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Assessment- Systematic

Bag Valve Mask

BVM continues to prove itself. Safe and effective. Less hypoxaemia and less aspiration.

#FANEed & #FANEcc

Freely Accessible Nurse Education education

Freely Accessible Nurse Education critical care

The FANEed and FANEcc acronyms are designated to learning resources and information that can be accessed via limited bandwidth. They are also aimed at nurses (#FANE) and critical care nurses (#FANEcc) who work in Developing Health Systems, especially sub-Saharan Africa and sub-regions within SE Asia. In these regions, the internet is typically accessed by health professionals via a smartphone with limited memory / storage and a restrictive data plan.

YouTube The mobile version of YouTube only receives low-quality videos that are surprisingly easy to download in a low-bandwidth environment. You Tube is avidly used by Registered Nurses in LMIC’s to learn about physical  assessment and advanced practice. When I am doing teaching and training in resource-limited environments, I make a point of finding out which You Tube videos are being downloaded and used to develop the nurses clinical skills. My experience within Uganda and The Gambia is that Registered Nurses invariably discover legitimate sources of information, albeit the videos may contain information about equipment that is not available within the locale.

Facebook Lite An Android app, this version of Facebook is designed to work smoothly with poor data connections and low-end phones. For example the download is under 1MB and typically takes up 3 MB of space on the device. In contrast, the Android app for Facebook can take between 195-200 MB. Facebook lite has various settings that are designed to give a satisfactory experience with smartphones that have a limited amount of RAM andlow CPU power. For example, low-resolution versions of photos are downloaded. These can become higher resolution photos by tapping the low-resolution version. The basic tabs from the full version are all available.

Facebook Messenger Lite The core messaging function is integral and effective, but additional features such as Stickers are scaled down and not fully featured. The video-chat tool usually provides good quality display but uses less battery power and I have found it to work well compared to Skype (Android version).

WhatsApp This ubiquitous software works in locations with low-bandwidth. The chat and video call functions are used extensively by all health professions in countries with well-known low-bandwidth provision.

Adapting available equipment

 To clear secretions in patient’s mouth in a resource-constrained area. I use a 60 ml syringe and a naso-gastric tube of different size, according to the age of the patient. I insert the tube in the patients mouth as far as i can see. I then attach a 60ml sryinge to the tube and was able to withdraw out secretions. This is done periodically to maintain a patent airway for critically ill patients


Alhagie MM Baldeh

The Gambia




Do you use Twitter?

Look out for #FANE Free Accessible Nurse Education and #FANEcc Free Accessible Nurse Education critical care . Both Twitter hashtags are for nurses who work in resource constrained environments or Developing Health Systems. They will be emphasising resources that are low bandwidths or that have been ammended to reduce the size of the content..


WFCCN Conference in Sri Lanka

critical care nursing in Nepal | CCNEPal 2017

Early Enteral Feeding

Early enteral feeding is not dependent on presence of bowel sounds but should be delayed in patients with >500 millilitres gastric residual volume in 6 hour period.

South African Triage Scale (SATS)

Patients become critically ill before they appear on ICU. Ideally, a pre-hospital life support is available within a local ambulance service. In reality, many deteriorating patients simply arrive at a clinic or hospital and join a queue of people waiting to be seen by a doctor or a nurse.

The SATS system is an effective and evidence-based method of sorting and prioritising adults and children according to the severity of their illness. It provides a way of screening the severity of illness of adults and children as they arrive at a clinic or hospital.

The above website contains a large collection of clinical guidelines and learning resources.

The manual is currently under review and a revised version is scheduled for late 2017.

The SATS system has been designed and tested in resource limited environments and the literature and audio-visual guides are full of practical content.

The Silent Child

The silent emergency – the critically ill child. What are the oxygen requirements?