Training is OVER!

I cannot BELIEVE how fast the Emergency Training week went!  Today was our last day and most exciting day...in my opinion.  We trained them in CPR, spinal immobilization, triage, holistic healthcare, intubations, respiratory emergencies, and strokes then allowed them to put it all together with a double drill today!  We did an explosive fire drill inside the hospital for the hospital doctors and nurses to practice with and then a car accident outside for the ambulance doctors, nurses, and drivers to practice with.

I did the makeup for the victims in each of these drills.....and it turned out REALLY realistic and pretty cool!  We put bruises, cuts, blood, etc on the victims and gave them scenarios to play out.  Then we put them in positions and started the "fire" and the "car crash."  Then we sat back and watched...took notes...and gave them feedback when it was over.

I mostly stayed outside to watch the ambulance staff work.  The ambulance doctors, nurses, and drivers are not fully trained like the paramedics and EMTs in America.  They are allowed to do very little for the patient other than transport which is the root of many problems in Mongolia.  Because of traffic in a city that has 1.5 million people in it and provides healthcare for the entire country, it takes ambulance drivers sometimes over an hour to reach a patient call and to transport them back to the hospital if necessary.  If they aren't trained or legally allowed to perform tasks necessary to stablize patients, then that patient has a high likelyhood of dying!  We gave some training to the ambulance staff but until policy changes in Mongolia there is not much more we can do.  Still, the ambulance staff are incredibly intelligent and eager to learn.  They can and want to do more for their patients so it was very exciting to watch them work.  You could tell that they felt like they really had something to prove to everyone else.  They did an amazing job and had a lot of fun during the drill.

When the ambulance drivers drove their victims to the emergency room, I got to see what the inside drill was like.  The ambulance drivers handed their patients over so that the emergency room doctors and nurses now had an overload of patients and had to deal with the disaster scenario.  They did not do as well as I had hoped however.  They were not used to that number of patients and were not comfortable delegating.  Patients were forgotten and doctors tried to do everything themselves.  This is once again a problem with policy in Mongolia because nurses are not allowed to do half the tasks nurses in America do for doctors everyday.  Thus a nurse will sit with a critical patient, not allowed to do much to help them, until the doctor has time to come and see that patient.  It makes for an inefficient system and at times of disaster, I confused and ineffective system.

So hopefully our training helped them enough to stabilize patients.  The hospital doctors and nurses DID prioritize patients from most critical to least and they did stabilize them correctly etc which was VERY good.  Also hopefully our suggestions on how they can establish an effective, efficient emergency care system in Monoliga were heard and steps can begin to be taken to make things better for the healthcare system here!

Overall the drills were VERY fun and I had fun with the victims.  We went to a traditional Mongolian song and dance show last night that was incredibly interesting.  We got to see an orchestra with traditional Mongolian instruments, throat singers (men who sing from their deep throat and can reach about 3 notes at the same time!), and contortionists.  Tonight we went to a more touristy Mongolian restaurant that has a band with a throat singer but this time is was more modern music....Mongolian rock I call it.  It was very fun.  We said goodbye to most of the people we worked with this past week and gave gifts and certificates, etc.

Tomorrow we are spending the day with some friends we made while being here and a couple docs from the hospital going shopping, etc.  It should be a busy but relaxing day!  Sunday we are going to see various churchs, maybe back to the orphange, and maybe see the cancer center with their hospice care which should be incredibly interesting!