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CALICUT

KOCHI

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A Joint Venture byNational Rural Health Mission, Kerala (NRHM)

Kerala Health Services (KHS)NICE International &

Kerala Federation of Obstetrics and Gynecology (KFOG)

EmOCaLsand QUALITY STANDARDS

in Obstetric Care

PROJECT REPORT

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CONTENTS

1. Preface 07

2. Introduction 08

3. Executive summary 10

4. MOA 12

5. Office bearers 14

6. List of Faculty 15

7. Emocals D

Report 16

Pre-test and Post test Model 19

Curriculum 20

Sample Programme 22

List of Delegates 23

8. Emocals N

Report 35

List of delegates 36

Sample programme 38

9.Quality Standards in obstetric care

Report 44

Sample programme 46

Details of instruments supplied as training material 47

Utilisation Certificate 57

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Kerala has got much better health indices like Maternal MortalityRatio (MMR) and Infant Mortality Rate (IMR) compared with otherstates in India. But the question often asked is, whether Kerala hasachieved its potential in this regard. We have to consider that MMRof Kerala in early nineties was said to be 87. According to theMillennium Development Goal 5, Kerala’s MMR should thereforecome down to about 20 by 2015. As per the latest SampleRegistration Svstem (SRS) the MMR of Kerala was 66 (SRS 2010-12). Kerala Federation of Obstetrics & Gynecology estimates thisto be about 50 on the basis of Confidential Review of MaternalDeaths (CRMD). All these figures suggest that there is need forurgent action in reducing maternal deaths in our state. Our analysisof the situation in Kerala has clearly shown that the steps urgently requiredare :

1. To increase the competence of the practicing obstetricians andlabour room staff in providing emergency obstetric care and basic lifesupport (EMOCALS). 2.To ensure that the quality of obstetric careprovided is standardised. That is the background to the launch of thisproject. The National Rural Health Mission (Kerala) (NRHM) andKerala Health Services have realised the need for this venture andsupported it wholeheartedly. The financial support was by the NRHM.We are grateful to the Government of Kerala, Department of health,and the National Rural Health Mission for all the support andencouragement.

While the project was in progress, at the instance of the then PrincipalSecretary Health, a tie up between Kerala Government Health Servicesand the Nice International of the United Kingdom was established. NICEhighlighted the importance of establishing quality standards in obstetriccare based on the findings of Confidential Review of Maternal Deathsconducted by KFOG. After many interactive sessions , a new dimensionto the obstetric care in the state was added – quality standards inobstetric care. The NRHM and KFOG joined hands with KHS andNICE in the launch and execution of the new project and part of thefunds allotted to EMOCALS originally was transferred to that. Thisreport will include details of that project and its accounts.

PREFACE

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The Kerala Federation of Obstetricsand Gynecology has been conductingconfidential review of maternal deathssince 2004 and the findings of first sixyears (2004 to 2009) are published in twovolumes. The reports have shown that thereare many avoidable maternal deaths inKerala. These are mainly due to postpartumhemorrhage, hypertensive disorders ofpregnancy, sepsis, and amniotic fluidembolism. Early detection and prompt careof these problems would have saved manyof these lives. If the patient has an acutecollapse, life support measures have to beinitiated immediately. For this theobstetricians and labour room nurses haveto be trained and retrained.

The developed countries hadrecognized this long ago. They insist thatall obstetricians should undergo skills inmanaging obstetric emergencies andbasic life support - eg: courses likeMOET(Managing Obstetric Emergenciesand Trauma) and ALSO (Acute LifeSupport in Obstetrics). The KeralaFederation also has recognized the needfor such training and has been conductinga certified training programme with thehelp of senior obstetricians and critical care/

Need for EMOCALSTraining

and the introduction ofQuality Standards

INTRODUCTION

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anesthesia specialists. We request thegovernment to make it compulsory for allpracticing obstetricians to undergo thistraining.

In many labour room settings theobstetrician may not be available on thespot when such emergencies develop. Itwill be only the nurse/midwife or thenursing assistant/attender who will beavailable. So it becomes imperative totrain them in recognising the critical situationand provide the first aid. Accordingly, theEMOCALS training programme addedan additional scheme as EMOCALS (N)for nurses and nursing assistants. Theoriginal EMOCALS was redesignated asEMOCALS (D) for doctors.

The need for improving standard ofobstetric care was realised afterdiscussions with NICE international.After analysing the causes of maternaldeaths revealed by the CRMD andpublished in Why Mothers Die, Kerala,the international body (NICE) suggestedthat the way forward in reducing maternaldeaths is to establish Quality Standardsin obstetric care. It meant establishingminimum standard steps in managementof labour and delivery and associatedproblems that may develop. These minimum

standards were worked out after manysessions of discussions between technicalexperts of NICE and members of KFOGand officers of NRHM and Kerala HealthServices. As a first step standards weredeveloped for reducing deaths due to PPH(Post Partum Hemorrhage) andHypertension. It was decided to pilot this inhospitals of various levels from MedicalCollege to Community Health Centre. Theproject was launched by the government ofKerala and NICE international. There wasneed for visiting the various centres, analysingthe situation, identifying any gaps, trainingthe staff and data collection. KFOG wasentrusted with the training of the staff andpart of the fund originally allotted forEMOCALS was earmarked for this. Theproject was implemented from first April2013 . Six hospitals from the Governmentsector and two from the private sector wereselected for the pilot scheme. This reportcovers the Quality Standard project as well.

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EMOCALS (D and N) training - Theability to provide emergency care and lifesupport measures is a must for anybodyattending a laour and delivery. The KeralaFederation evolved a compact trainingprogramme called EMOCALS to trainobstetricians(EMOCALS- D) andNurses(EMOCALS _N). The KeralaHealth Services and NRHM realised theimportance of the training programme forthe staff in the Health Services and hencethe project was launched. It is a jointproject of the Kerala Federation ofObstetrics and Gynecology, KeralaHealth Services and the National RuralHealth Mission (NRHM) Kerala.

The urgent need for training theobstetricians and nurses, especially in theperipheral centres, was highlighted by theConfidential Review of Maternal Deaths(CRMD). During this audit it was seenthat many maternal deaths that occurredin the higher centres had the initialtreatment and serious turn of events inthe peripheral centres. These patientswere then transported to higher centreswithout giving adequate first aid. Thisresulted in their death on the way or onreaching the higher centres in irreversiblelethal conditions. The competence inadministering essential care at thebeginning of the problem will make allthe difference in the outcome.

The Kerala Federation impressed upon

the Health department and the NRHMthese facts. A memorandum of agreementwas signed on 27th September 2012 . Theproposal was to give this training toobstetricians in six centres of Kerala.

