Patrick Olomu, MD, FRCA, Dipl. Anes (Nig)
Associate Professor of Anesthesiology
UTSW & Children’s Medical Center, Dallas
Global Health Grand Rounds – September 4, 2013
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Received donations from several airway
companies to support this program and as a
donation to Nigerian anesthesiologists.
No personal financial relationship with any of
these companies.
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Describe the Planning and Execution of the first
ever advanced airway workshop in Nigeria
Discuss the Challenges and Rewards of this
program
Discuss future initiatives for advancing
anesthetic practice and Airway management in
Nigeria
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Overview of Nigeria
Goals and Objectives of Conference
Faculty
Preparation and Planning: Communication,
local coordinators
Donors and Sponsors - Airway companies
Lectures and Airway Stations
Rewards
Summary
Approximately 12 hours non-stop
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Population:177 million
Most populous country in
Africa
Area: 356, 376 Sq. Miles
(Texas: 268,820 Sq. Miles)
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1.3x the size of Texas but
7x the population!
2x the size of California
Same size as CA, NV, and
AZ combined
2.1 million barrels of
crude per day
4th largest supplier of
crude to the United States
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GDP - $236 Billion – 0.5% of World Economy
GDP growth – 7% per year X last 4 years
Federal Budget for Healthcare - $1.8 Billion
Teaching Hospitals -56 (Federal, State, Private)
Accredited Medical Schools – 31
14 Specialty Hospitals – Psychiatry 6, Ortho 3,
Pediatric 2, Eye 1, ENT 1, OB fistula repair
center 1
Medical Graduates per year - 2300
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58, 325 physicians in Nigeria ( 1: 3000 people)
954, 224 physicians in America (1: 300 people)
UK
Nigeria
Population (million)
64
160
Maternal mortality
/100,000
11.39
630
0.31/100,000
1in 100
maternities
CS anesthetics
Deaths from anesthesia
Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives: reviewing maternal
deaths to make motherhood safer: 2006–08. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United
Kingdom. BJOG 2011;118(Suppl. 1):1–203.
WHO, UNICEF, UNFPA,The World Bank and UN Population Division Maternal Mortality Estimation Inter-Agency Group
Nigeria
Enohumah KO, Imarengiaye CO. Factors associated with
anesthesia-related maternal mortality in a tertiary hospital in
Nigeria. Acta Anaesthesiologica Scandinavica, 2006, 50:206–10.
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USA: 48,000 Anesthesiologists (1 per 6,250 )
Nigeria: < 1000 Anesthesiology providers (MDs
and CRNAs ( 1 per 170, 000)
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Federal and State Budgets – 75% Recurrent
Expenditure (Salaries and Benefits, social
services)
Unemployment rate is 24% (2011)
No Government funding or support for this
program
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Reports of Airway mishaps from US-based
visiting surgeons
Need to provide education on modern
techniques for airway management
A calling to give back to the motherland
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Discuss the identification and management of the
difficult adult and pediatric airway.
Discuss recent advances in airway management with
emphasis on evidence-based, life-saving, approaches to
the normal and difficult airway.
Provide hands-on experience on modern techniques for
advanced airway management in adults and children.
Train “Super Users” who will champion the education
and mentorship of other Nigeria-based anesthetists
and residents.
Provide a forum for networking between leaders in
anesthesiology and industry with a view to facilitating
availability of advanced airway devices in Nigeria.
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Making the decision – see it thru regardless of
obstacles
Curriculum / didactics
Local faculty involvement/assistants
Equipment and supplies and keeping track of all
equipment – avoid loss and damage
Funding
Transportation and shipment
Dealing with customs and port authority in
Nigeria
Personal Security – keep a low profile
Resistance by companies to do business in Nigeria
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Initial Consultation Phase
 SAM Members
 Airway Companies
 Colleagues at various institutions
 Colleagues in Nigeria and the Nigerian Society of
Anesthetists
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Consultation with Nigerian Anesthesiologists
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Confirm Goals and Objectives
What do they want to know? Didactic schedule
Who will be attending – MDs, CRNAs, ICU RNs, ER staff,
etc
How many will attend?
