Just a regular Monday at CHUK

Today was our first official day of teaching at CHUK.  Monday is the academic day of teaching.   We started early at 7:00am with morning report.  An interesting case was presented that was scheduled for the OR today.   A difficult airway case in an elderly male was discussed.  The anesthesia staff and residents systematically discussed options for anesthetic management.   Unfortunately their options are fairly limited and the real question centered around whether to perform an awake trach or attempt direct laryngoscopy.  Per report, the case went well and an awake trach was not needed.  After morning report we had a surprise CHUK operating room meeting including all of the surgeons, anesthesia staff, and nurses.  The meeting was led by Dr. George, the head of surgery at CHUK and focused on the importance of teamwork in the operating room. In addition, there was much discussion focused around delayed OR start times, poor turnover time, and patients stuck in the PACU because there were no hospital beds available.  Sound familiar?  I felt like I was at home.  In addition the entire meeting was conducted over a 2 hour period in Kinyarwanda (local language).  One of the senior surgical residents was kind enough to interpret for us.

Luckily we escaped at 10:00 and started our scheduled lectures with the residents.  After a warm welcome and introductions, Michael gave a great lecture on respiratory physiology.  The residents were attentive, prepares and very engaged in the learning process.  I was very impressed with their level of knowledge and understanding of the topic. 

Around noon, (after 1 ½ of respiratory physiology) everyone was ready for lunch.  Michael and I decided to leave the hospital and go to a little restaurant down the street called Cameillas. It was a buffet Rwandan style.  Luckily there was someone in line who spoke a little English and could identify some of the food that I could not.  Overall it was a yummy experience.

Michael's plate of food.  Note the diversity of color

The afternoon session started around 1:30.  I gave a lecture covering the introduction of the pediatric patient.   We discussed the physiological differences between neonates, children, and adults as related to anesthetic care.  Again, the residents were very engaged and asked many good questions.  From our discussion, it is clear that the residents do a fair number of pediatric cases included complicated neonatal cases.

The final session of the day was a case presentation by Adolph.   It was about a young boy who was transferred from the district hospital with hypertension and a large abdominal mass and a blood pressure of 150/110. It was well presented and provided many valuable teaching points for both the staff (including me!) and the residents.

It was a full day and I think both Michael and I are exhausted.  I  always forget how talking all day can wear me outJ  It is only the beginning of what I hope will be a very productive and rewarding month.