There was agreement to train a core teamof trainers from among the nurses so thatthey can be used to train the rest of thenursing community ( including nursesand nursing assistants). There wasbudgetary provision to purchasemanikins and training materials andmake them available at the five regionalcentres in addition to the head quartersof KFOG at Thrissur. Altogether theproposal was for Rs.49, 03,110/- .

At the completion of four sessions fordoctors and one session for nurses, therewas a review of the programme on 15th

December 2012. This was attended by thePrincipal Secretary Health and the StateMission Director. Principal Secretarygave instructions to make sure that nursestraining is attended by faculty fromgovernment nursing colleges and schoolsso that they can take up the training ofthe nurses in service.

The remaining training sessions werecompleted as per schedule.

Quality Standards After the proposed training sessions fordoctors and nurses were completed and

Executive Summary

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the manikins were purchased, there was stillan excess of funds. Part of this (Rupees ninelakhs twenty eight thousand five hundred andforty four ) was then transferred to QualityStandards project of the Kerala HealthServices and NRHM in partnership withNICE international. KFOG was invited tojoin this new project and help in conductingthe training of the staff of the hospitals pilotingthe Quality Standards project. (As per orderNRHM/1293/M&E(QA)/2013/SPMSUdated 29/03/2013)

KFOG volunteered to conduct some moretraining sessions and utilise the entireamount originally allotted. This was doneby conducting four more training sessionsfor doctors. Two additional sessions wereconducted for nurses, to help with the qualitystandards project.

Manikin purchaseUtilising the funds allotted we have purchasedmanikins for training in airway management,cardiopulmonary resuscitation,and neonatalintubation and supplied a minimum set ofmanikins to each of the six centres. Inaddition uterine models, laryngoscopes,LMA (laryngeal mask airway), Endotrachealtubes, oropharyngeal and nasopharyngealairways, face masks, fetal skull, pelvic standand pelvis and almirah were supplied to eachof these centres. Trolley bags were providedto carry them.

For administrative convenience theEMOCALS projects for doctors and nurseswere separated with separate office bearerswith Dr.V P Paily remaining as thecoordinator and Dr.V Rajasekharan Naircontinuing as the Liaison officer for all threedivisions of the project. The whole projectwas under the supervision of the StatePresident of KFOG (Dr.Kunjamma Royfor the year 2013 and Dr.Lalithambika forthe year 2014) and the State Secretary o fKFOG Dr.Fessy Louis. Dr.Bindu Menonand Dr.Neetha George supervised theEmocals-D and Dr.Deepthy M and Dr.BetsyThomas supervised the Emocals –N.Dr.Lola Ramachandran was the treasurer.Dr.Vasanthi Jayaraj, Dr. V.L. Arathy andDr.A P Geetha supervised the qualitystandards training.

We acknowledge the services of the criticalcare department of Vinayaka Institute ofMedical Sciences,Salem, in providingtraining in emergency resuscitation in the earlypart of the project.

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1.This Memorandum of Agreement ismade between STATE MISSIONDIRECTOR (NRHM), KERALA, StateProgramme Monitoring and SupportUnit, NRHM Building, DHS Office,General Hospital Junction (hereinafterreferred to as the NRHM)Thiruvananthapuram - 695 035 and theSecretary General, Kerala Federation ofObstetrics & Gynaecology, TogsAcademia, East Sooryagramam,Thrissur-5 (hereinafter referred to as theKFOG) on 27th September 2012.

2.The object of this MoA is to facilitateconducting of Training in basic andemergency obstetric care and Basic lifesupport for obstetricians and nurses inthe state of Kerala for the year 2012.KFOG submitted a proposal to theNRHM to conduct the above mentionedTraining and NRHM after havingcarefully considered the proposal andafter holding a detailed meeting withKFOG has agreed to approve theproposal subject to the following termsand conditions:

a.KFOG will conduct minimum of twobatches of TOT (Training of Trainers)for Nurses and six batches of trainingfor Obstetricians as per the proposalsubmitted. The total budget approvedby NRHM under this understandingis Rs 49,03,110/- under the headA.9.3.1.

MEMORANDUM OF AGREEMENT

b. KFOG shall procure and supply themanikins and other teaching materialsfor the project.

c. Preparation, printing and distributionof teaching materials will be done byKFOG.

d. KFOG shall carry out the work indistricts in consultation with the StateProgram Manager (RCH) andconcerned District ProgrammeManagers.

e. KFOG shall provide goodaccommodation on twin sharing basisto the Trainees.

f. TA/DA to Trainees and Trainers willbe provided by KFOG as per existingrates.

g. KFOG shall arrange proper venue,training aids, teaching materials andprovide lunch/refreshments.

h. KFOG shall submit the trainingreports, list of trainees who attendedthe training, copy of attendance sheetand a copy of teaching materialsincluding soft copy developed fortraining to NRHM

i. All the trainings shall be conductedand Final Project Completion Reportalong with the SOE shall be furnishedin by 15th February 2013 by KFOG.

j. A provisional utilization statementshall be furnished by KFOG by 15th

December 2012 and by 15th February2013 by KFOG.

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Dr. M Beena, IASState Mission Director (NRHM) KeralaFor & on behalf ofNational Rural Health Mission, Kerala,NRHM Building, DHS Office,General Hospital Junction,Thiruvananthapuram – 695 035

Dr V.P. PailyPresident, KFOGFor & on behalf ofFederation Of Obstetrics & GynaecologyTogs Academia, East SooryagramamThrissur-680 005

Signed and Delivered byin the presence of witnesses

1 : ............................................

2 : ............................................

Signed and Delivered byin the presence of witnesses

1 : ............................................

2 : ............................................

k. Accounts duly audited with audit reportand Utilization Certificate shall befurnished by KFOG to NRHM by 15th

March 2013.l. NRHM will transfer the approved budget

in advance to KFOG.m. Amounts shall be transferred only

through electronic banking to the officialbank account of KFOG bearing number036805000019265 of Kerala Federationof Obstetrics & Gynaecology, SouthIndian Bank, East Fort Branch,Thrissur-5 subject to the vendor form of NRHMbeing duly filled in and submitted.

n. KFOG agrees to use all necessary skills,care, diligence and efficiency in

conducting the training andcompleting it within the stipulatedtime-frame.

o. Excess amount of fund over andabove the budget will not beprovided. Balance amount ofutilized fund at the end of theproject period shall be refunded toNRHM.

KFOG shall endeavour to cooperatewith NRHM and Kerala HealthServices Department in similartechnical assignments during theperiod of this agreement and ahead,for improving the public healthservices in the state of Kerala.

