommended constraints as there was an uncontrollable enthusiasm for this course. The first day of the foundation and inaugural session was started and finished in time. Some components of the course contents needed to be rushed, which is not desirable. Time keeping was mostly satisfactory but some speakers took longer than allocated time.

• Different presentation styles were used during the Foundation course and instructor day to provide modelling for future courses, many of which will be taught in locations without complex AV equipment.

Evaluation of the success and relevance of the course

Remarks made by the participants on the evaluation forms and during the evaluation session were favourable. In general the course was much appreciated; however, the participants would value more frequent courses and more time for skills stations.

Multiple Choice Questions


During the first and then the last day of the PTC course the participants were asked to fill in the MCQ’s, which appear in the instructor’s manual. These were used for motivational purpose and self evaluation was encouraged.

Media coverage Following is the text of the media coverage. Substantial media coverage was provided by Daily Dawn and Jang, the local newspapers in Pakistan.


Teaching materials provided Each member of the Foundation Course were presented with a copy of PTC Provider and a copy of Instructors manual, these having been provided by DUHS and PTC Sindh. Although the OHP’s were not used in teaching the course, the instructors were encouraged to use OHP’s as well, since the District hospitals will often not have facilities for PowerPoint.

Acknowledgements Once again, acknowledgements goes to Professor John Beavis and his IDEALS Charity , Dr Douglas Wilkinson, The Chairman of International PTC Foundation and Professor Rashid Jooma, the Chairperson of PTC Sindh for their continuing support to these courses. Without this support, it is not possible for Dr Shariq Ali to conduct these activities so frequently. Dr Shams Alam Nadeem, Dr Khalid Siddiqui and Dr Salim Ilyas were instrumental in facilitation of the program, and we are indebted to them. All the local arrangements were done by the team of Centre for Skills Development, DUHS. The whole team did an outstanding job to make this course a success. We would like to thank Lodox, Meximp for providing lunch for the instructors course. We would like to express our gratitude to the staff of DUHS for the catering and also for audiovisual support.

Finally I would like to thank my fellow instructors Dr Saeed Minhas, Dr NoorulHaque, Dr Shams Alam, Dr Jamil Akhter, Dr Safia Zafar and Dr Bushra Shirazi for their invaluable input during the course. The course would not have been such a success if it were not for them.

Dr Shariq Ali FRCS Director PTC Sindh

PTC National Coordinator Asst. Dean and Consultant Plastic Surgeon

Ziauddin Medical University Karachi, Pakistan

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