Maphunziro abwinobwino operekera pachipatala osamalira odwala omwe samalandira madokotala
Kufikira chisamaliro chamankhwala apamwamba kwambiri m'maiko otsika ndi ochepa (LMIC) kukuchepa. Point-of-care ultrasound (POCUS) ili ndi mwayi wokulitsa chisamaliro chodzidzimutsa mu LMICs. Maphunziro akutali kwambiri ndiye chinsinsi.
MALO idaphatikizidwa mu pulogalamu yophunzitsira ya gulu la anthu khumi osagwiritsa ntchito dokotala Emergency Care Provives (ECPs) kumidzi yaku Uganda. Tidayesa kuyang'anira kuunika kwakutali, kuwunika mwachangu kwa maphunziro a POCUS pazolinga zoyambirira za ECP ultrasound ndi cholinga chachiwiri cha kugwiritsidwa ntchito kwa ultrasound. Kafukufuku wokhudza maphunziro akutali adagawika magawo anayi kupitilira miyezi 11: mwezi woyamba wophunzitsira, miyezi iwiri yapakatikati pomwe ECPs idachita maulasite popanda kudziwitsa pakompyuta, komanso miyezi yomaliza pomwe ECPs idachita molakwika ndi mayankho akutali .
Ubwino udawunikidwa pamiyeso eyiti yojambulidwa kale ndi sikelo yotsogolera yaku US ndikuwunika mwachangu kunaperekedwa kwa ECPs ndi antchito am'deralo. Kuzindikira ndi kuwonekera kwa zomwe zapezeka pakuyesa kwa ma ultrasound a Focuse Test nayo Sonography for Trauma (FAST) anawerengedwa.
Maphunziro akutali kwambiri: kuyambitsa
Kufikira chithandizo chamankhwala chapamwamba kwambiri m'maiko otsika ndi ochepa (LMICs) ndizochepa, ngakhale kuyitanidwa kwaposachedwa kwambiri ku 2007 ndi WHO. Kuphatikiza apo, mayiko awa akukumana ndi gawo lalikulu la kuchuluka kwa matenda padziko lonse lapansi; kuchuluka kwaimfa ya ana, mwachitsanzo, nthawi zambiri 10 kupita ku 20 nthawi zambiri mu LMICs kuposa mayiko omwe amapeza ndalama zambiri.
Zambiri zimathandizira pakuchepa uku kusowa kwa chisamaliro, kuphatikizaponso kusowa kwa othandizira aluso. Sub-Saharan Africa imakumana ndi 25% yakulemetsa kwamatenda padziko lonse lapansi ndi 3% yokha ya ogwira ntchito azaumoyo. Kuti athane ndi kuchepa uku, mayiko ambiri agwiritsa ntchito njira yotchedwa "kusintha ntchito" momwe maluso ndi maudindo amagawidwira m'njira zatsopano pakati pa mabungwe omwe akuwapatsa chithandizo komanso ma cadre atsopano amapangidwa.
Kuchepa kwa akatswiri aluso pazosowa zopanda mphamvu izi nthawi zambiri kumachulukitsidwa ndi kulumikizidwa kwa zida zaumisiri, kuphatikiza ukadaulo woganiza. Mawonekedwe onyamula, opakidwa ndi manja ndiwotsika mtengo, osavuta kutumiza komanso ogwiritsa ntchito malo omwe njira zapamwamba zodziwira matenda sizipezeka. Maphunziro okhazikika mwachangu a gulu lazachipatala lomwe siliri madokotala mu point-of-care ultrasound (POCUS) munthawi yolimba komanso yokhazikika motero ali ndi kuthekera kokukhudza kwambiri kutumiza kwa chisamaliro mu ma LMIC.
Kafukufuku wakale adawonetsa kuti asing'anga othandizira amatha kuphunzitsidwa kuti azigwira ntchito modziyimira payekha mu luso lofunikira pakusamalira mwadzidzidzi. Kugwiritsa ntchito kwa POCUS ndi asing'anga ku LMICs kuli kale ndi zotsimikizika pakuwongolera odwala, monga kusankha chithandizo chamankhwala opangira opaleshoni kapena kusintha madongosolo othandizira.