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1. NRHM- State Mission DirectorDr. Beena.M, IAS

2. Liaison OfficerDr. Rajasekharan Nair

3. State Co-ordinatorsDr. V.P.PailyDr. Kunjamma RoyDr. Nirmala.CDr. Fessy LouisDr. Bindu M. - President, Emocals DDr. Neetha George - Secretary, Emocals DDr. Deepthy M. - President, Emocals NDr.Betsy Thomas - Secretary, Emocals NDr. Lola Ramachandran - Treasurer

4. Local Co-ordinatorsThiruvananthapuram

Dr. Lakshmiammal.P,Dr. Reji Mohan

KottayamDr. Sathi.M.S,Dr. Kala B.S

ErnakulamDr. Gracy Thomas,Dr. Sheela C Babu

ThrissurDr. Bindu.M,Dr. Neetha George

CalicutDr. Jayandhi Raghavan,Dr. Beena Guhan,Dr. Jyothi Chandran

KannurDr. Ajith.S,Dr. Cynthia A.K

OFFICE BEARERS OF THE PROJECT

Emocals

Qality Standards

Liaison Officer Dr. Rajasekharan Nair –

Organizing Committee:Chairperson: Prof.V.P.PailySecretary : Dr.Vasanthi JayarajTresurer : Dr. V.L.Arathy : Dr.A P Geetha

Local Cordinators

1. Dr. C.R.Renuka, W & C HospitalThycaud,Thiruvananthapuram 2. Dr. Sujamol, SAT hospitalThiruvananthapuram3. Dr. Sheela Sadasivam, Govt HospitalErnakulam4. Dr. V.L.Arathy, Mother Hospital,Thrissur

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OBSTETRICDr. Ajith.S,Co-operative Medical College,

Pariyaram, kannurDr. Anitha V, Govt.Medical College, KottayamDr. Ambujam.K, Govt Medical College, ThrissurDr. Beena Guhan, Govt Medical College, CalicutDr. Beenakumari, Govt.Medical College, KottayamDr. Betsy Thomas, Amala Institute of Medical

Sciences, ThrissurDr. Bindu K.M Govt.Medical College, KottayamDr. Bindu.M, Jubilee Mission Medical College,

ThrissurDr. Cynthia A.K, District hospital, KannurDr. Deepthi Balakrishnan, SUT hospital, TrivandrumDr. Deepthy .M, West Fort Hospital, ThrissurDr. Geetha A.P, Mother hospital, ThrissurDr. Girija Gurudas Medical Trust Hospital, ErnakulamDr. Gracy Thomas, City hospital, ErnakulamDr. Jayandhi Raghavan CalicutDr. Jayasree Thankachi, MMM Hospital,

Kolencherry, ErnakulamDr. Kala B.S, Govt. Medical College, KottayamDr. Kavitha, District hospital, KollamDr .Kunjamma Roy, Govt.Medical College, KottayamDr. Lakshmiammal, SUT, TrivandrumDr. Lola Ramachandran, Jubilee Mission Medical

College, ThrissurDr. Narayanan .T, Malabar Med College CalicutDr. Neetha George, Jubilee Mission Medical College,

ThrissurDr. Nirmala.C, SAT hospital, TrivandrumDr.Nishi Roshini, Govt Medical College, ThrissurDr. Paily, V.P, Jubilee Mission Medica College,

ThrissurDr. Priya.V, Govt.Medical College, KottayamDr.Rajasekharan Nair V, SUT hospital, TrivandrumDr. Reena Shaji Govt Medical College, ThrissurDr. Reji Mohan, SAT hospital, TrivandrumDr. Sangeetha Menon, SAT, TrivandrumDr. Sareena Gilvaz, Jubilee Mission Medical College

Hospital, Thrissur

Dr. Sathi M.S Govt.Medical College, KottayamDr. Sekharan.P.K, PVS hospital, CalicutDr. Sheela C Babu General Hospital, ErnakulamDr. Simi ADr. Smitha SreenivasanDr. Sreedevi.N.S, Pushpagiri Medical College,

ThiruvallaDr. Sujatha, SAT, TrivandrumDr. Sumangaladevi Govt Medical College, ThrissurDr. Resmi, Med.college, ThrissurDr. Suneela M.SDr.Vasanthi Jayaraj, Mother Hospital, Thrissur

NON OBSTETRIC FacultyDr. Babu Palatty, Jubilee Mission Medical College,

ThrissurDr. Chandramouli, Vinayaka Mission Medical College,

SalemDr. Gangalal , Vinayaka Mission Medical College,Dr. JanakyDr. Jayaraj, Jubilee Mission Medical College, ThrissurDr. LeelaDr. Meyei.S. Appachi, Vinayaka Mission Medical CollDr. Nisbet Samuel, Lisie Hospital, ErnakulamDr. Rajeev ,S N Medical CollegeDr. Shamshad, Medical College, ThrissurDr. Sreenath S, Vinayaka Mission Medical College,Dr. Vilasu, Aswini Hospital, ThrissurDr. VivekDr.Sudhakaran, West Fort Hospital ThrissurDr.Ashish K, Govt.Med. College, ThrissurDr.Anju Mariam Jacob, Jubilee Mission Med College,Dr.Raveendra Varma, Neonatologist, Mother

hospital, Thrissur

Special advisorDr.A.K.Unnikrishnan (Rtd professor medical

college, Thrissur), Consultant anaesthesiologist,West Fort Hospital, Thrissur

List of Faculty for Emocals D & N

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1st and 2nd courses of Emocals DThe courses were conducted simultaneouslyat Thiruvalla and Kollam so that the samefaculty could cover both places.

In Thiruvalla the training programme washeld at Pushpagiri Institute of MedicalSciences on 27th and 28th October 2012. Atotal of 36 doctors attended the programmeout of which 12 were from the governmentsector. Local arrangements were done byDr. N S Sreedevi and Dr. Sathi. TheNRHM observer was Dr. Jaysree , deputydirector(FW) DHS, Trivandrum.

A test was conducted at the beginning of thesession and also at the end of the course toassess their understanding. Feedback formswere made for further improvement.

The basic life support workshop was headedby Dr. Sreenath and team from Vinayaka

Mission Medical College Salem. Referencebooks distributed were:

1. KFOG protocol book,

2. 2nd Edition of ‘Why Mothers Die-Kerala’ and

3. A manual on Basic and Advancedlife support by the Salem team.

In Kollam, the Emocals programme washeld on 27th &28th October 2012 at HotelVaidya. The obstetric team was headedby Dr.V P Paily & Dr.V RajasekharanNair. The local co-ordinators wereDr.Lakshmi Ammal and Dr.Kavitha.Dr.Sreenath and team conducted the lifesupport workshop.

