US training challenges

Haiti challenges

1

Patients with large body habitus.

1

Lack of anesthetic tubing requiring reuse.

2

Vapor lock with sevoflurane not filling.

2

Inconsistent wall suction.

3

Prone position and pressure point protection.

3

Rationing of O₂, N₂O, sevoflurane tanks.

4

Laryngospasm treatment.

4

Malfunctioning ETCO₂ monitor.

5

Flat reservoir bag due to leaky scavenger valve.

5

Asthma presented on table requiring albuterol administration in ET tube with sevoflurane.

6

Nasogastric tube placement entering the trachea which deflates bellows on ventilator.

6

Rudimentary C-arm and orthopedic tourniquets.

7

Beta-blockers for tachycardia.

7

Refilling of Sodalime.

8

Diagnosis of dead space ventilation.

8

Zeroing of ETCO₂ and O₂ causes 5 seconds without monitoring.

9

Delayed post induction oral airway insertion to prevent biting down on tube during emergence.

9

Preparation of drugs and equipment for unanticipated arrival of cases.

10

Lack of syringe labels.

11

Shortage of blunt needles.

12

Shortage of IV extension tubing.

13

Setting-up delays due to OR changes and unfamiliarity with rooms.