Maphunziro akutali kwambiri - Pali kafukufuku wocheperako yemwe amafufuza kuthekera kwa omwe asing'anga azachipatala omwe amapereka chithandizo chodzidzimutsa mu LMICs kuti aphunzire POCUS ngati cholowera chisamaliro chokhazikika. Robertson et al. adalongosola kugwiritsidwa ntchito kwakanthawi, koona kwa nthawi ya FaceTime kuphunzitsa ndi kuyang'anira POCUS ndi omwe sanali madokotala ku Haiti ndi Levine et al. adawonetsa kuti zithunzi za FaceTime pakuwunikira kwa telefoni sizotsika poyerekeza ndi zomwe zidagwidwa pamakina a ultrasound. Mpaka pano, palibe chilichonse chosindikizidwa chofotokoza kugwiritsa ntchito tele-kuwunika kugwiritsa ntchito POCUS kugwiritsa ntchito ndi luso kwa omwe si madokotala a LMICs.
Pachikhalidwe, maphunziro a ultrasound a othandizira amachokera ku maphunziro amodzi kuyambira masiku awiri mpaka masiku awiri mpaka maphunziro amodzi a chaka chimodzi. Magulu ena apeza kuti popanda kupitiliza kuthandizira, magawo ophunzitsira mwachidule samapereka luso kupitilira. Komabe, kuphunzitsira kuyang'ana mwachindunji kwa munthu m'modzi pafupi ndi bedi kumatha kukhala kopanda mphamvu pazida za LMIC, makamaka ngati kuyang'anira kumaperekedwa ndi akatswiri omwe siam'deralo omwe akupita ku LMIC makamaka kuti akapereke maphunziro. Apa tikufotokozera chida chothandizira pophunzitsira kuti chikhale "mwachangu,", kutsimikizika kwamaudindo komanso mayankho kwa gulu la asing'anga madera akumidzi aku Uganda komanso momwe lingathandizire popitiliza maphunziro ndikusungira maluso a POCUS.
Kuyambira 2009, asing'anga othandizira adotolo adaphunzitsidwa pachipatala cha zigawo kumidzi yaku Uganda, omwe adalandira pulogalamu yotchedwa Emergency Care Practitioners (ECPs). Kukhazikitsidwa kwa zipatala ndi pulogalamu yophunzitsira ikufotokozedwa mwatsatanetsatane kwina POCUS idaphatikizidwa ndi maphunziro omwe amapatsidwa mwayi wochepa wothandizira pazowonera radiology. Tidayesa kuyang'anira kuunika kwakutali, kuwunika mwachangu kwa maphunziro a POCUS pakugwiritsira ntchito kwa ultrasound ndi luso mu gulu la anthu khumi a ECPs.
Maphunziro akutali kwambiri - Njira
Kukumana konse kwa odwala kudakonzedwa mwachidziwikire kukhala mndandanda wazidziwitso zamagetsi zamagetsi. Zomwe zinasonkhanitsidwa zinaphatikizapo madandaulo akulu, zidziwitso za anthu, kuyesedwa kapena kuchita (kuphatikiza ECP POCUS), zotsatira ndi malingaliro. ECPs idapeza zithunzi za ultrasound ndi Sonosite Micromaxx (Bothell, WA) pogwiritsa ntchito 2-5 mHz curvilinear transducer, 6-13 mHz linear transducer, kapena 1-5 mHz phr-transducer X.
Pogwirizana ndi maphunziro akutali kwambiri, monga gawo la kafukufuku wofufuzira, zidziwitso pa ultrasound yomwe yachitika, zojambula za sonograph ndi matanthauzidwe oyambilira zinajambulidwa ndi ECPs kenako ndikuziika mu pulogalamu yapa intaneti yopangidwa ndi mmodzi mwa olemba (* *) chifukwa cha chitsimikizo chakutali. Kuwunikira kwa chithunzithunzi kunachitika kutali ndi asing'anga aku US omwe ali ndi maphunziro othandizirana ku POCUS. Mayankho mwatsatanetsatane adatumiza imelo kwa antchito ofufuza am'deralo omwe adasindikiza ndikugawa ndemanga ku ECPs.
Cholinga chathu chachikulu chinali ndi kusintha muyezo wazophunzitsira kwakanthawi (kutanthauzira ndi kupeza kwa zithunzi). Cholinga chathu chachiwiri chinali ndi kugwiritsa ntchito kwa ultrasound. Ma Ultrasound ochitidwa mwaokha mwa kuyendera madokotala sanathere. Ntchitoyi idavomerezedwa ndi Institutional Review Boards of [odziwika] ndi [odziwika].