Delegates were from Trivandrum andKollam. Out of a total of 38 participants13 were from the government sector.Dr.Anu, Jr.Administrative Medical Officer,DHS was the NRHM observer. All the three

Emocals - DReport of courses conducted for doctors

List of courses conducted in the financial year 2012 -13

Place date venue No of doctorsgovt private

1 Thiruvalla 27&28 october 2012 Pushpagiri Medical College 12 242 Kollam 27&28 october 2012 Hotel Vaidya, Kollam 13 253 Calicut 1st&2nd December 2012 IMCH, Calicut 27 114 Kasaragod 1st&2nd December 2012 CPCRI, Kasaragod 9 285 Thrissur 2nd &3rd Feb 2013 TOGS Academia, Thrissur 17 76 Ernakulam 2nd &3rd Feb 2013 IMA Hall, Cochin 26 3

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books were distributed to the delegates.Most of the delegates got more than 90% inthe post test.

3rd and 4th Courses of Emocals D wereheld at Kasaragod and Calicut on 1st and2nd of December 2012. There were 38delegates in Calicut – 27 from thegovernment sector and 11 from theprivate hospitals. Dr.Beena Guhan,Dr.Jayanthi Raghavan and Dr.JyothiRameshchandran were in charge of thelocal arrangements. The venue was atIMCH Calicut.

Dr.V P Paily headed the obstetric teamand Dr.Sreenath and team conducted thebasic life support workshop. The sessionswere very interactive.

Kasaragod: The local coordinators wereDr.Sobha Mayya and Dr.Jyothi. Total of37 delegates attended, out of which only9 were government doctors and the restwere from private hospitals. Issues likeabsence of blood bank facilities, roadtransport, referral centres and nonavailability of blood components werehighlighted by the delegates. Programmewas well appreciated. All the threereference books were distributed to thedelegates. Pre and post tests wereconducted.

5th & 6th CoursesThese were held at Thrissur and Ernakulamon 2nd and 3rd of February 2013.

Thrissur: The venue was TOGS AcademiaThrissur. Dr.Bindu Menon and Dr.NeethaGeorge were the local coordinators. Totaldelegates were 24, of which 17 were fromthe government hospitals. Basic life supportworkshop was organised by Dr.Babu Palattyand team from Jubilee Mission MedicalCollege Hospital, Thrissur. A slightmodification was made this time – onlythose who scored above 70% in the posttest were given the completion certificateof the Emocals training programme.Others were given only the participationcertificate.

Ernakulam: Venue was IMA Hall,Cochin. Local coordinators wereDr.Sheela C Babu and Dr.Gracy Thomas.A total of 29 doctors attended the course,out of which 26 were recruited from thegovernment sector. Pre and post testswere conducted and completioncertificates were mailed to themaccording to the post test results.

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These were also conducted in the samepattern as the previous six courses.Training was for two days - one day wasassigned to critical care and one day toobstetric topics. Most of the presentationswere as workshops, drills, videos ordemonstrations. The sessions wereinteractive; a pre and post tests wereconducted on both days. The delegateswere given the two books – KFOGprotocol book and the Why Mothers Die- Kerala 2nd edition. The wholeprogramme was planned and chaired byDr. V.P.Paily and Dr. Kunjamma Roy.

1st course conducted at Trivandrum wasattended by 30 delegates, out of which10 were staff nurses. All were from thegovernment hospitals. Dr.Lakshmiammaland Dr.Reji Mohan were the co-ordinators.

The second one was at Malappuram andthe co-ordinators were Dr.Beena Guhanand Dr.Jyothi. It was attended by 33delegates, 14 from the government sectorand 19 from the private hospitals.

Third programme was held at IMCH,Kottayam on 26 &27th October 2013. Atotal of 35 doctors attended the course.The local co-ordinators were Dr.Sathi Mand Dr.Kala.

Fourth course was at AnjarakandyMedical College, Kannur on 11th &12th

of January 2014. It was attend by 35delegates including postgraduatestudents. Dr.Cynthia and Dr.Kunjikannanwere the co-ordinators.

Programmes conducted in 2013-14

List of courses conducted for doctors in 2013-14District date venue No. of delegates

Govt Private1 Trivandrum 15,16 June 2013 Trivandrum 30 -

2 Malappuram 24,25 August 2013 Malappuram 14 19

3 Kottayam 26,27 October 2013 Kottayam 13 10 + (12 PGs)

4 Kannur 11,12 January 2014 Anjarakandy 13 16 + (6 PGs)

Medical College,

1919

5. Expand the acronym HELPERR forshoulder dystocia

6. Three variables you will look for in aCTG

7. Loading dose of MgSO4 in regimepromoted by KFOG

8. Two pre-requisites for Factor V11aadministration

9. Two pre-requisites to apply an outletforceps

10. The four Ts as causative factor of PPH11. Any three surgical steps to control

bleeding in atonic PPH12. Patient, post LSCS, day 4, is seen in

ward with convulsions, drowsiness,right sided weakness, BP 140/80a. Your first diagnosisb Three steps to avoid development ofthis conditionc. Gold standard investigation fordiagnosisd. Any two steps in management

13. Primi, 35 wks with acute onset of painabdomen, absent FM, mild bleeding P/Va. Your diagnosisb. Two relevant investigationsc Three complications

14. A 25 yr old primi presents with acutepain abdomen and bleeding p/v at2months amenorrhea. Threedifferential diagnosis

15. Dose of Fresh Frozen Plasma

1. I V fluid of choice in the initialmanagement of patient in shock is -

2. Rare but significant lung injury causedby blood transfusion is -

3. An antibiotic used against Methicillinresistant staphylococcus aureus is -

4. Pathogen responsible for acutepyelonephritis is -

5. Rectal mucosa in a 4° perineal tear issutured with which suture material

6. Normal range of fibrinogen in an adultis

7. Expand PRES8. Steroids in a pregnant overt diabetic

can precipitate which complication9. Primi, 30 weeks, with blood pressure

180/120 and urine albumin ++.Antihypertensive of choice for rapidcontrol of BP will be-

10. The most dreaded cerebral pathologycontributing to maternal mortality inuncontrolled hypertension inpregnancy is –

Short answers (Points only)1. 3 components of active management

of 3rd stage of labour2. Instruments in a cervical inspection set3. Two special steps different in obstetric

hysterectomy compared withgynecological hysterectomy

4. Any two methods to deliver theaftercoming head in breech.

EMOCALS –DPRE-TEST AND POST TEST MODEL

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The topics covered are listed below. Modifications were made depending onrequests by the trainees.

