More than 1,600 healthcare workers were trained on treatment and management of Acute Respiratory Distress Syndrome (ARDS) – an inflammatory lung injury with a high mortality rate – through a program led by the Ministry of Health and Population (MoHP) with support from the World Health Organization (WHO), Country Office for Nepal.
The training was modelled around the national guideline on ARDS, the first of its kind document which provides guidance in proper diagnosis and management of ARDS in Nepal, including oxygen therapy and handling critical patients in high dependency and intensive care units. The guideline, developed with support from WHO and USAID, was disseminated last month.
The National Guideline on Acute Respiratory Distress Syndrome which was launched on 10 January 2022 in Kathmandu, Bagmati Province. Photo Credit: WHO Nepal/A.Maharjan
Early recognition of ARDS is the key to its successful management. Symptoms include difficulty in breathing, fast breathing, low oxygen levels, low blood pressure, muscle fatigue, weakness, cough, fever, increased heart rate, and confusion. Symptoms of another organ dysfunction may also be present.
Treatment requires a multi-dimensional approach and is usually a medical emergency. Specific medications, oxygen therapy, mechanical ventilation, critical care support, nutrition support, and rehabilitation are major treatment modalities.
Recognizing that the healthcare workers needed to be aware of such important aspects to diagnose and effectively manage ARDS, MoHP formed a team of critical care experts to develop a training module which incorporated various aspects of ARDS diagnosis and management from the national guideline. The training was then provided to doctors, medical specialists, medical students, dentists, nurses, and paramedics, in two separate batches.
To develop this essential document - National Guideline on Acute Respiratory Distress Syndrome (ARDS) - MoHP had formed a technical working group with experts from different professional societies involved in COVID-19 patient management with support from WHO, Country Office for Nepal. This technical working group, led by COVID-19 Unified Central Hospital, Bir Hospital, included intensivists, pulmonologists, critical care nurses, rehabilitation experts, and public health experts, who provided the latest, evidence-based inputs to be included in the document.
Dr Dipendra Raman Singh, Director General of the Department of Health Service, MoHP, at the launch of the ARDS guideline in Kathmandu, Bagmati Province. Photo Credit: WHO Nepal/A.Maharjan
“This training will strengthen the overall clinical management of COVID-19 throughout the country by bringing uniformity in early diagnosis, evaluation, and treatment of critical patients with ARDS in Nepal”, said Dr Roshan Pokharel, Hon. Health Secretary, MoHP. “Such collaborations between the MOHP and WHO has been leading to better results in the treatment of COVID-19.”
The sessions follow previously held virtual training for national healthcare workers - provided by MoHP and WHO - to manage critically ill patients with COVID-19, most notably the Essential Critical Care Training (ECCT) and the Pediatric Essential Critical Care Training (PECCT).
“Virtual training can be very effective during a pandemic where physical distancing is crucial to protect each other, and WHO will continue to provide more capacity-building training in the future to save more lives,” said Dr. Rajesh Sambhajirao Pandav, WHO Representative to Nepal.