KEY ACHIEVEMENTS
Below is a selection of my key achievements from the past few years:
- Resuscitation training In response to the frequent poor resuscitation outcomes for children in clinics and the transport setting, I developed several training programs. Creating the materials and employing 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) were incorporated. I ran courses for frontline staff and conducted Train-the-Trainers courses. I did this for my own courses, as well as for existing ones (e.g. WHO ETAT, India Pediatric Resuscitation & Emergency Medicine (PREM)). My goal was 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 was to help them safely manage critically ill children at lower levels of care, whilst they were awaiting transport (which can take many hours in low-resource setting).
- “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, sourced 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. I was instrumental in 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 was editor of a very popular PEM Guidance (PEMG) book & App for low-resource settings from 2010 to 2021. These guidelines were hosted on the hugely popular App called "Essential Medical Guidance" This was an award-winning free app, with over 32,000 users in Africa and up to 3,500 views per week in the 2018-2019 period. The PEMGs were amongst the most viewed of all guidelines and are used by doctors all over Africa.
- ETAT-SA - I chaired the South African 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 I co-chaired (with Dr Michelle Twomey) the provincial technical workgroup that adapted the South African Triage Scale (SATS) child component. A two year process involved combining ETAT-SA with SATS to produce the 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 and authored Chapter 1: Triage & Emergency Conditions in the South African 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