APH, PPH atonic and traumatic Active Management of third stage

Surgical procedures to arrest bleeding,Obstetric hysterectomy, Rupture uterusPre Eclampsia, Eclampsia

Anticonvulsants, AntihypertensivesOperative deliveriesBlood and component useAcute collapse, Amniotic fluid embolismThromboprophylaxisShoulder dystociaEmergency cerclageCTGSepsis, Antibiotic useNeonatal resuscitation

Life supportVascular access, Commonly used monitorsCardio respiratory arrest, managementAirway management,DefibrillatorsFluid and electrolyte management

SAMPLE PROGRAMME - OBSTETRICS8.15 – 8.45 Pre TestSession 1 Lectures845-8.55 Introduction and Overview of programme9.00-9.40 Active management of 3rd stage & 4th stage of labour

PPH drill and management of PPH, PPH Box9.40-9.55 Cervical, vaginal and perineal tears(video)9.55-10.05 Recap and interaction10.05-1015 Rupture uterus(Demonstration)10.15-10.25 Obstetric hysterectomy (Demo)

Curriculum

2121

10.25-10.35 Internal iliac ligation10.35-10.50 Recap and interaction10.50 -11.00 Coffee break, photo

Session 2 Lectures11.00 – 11.15 Acute hypertension, Eclampsia, MgSo4 use, Eclampsia box11.15 – 11.30 Cerebro vascular emergencies11.30-11.40 Anticonvulsants other than MgSo411.40-11.50 Discussion & Recap11.50 – 12.10 Demonstrations Extension of CS incision, forceps in C.S, Abnormal presentations

Session 3 Lectures12.10-12.25 Blood components12.25-12.35 DIC, Factor VII A12.35-12.50 Acute collapse12.50-13.05 Thrombo prophylaxis13.05 -13.15 Discussion, Recap13.15 -14.00 lunch

Session 4 Workstations14.00- 15.10 1. Cervical inspection, uterine packing, condom tamponade

2. Uterine, ovarian branch ligation, Brace stitch3. Shoulder dystocia4. Venous cut down, Cavafix5. Instruments, digital rotation6. Emergency cerclage, emergency trolley ,

15.10-15.30 Review of workstations, discussion & Recap

Session 5 Lectures15.30 - 16.00 Septic shock16 .00 –16.15 Early pregnancy emergencies16.15-16.30 Jaundice in 3rd trimester16.30-16.45 Discussion & recap16.45-16.55 Tea 16.55-17.05 Abruption17.05-17.25 Obstetrician and the neonate17.25-17.45 Videos - Difficult CS, Morbidly adherent placenta,

Common Iliac clamp17.45-18.00 Situation management18.00-18.15 Cord prolapse18.15-18.30 Multiple pregnancy18.30 Post test, High tea

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8-8.30 am Breakfast

8:30-8:45 Multiple gestation

Session 1 Lectures

8.45-9.10 Basics of ECG relevant to obstetrics Salem 25’

9.10-9.30 Monitors Salem 20’

9.30-9.50 Resp and Ventilatory support Salem 20’

9.50-10.00 Discussion

10.00-10.30 Coffee break

Session 2 Lectures

10.30-10.50 Fluid ,electrolyte management Salem 20’

10.50-11.10 Vasoactive drugs- when to use Salem 20’

11.10-11.35 ABG- how to interpret Salem 25’

11.35-11.55 Cardiac arrest Salem 20’

11.55-12.15 Non pneumatic Antishock garment Salem 20’

12.15-12.45 Neonatal Resuscitation Salem 30’

12.45-1pm Discussion

1-2 pm Lunch break

Session 3,2-3.30 pm Work stations 15’each

BLS

Central venous access

Newborn resuscitation

Defibrillation & cardioversion

ECG

Airway basics & beyond

3.30-3.15 pm Review

3.15 pm Photo, Certificate distribution

EMOCALS-DSAMPLE PROGRAMME – Basic Life Support

2323

Sl No Name & Address Phone1 Dr. Ambily M Prakash, 1st year P.G Student, Medical College, Kottayam. Ph: 98951991752 Dr. Anuja Thomas, Mercy Hospital, Pothi, Thalayolaparambu Ph: 94473169783 Dr. Biji A.S, Jr Consultant in OG, General Hospital Pathanamthitta, Ph: 046823204664 Dr. Bini S Raj, Jr Consultant, W&C Hospital, Alappuzha Ph: 94959396385 Dr. Deepthi P.S, Jr Consultant, THQH, Thiruvalla Ph: 98959345956 Dr. Deepthi Raghavan P, Jr Consultant, W&C Hospital, Alappuzha Ph: 0477-22531517 Dr. Divya Gopinath, Jr Consultant, District Hospital, Mavelikkara Ph: 94959878488 Dr. Geethalekshmy P.L, District Hospital, Kozhenchery Ph: 94470965649 Dr. Latha C.R, Consultant, THQH, Chengannoor Ph: 0479-245226710 Dr. C.R Mini, Consultant, General Hospital, Adoor, Pathanamthitta Ph: 944759448311 Dr. Grace Kuruvilla, St. Gregorios Mission Hospital,

Parumala Thiruvalla 689636, Ph: 0479 - 231226612 Dr. Leena A Joseph, St. Joseph’s Hospital, Dharmagiri Kothamangalam. Ph: 944723360013 Dr. Nithya R, Junior Resident, Dep. Of O & G , Kottayam Ph: 994676316714 Dr. Prasanth Kumar G.N, Junior Resident, Govt. Medical College, Kottayam Ph: 996152402715 Dr.Prabhavathi C, Junior Resident, Govt. Medical College, Kottayam16 Dr. Rajakumari A, Senior Resident, Medical College, Kottayam. Ph: 984666512417 Dr. Rani Yogidas, Junior Resident, Govt. Medical College, Kottayam Ph: 974700044318 Dr. Rachel Mathew, Assistant Professor, Pushpagiri Medical College, Thiruvalla Ph: 944715948819 Dr. Reeba Sara Mathew, Jr Consultant, Govt Hospital, Adoor20 Dr. Sherin Sams, Junior Resident, Medical College, Kottayam. Ph: 0481 - 259731121 Dr. Sandhya B, NIMS Medicity, Aralamoodu, Neyyatinkara, Trivandrum Ph: 0471 - 395111122 Dr. Sreedevi Antharjanam, Mariya Hospital, Adoor, athanamthitta. Ph: 04734 - 22804623 Dr. Sreelakshmy R Nair, MS Pushpagiri Medical College, Thiruvalla Ph: 854758733124 Dr. Tinu Philip, ST. Gregorios Mission Hospital, Parumala P.O, Thiruvalla Ph: 949518408725 Dr. Thiruvenkideswary B, Asst Surgreon (CMO),W&C Hospital Alappuzha Ph: 974686794026 Dr. Usha S, ST. Thomas Hospital, Chettipuzha, Changanassery. Ph: 0481 - 272900027 Dr. Valsa C.A, Pushpagiri Medical College, Thiruvalla Ph: 949649316728 Dr. Vinitha Wills, Pushpagiri Medical College, Thiruvalla Ph: 944714019929 Dr. Kuttappan K, Consultant, THQH, cherthala Ph: 944720485330 Dr. Harsha Beegam, Consultant OG, District Hospital, Kottayam31 Dr. Kishore Kesarkar, Pushpagiri Medical College, Thiruvalla Ph: 0773686363132 Dr. Olive Anna Varghese, Charakunnel House, Puramattom P.O, Thiruvalla Ph: 944735223633 Dr. Simi Mohandas, Junior Resident, ,Medical College, Kottayam.34 Dr. Tintu Parakkal, MS, Pushpagiri Medical College, Thiruvalla Ph: 949742684435 Dr. Shiby Jose, Assistant Professor, Pushpagiri Medical College, Thiruvalla Ph: 960522104636 Dr. Resmi Rajendran