Advertisement of program – email, Facebook, flyers
Set deadlines for tasks
Make draft program and workshop schedule
Venue, supplies, power supply for devices, Adaptors,
Audiovisual devices, Mac vs PC, etc.
Security (personal and Equipment and supplies)
Local Transportation
Six months of Work
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Sea Cargo – 6 big boxes of supplies
Air Cargo – 250 pounds of supplies and
equipment from Dallas and Dublin to Lagos,
Nigeria.
Donated Items from other donors –
shipped to Nigeria from Dallas
Mercury Medical Donated 700
Air-Q ILMA to Nigerian
Anesthesiologists, Lagos, Nigeria
Olomu, USA -Chair
Enohumah, Ireland
Siddall, UK
Imarengiaye,
Nigeria
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Difficult Airway Algorithms
Pediatric Airway Differences
Surgical Airway and Tracheostomy
Management of Difficult Pediatric Airway
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AIRWAY WORKSHOP
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NAP4 Audit
Pediatric Supraglottic Airway Devices
Difficult Airway in the OB suite
Pediatric Video Laryngoscopy
“DARE TO SHARE” – Difficult Airway Cases
Mini Workshop – by demand!
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Supraglottic Airways
Optical Stylets
Videolaryngoscopy
Airway Exchange Catheters and Lung Isolation
Techniques
Fiberoptic Intubation and Airway Anesthesia
Surgical Airway and Jet Ventilation
Special Endotracheal Tubes
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Supraglottic Airways
Optical Stylets
Videolaryngoscopy
Pediatric lung isolation
Fiberoptic Intubation
Surgical Airway
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150 attendees
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Attending
Anesthesiologists
Anesthesiology
Residents
CRNAs
ICU Nurses
ED Nurses
Anesthesia
Technicians
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Immediate Impact of workshop
Excellent opportunity to give back – donation of equipment
and supplies worth over $25,000
Opportunity to meet with leaders in healthcare,
anesthesiology, and US Embassy Commercial Attaché
First hand knowledge on the state of anesthetic practice in
Nigeria – chronic severe anesthesia workforce deficiency
Enthusiastic learners
Small step toward improving airway management and
education in Nigeria
Foundation for future programs – education, resident
training, collaborative research
Connecting US/European corporations with Nigerian
distributors
Chief Medical
Director
Director of
Administratio
n
Deputy Directors
(RN, Fin, HR)
Chairman Medical
Advisory
Committee
Heads of
Department
s
Attendings
/ Faculty
TRAUMA, 68
NEURO, 172
OMFS, 105
ENT, 171
URO,
356
PLASTIC, 242
GEN
GEN, 905
PEDS
GYN
ORTHO
OB
PEDS, 995
OB, 1231
ENT
URO
OMFS
NEURO
GYN, 554
ORTHO, 359
TRAUMA
PLASTIC
Dr. Podolsky meets with Nigerian State
Governor in Dallas on 11/14/12 in Dallas
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Delta State University Teaching Hospital
(DELSUTH)
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Only Tertiary center in state
Has a functioning CT scanner, ICU, blood bank
services, laboratory and surgical and anesthesia
services.
UT signed an MoU to collaborate on development of
a kidney diseases center to include dialysis and
kidney transplantation.
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Equipment and supplies
Training of local Airway Experts
Support Residency and MLP Training
On-line Airway Forum- case discussions
Development of long-term plan to address
manpower shortage – medical students
Research collaboration
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I have discussed the planning and execution of
the first ever airway seminar and workshop in
Nigeria
Much work is needed to grow the anesthesia
workforce in Nigeria
Nigerian anesthesiologists are enthusiastic
learners and will truly benefit from our
support
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My wife and daughter for putting up with my
turning our house into a warehouse
My Colleagues at UTSW/ CMCD
My Team
All corporate sponsors and Donors
Society for Airway Management
Thank you for your attention