Thursday, December 8

Third wave preparation West Bengal government to train health workers on kids’ care

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Apprehending that a large number of children could be affected during the pandemic’s third wave, which is expected to strike later this year, the Bengal government has drawn up an elaborate programme — named Training of Trainers (TOT) — for paediatricians who, in turn, will be passing on the skills to medical officers and nursing staff across state hospitals who would be handling such cases.
Since most of the latter group are not trained for the specific purpose, the guidance will help them provide effective and life-saving treatment to children, according to the state health department.
The department has decided to establish 1,300 PICU (paediatric intensive care unit) and 350 NICU (neonatal intensive care unit) beds at its existing Covid facilities, where the trained personnel will be posted. In addition, 10,000 beds where mothers can be treated along with their children are also being earmarked across state-run hospitals.

The training will be held both offline and online in two phases. In the first phase, scheduled to begin on Monday, paediatricians will be trained; in the second, they will be passing on their training to medical officers and nurses across districts, including Kolkata.

Four major areas will be covered: severe pneumonia and ARDS (acute respiratory distress syndrome); shock; central nervous system (CNS) and renal failure; and miscellaneous other treatment. Stress will be given on providing oxygen therapy, devising a ventilation strategy, neonatal CPAP in Covid and general care and monitoring of ventilated patients suffering from severe pneumonia. To deal with children in shock, the training will focus on assessment of paediatric haemodynamic status, cardiogenic shock, apart from management of fluids and electrolytes, among other issues, said sources.
The module on CNS and renal failure will provide training on neuroprotective strategy, blood transfusion in sick children and management of epilepticus. Management of acute kidney injury will also be taught and a list of dos and don’ts for the care-giver will be distributed.

Dibyendu Roy Chowdhury, assistant professor of paediatrics at Medical College Hospital and a member of the expert committee formed to devise and conduct the training modules, warned that children may be affected in large numbers in the coming wave. “We need to spruce up the infrastructure with enough space to accommodate an increased number of beds, equipment like pulse oximeters, ventilators and oxygen delivery devices. The government is in the process of doing this on an emergency basis. Most important is clinical monitoring, taking decisions on that and the skill to take care of children. So, there is a need for all healthcare workers — doctors, nursing staff, technicians and others to have knowledge of critical care service,” he said.

The training is an extremely good step and will help save lives, said IPGMER professor Diptendra Sarkar. “Paediatric care, especially Covid management, is entirely different from that of adults. From the drugs and their dosage to methods of intubation, everything is specialized and needs trained personnel. Since it’s not possible to have so many paediatricians, this is the best possible move,” he told TOI.

Under the miscellaneous training module, healthcare workers will receive training on cardiopulmonary resuscitation, electrolytes, paediatric drug dosage, use of early warning score in emergency and wards, and the skill of communicating with parents.

A distinguished panel of senior teachers from across government hospitals will conduct the training. They will be joined by Jayashree Muralidharan and Arun Bansal from PGIMER, Chandigarh.

RG Kar Medical College head of paediatrics Tapas Sabui, Kalpana Datta of the department of paediatrics, Medical College, with Mihir Sarkar, the PICU in-charge at Medical College Hospital, Uttam Mondal, assistant professor of neonatology, IPGMER, Kolkata and Sumantra Raut of the department of nephrology at North Bengal Medical College and Mihir Sarkar are among the 11 doctors who will act as trainers in the state faculty.

The training modules, according to a health department notification, will be short, ranging from 15 minutes to 30 minutes.

Source: Times of India

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