27th & 28th October 2012, Thiruvalla

Emocals Training ProgrammeList of delegates

24

27th & 28th October 2012, kOLLAM

Sl No Name & Address Ph: No1 Dr. Anjana AnilKousthubham, Vettipuzha South, Punalur 0475 - 22200102 Dr. Annamma M.G, Gynaecologist, N.S Hospital, Palathara, Kollam 0474 - 27231973 Dr. Beena Shaji, Thengayyam Melrose, Mulavana P.O, Kollam - 691503 94474541064 Dr. J.P Jaikumar, Govt. Taluk Hospital, Karunagapally 94472553565 Dr. S. Beena, Junior Consultant, District Hospital, Neyyatinkara 94478921636 Dr. Mini Xavier, Consultant O&G, Taluk Head Quarters Hospital, Thodupuzha 98952878797 Dr. Rashmi Devi L, Consultant, Govt W&C Hospital, Mattancherry 94959299448 Dr. Deepa E George, A.G.C. Nursing Home, Beach Road, Kollam 0474 - 27485849 Dr. Dhanya G. Krishnan, Junior Consultant Govt. Victoria Hospital, Kollam 0474 – 275270010 Dr. Mercy A, Medical Consultant in O & G, Govt. Victoria Hospital, Kollam 0474 - 275270011 Dr. Anila G , Taluk Head Quarters Hospital, Kottarakkara 944781850012 Dr. Nithya Raj, SL Villa,, TC 3/2435, TKD Road, Pattom, Trivandrum - 4 999502647413 Dr. Veena R, Junior Con. O & G, Taluk Head Quarters Hospital, Kundara 0474 - 252694914 Dr. Indu V, Chaithanya, House No: 17, Krishna Nagar, Neyyatinkara 944758570215 Dr. K. Devaky, Upasana Hospital, Kollam, 0474 - 274966816 Dr. Sudha Harendrababu, Pranav Hospital, TB Junction,

Vidhya Nagar, Kottarakkara 0474 - 245182817 Dr. K. Prasanna Kumary, Sreenidhi, Kollasseril, 9847359382

Bhavana Nagar 62 - 8, Kadappakada P.O, Kollam - 69100818 Dr. Sonia Arnowalt, Junior Consultant, W & C Thycaud

Govt. Hospital, Trivandrum 984638842719 Dr. P. Sujatha Devi, Govt. Victoria Hospital, Kollam 0474 - 275270020 Dr. Prasanna Venugopalan, Upasana Hospital, Kollam 944651565621 Dr. Anitha K 2731742, Athira, Near Town Limit, Vrindavanam Nagar - 9,

Kadappakada P.O, Kollam22 Dr. Kavitha V.K, Deepam, H No: 44 A, Neethinagar, Pattathanam, Kollam 0474 - 274411523 Dr. Biju P, SBM Hospital, Karunagapally, Kollam 0476 - 262030324 Dr. Jayakumari K.S , Sri Sathya Sai Super Speciality Hosp, Kottarakkara 0474 – 245228925 Dr. Mohana Menon ,Aathira,49 - Keerthi Nagar, Asramom, Kollam - 691002 0474 – 274048126 Dr. Lizy Isaac , Pampalil, Near Tel. Exchange, Kundara P.O, Kollam 944730467427 Dr. Leena Sunny Joseph, S.G.M Thekkedathu Hospital Pathanapuram 0475 - 235312528 Dr. Susan Ashok , Bhanu Nursing Home, Market Road, Punalur - 691305 984711462829 Dr. Jyoti Nayar, Ashtamudi Hospital & Tromma Care Centre, 9947300929 Thattamala P.O, Kollam - 691020 0474 - 656565230 Dr. Nagamani M, Consultant, N.S Hospital, Bypass Road, Palathara, Kollam 0479 – 272319931 Dr. Radha Bhai, Anupama, Vadakkumbhagam, Kollam - 1 944736374632 Dr. V. Jayadharan , JSM Hospital, Karamcode P.O, Kollam 0474 – 259427433 Dr. Beena C 2701121, P.N.N.M Hospital, Anchalummood, Kollam34 Dr. Anjaly J, Victoria Hospital, Kollam35 Dr. Shiny, Taluk Head Quarters Hospital, Karunagapally36 Dr. Renjini Devi37 Dr. Pramod Roy John38 Dr. Vijaya Zacharia

2525

1st & 2nd December 2012, KOZHIKODE

Sl No Name & Address Ph: No1. Dr. Sajeethe Hydrose, Tirur Misssion Hospital 0494 - 3229486

sajithenishana@gmail.com 98951386332. Dr. Latha K.G, TH, Kunnamkulam 04885 211236

lathagovindan@yahoo.co.in 94460869063. Dr. Sujaya K, THQH, Wadakkancherry Ph 9446660900

04884 2350004. Dr. Preethi S, District Hospital, Thrissur 9447331231

0487 - 23734205. Dr. Hitha K, Govt. General Hospital , Calicut 0495 2482954

drhitha@gmail.com 98471452206. Dr. Roja T., Consultant (Gynae) , THQ Hospital, Koyilandy 9446435645

0496 - 22104077. Dr. Ramesh Kumar T , District Hospital , Mananthavady 9447934605 drtrkumar@gmail.com8. Dr. Shainimol A , Jr Med.Consultant, General Hospital, Pala 9447571460

04822 - 2168709. Dr. C.V Jose, Junior Consultant, Taluk Hospital, Tripunithura 0484 - 2449345

Josecv90@yahoo.com 944760554210. Dr. Padmakshen K , District Hospital, Kannur 9495111339

Padman-sheela@yahoo.mail 0470 - 235586211. Dr. Rinu Anaz , Consultant Gynaecologist, THQH, Adimali, Idukk 0474 - 2747727

rinvanaz@gmail.com 949543394212. Dr. Shabna P , Junior Consultant , THQ Hospital, Koyilandy 0494 - 2410320

drshabna101@gmail.com 965605446713. Dr. Nazrin Ansari, General Hospital, Manjery 0483 - 2766580 drakra007@yahoo.com 999580917714. Dr. Deepthi B.K, Junior Consultant in OBG, Govt General Hos., Manjer 0495 - 2430847

drdeepthibk@yahoo.com 944653536915. Dr. Anuja V., Govt. Hospital, Vatakara, Kozhikode anujabinu@gmail.com 9 49511708516. Dr. Manoj Ninan, Taluk Hospital, Muvattupuzha, 9447102067

manojsely@yahoo.com 944732822717. Dr. Lathika C.K, Medical Consultant, W&C Hospital, Palakkad 0491 - 2535466

drLathikack@gmail.com 984740546618. Dr. Sandhya A.K , PVS Hospital, Calicut, ak2sandhya@gmail.com 994669383419. Dr. Ratnam K, Fathima Hospital, Calicut , rkanathezhath@yahoo.com 999522335720. Dr. Basima P, CHC Mukkom, Calicut , busidhanny@gmail.com 994756962321. Dr. Pushparani K , Malabar Hospitals, Eranhipalam, Calicut 0495 - 2356738

ranikpushpa@gmail.com 984778989522. Dr. Radhamani K.O , Malabar Hospitals, Eranhipalam, Calicut 9447306020

drradhanambiar@yahoo.co.in23. Dr. Raji P.G, Senior Consultant, Vadakara 964517174124. Dr. Kavitha M.R, Nahas Hospital, Parappanangadi,

drkavithamr@yahoo.co.in 9744735422

26

1st and 2nd December 2012, KASARAGOD

25. Dr. Saleem Mohayideen P.A, TQH, Ponnani, Malappuram 9995812973drsaleam-m@gmail.com

26. Dr. Rahmath Beegam C.H Hospital, Valancheri , 9567761777rahmathbeegamdr@gmail.com 0494 - 2460446

27. Dr. Rema Ramakrishnan, THQ, Tirurangad 0494 - 2423970dr.rema@g.mail.com 9447758971

28. Dr. Santhosh Kumari K, District Hospital, Tirur 0494 - 2423331santhoshkumari@gmail.com 9447227519

29. Dr. Naseem K.A THQH, Tirurangadi, Malappuram 0494 - 246269breezetgi@gmail.com 9495077204

30. Dr. Bindhu C, THQH, Nilambur 944658109704931 - 222999

31. Dr. Dhanya P Vava Junior Consultant (O & G) THQH Fort Kochi 9995397492 dhanyapvava9@gmail.com32. Dr. Ditto Tom P, THQH, Chavakkad ditto-tom@rediffmail.com, 9249217000

980977802033. Dr. Ameena T.P, ameenaeshan@gmail.com 0497 - 270774534. Dr. Aseema V.N , ESI Hospital, Feroke , Kozhikode 0495 - 2371669

naseemavadakkan@gmail.com 944604066935. Dr. Shalima Padman, Consultant, District Hospital, 944764079036. Dr. Anupama , THQH, Malappuram 9495961317

0483 - 273868637. Dr. Fathimath Zuhra M.M, MIMS Hospital, Kottakkal, zuhraarif@yahoo.com 944752042238. Dr. Remadevi K.B, ESI Hospital, Feroke 0495 - 2358149

drremajyodish@gmail.com 8089704608

Sl No Name & Address Ph: No1 Dr. Ambujakshy2. Dr. Anupama A Jr. Consultant (OBG), CHC Manjeshwar3 Dr. Anupama Suresh4 Dr. Archana5 Dr.Beena C Shetty6 Dr.Bharathi7 Dr.Deepika PG Student, KMCL8 Dr.Isha Varghese9 Dr.Jayalakshmi Suraj10 Dr.Jayasree11 Dr.Jyothi S, Consultant, Govt. General Hospital, Kasargod12 Dr.Kala Raman13 Dr.Krishna Kumar14 Dr.Kunhi Kannan Med. Consultant OBG,Taluk Hospital, Taliparamba15 Dr.Lakshmi Mohan16 Dr.Leela V, Med. Consultant, District Hospital, Kanhangad

2727

17 Dr.Lysamma Mathew, Jr. Consultant, District Hospital, Kanhangad18 Dr.Manoj Kumar, Junior Consultant, OBG, Taluk Hos., Payyannur19 Dr. Maya S Mallya20 Dr. Nebissa P.K21 Dr. Padmavathi22 Dr. Prathima PG Student KMCL23 Dr. Praveena G PG Student KMCL24 Dr. Rasheeb Razak Jr. Consultant, Govt Hospital, Thalenchery25 Dr. Rehima26 Dr.Sameer27 Dr.Shameena28 Dr.Shoba29 Dr.Shobha A, Jr. Consultant , Govt. Hospital , Kasargod30 Dr. Susheela Lazar31 Dr. Swapna, PG Student, KMCL32 Dr. Usha Menon33 Dr. Vasanthi, Jr. Medical Consultant, General Hos., Kasargod34 Dr. Veena35 Dr.Vidhya36 Dr.Yasodha T.K37 Dr.Zuhra, Carewell Hospital, Kasargod

2nd & 3rd February 2012, THRISUR

Sl no Name Phone1. Dr. C.S Anasuya, Junior Resident, Thrissur Medical College 94475190842. Dr. V Arthi, Junior Resident, Govt. Medical College 95672629733. Dr. Deepthy G, PG Student, Jubilee Mission Medical Hospital 98463808674. Dr. Elizabeth V Issac, PG Student, Jubilee Mission Medical Hospital5. Dr. Kochuthresia, PG Student, Jubilee Mission Medical Hospital6. Dr. Ciciliamma Thomas, Consultant, District Hospital, Tirur 7. Dr. Megha Jayaprakash, Assistant Pro. O & G, Govt. Medical College 8. Dr. Molly Thettayil C, Junior Medical Consultant OBG, W&C Hospital, Calicut 9447869124 9. Dr. Renuka U, Junior Consultant OBG, District Hospital, Thrissur 994687319910 Dr. Manju K.P, Junior Consultant OBG, THQH, Chalakudy 949724556911. Dr. Liby Thomas, MBBS, DGO, Junior Consultant, District Hospital, Tirur, Malappuram 924972418812. Dr. Shemla V.S, Junior Consultant OBG, THQH, Ponnani 808959588713. Dr. B Rajmohan, Consultant O & G, District Hospital, Thrissur 0487-242738314. Dr. Sreeja V, Junior Consultant OBG, Govt. Taluk Hospital, Kuthuparamba 944744849715. Dr. K.P Rajamani, Consultant OBG General Hos., Manjeri, Malappuram 934989434616. Dr. Jerry Thomas, Junior Medical Con.,Taluk Hospital, Kuttiyady, Kozhikode 989507134817 Dr. Ranjitha Rajan, Junior Consultant, THQH, Quilandy 0495-249212518. Dr. Mercy C.V, Consultant, THQH, Chalakudy, Thrissur 944724281319. Dr. Sini A.T, Junior Consultant OBG, THQH, Perinthalmanna, Malappuram 0493-322727920. Dr. T.V Girijadevi, General Hospital, Thalassery, Kannur 0490 - 232251

28

2nd & 3rd February 2012, ERNAKULAM

21. Dr. Biny B, Junior Consultant, THQH, Vythiri, Wayanad 04936 - 25522822. Dr. Geetha M.K, Consultant in O & G, THQH Hospital, Irinjalakuda 944687302123. Dr. Bindu Ajith, Junior Consultant, THQH Hospital, Kodungallur 944623540124. Dr. Leena James, Consultant O & G, District Hospital, Thrissu 9446765092

Sl no Name Phone1. Dr. Nergis S, Consultant O & G, THQH, N.Parur 94467428862. Dr. C.G Premlatha, Consultant O & G, THQH, Kothamangalm 94472819263. Dr. Pauly K.A, Medical Consultant, THQH, Fort Kochi 94467428864. Dr. Beena P.K, Junior Consultant, W & C Hospital, Mattancherry, Ernakulam 0484 - 22245115. Dr. A Khairunniza, Consultant O & G , Taluk Hospital, Nilambur, Malappuram 04931 - 2228316. Dr. K.V Vinayakumar, Medical Consultant, Taluk Hospital, Perumbavoor 0484 - 25231387. Dr. Swapna Bhasker, Junior Consultant, THQH, N.Parur 94473566818. Dr. Annie Tresa V.J, Consultant O & G, District Hospital, Aluva 0484 - 26240409. Dr. Anu Philip, Junior Consultant, THQH, Muttatheril - Bethel , Haripad 965641914110. Dr. Manoj A, MBBS, DGO, Taluk Hospital, Perumbavoor 0484 - 252313811. Dr. Madhu B, MS, DGO, Junior Consultant, District Hospital, Aluva 989504750512. Dr. Binu Thomas, Consultant O & G, W & C Hospital, Alappuzha 934902427013. Dr. Sudhamony A.K, W & C Hospital, Alappuzha 944710316614. Dr. Lekha Sunil, District Hospital, Mavelikkara 0479 - 230409515. Dr. Vincent Lobo, Gynaecologist, District Hospital, Idukki 974405485116. Dr. Mini George, Kunhalis Nursing Home, Kochi - 11 0484 - 236845117. Dr. V. Girija, Consultant Gynaecologist, General Hospital, Ernakulam 0484 - 231268318. Dr. C Pretihbha, Consultant O & G, W & C Hospital, Mattancherry, Ernakulam 0484 - 222451119. Dr. Sathya Babu N.U, Junior Consultant, THQH, Adimaly 04864 - 22270320. Dr. Rahana Dhavan, Junior Consultant, Taluk Hospital, Fort Kochi 0484 - 253042821. Dr. Mini Abraham, Consultant O & G, THQH, Vaikom, Kottayam 938888112122. Dr. Kochurani John, Junior Consultant, THQH, Vaikom, Kottayam 944777453823. Dr. Seena Aboobacker, Junior Consultant, THQH,Perumbavoor , Ernakulam 984735876324. Dr. Jolly Thomson, Consultant Centre for Reproductive Care 0484 - 2663346,

Thevara, Kochi - 1325. Dr. Seena T.S, Junior Consultant, Taluk Hospital, Cherthala 999518572426. Dr. P.M Rajeswary, Consultant, General Hospital, Ernakulam 04842 - 38176827. Dr. KalaKumari Thankachi, Senior Consultant, General Hospital, Ernakulam 944642567028. Dr. T Geetha, St. Joseph Hospital, Kothamangalam 0484 - 286113329. Dr. Pramod P.S, Junior Consultant, Taluk Hospital, Thodupuzha 9447270718

2929

Government Doctors1 Dr. Mini Joseph SSNMM Hospital, Varkala

Ph: 0470 2602228(Hos) 94460644331 Dr. Ambily P.C THQH, Malappuram 94959532422 Dr. Rehna U CHC, Vengara, Malappuram 92491255053 Dr. Jasmin Ismail Junior Medical Consultant, THQH, Nilambur 98479899494 Dr. Mini P THQH, Malappuram 94464353815 Dr. Sreeja P.T Assistant Surgeon of Gynae., THQH, Nilambur 99617627446 Dr. Naseera K Jr. Consultant, THQH, Perinthalmanna 94956216267 Dr. Meharunnisa NRHM Specialist Doctor, Gynaecologist 9447231786 THQ Hospital, Perinthalmanna 8 Dr.Y. Mumtaz Consultant Gynae., Taluk hospital, Thirurangadi 93881207339 Dr. Naseem K.A THQH, Thirurangadi 949507720410 Dr. Shalima T.V Gynaecologist, CHC Areacode 949553624011 Dr. Lekshmy L CHC, Edappal 989545568512 Dr. Devakikutty CHC, Kondotty 483271143413 Dr. Anisa P.M CHC, Pothukal 974798078914 Dr. Jyotsna S Jr. Consultant OBG, GH Manjeri 9400766724

Doctors from Private hospitals1 Dr. Suhara A.K Kottakkal Nursing Home, Kottakkal 94461031012 Dr. Saritha Rejith MS Malathy Hospital, Tirur 96456930203 Dr. Ansamma Mathew Tirur Mission Hospital 94956222504 Dr. Manorame M.V Savera Hospital, Tirur 49424226875 Dr. Kadeeja T.K Co-Operative Hospital, Tirur 94953253636 Dr. Rathi Venugopal Tirur Nursing Home, Tirur 98951392807 Dr. Indira V.K.P Tirur Nursing Home, Tirur 93874230308 Dr. Ananda Narayanan V Edappal Hospital (p) Ltd., Edappal 98470137889 Dr. Hemalatha Dixit Daya Hospital, Edavanna, Malappuram 963323307010 Dr. Leena Sankunni CWC Mission Hospital, Malappuram 938772956211 Dr. Jayakumari S Devi Nursing Home, Nilambur, Malappuram 949513810512 Dr. Najma Mol Chirayakuth Al-Shifa Hospital, Perinthalmanna 974566624913 Dr. Mumtaz P.M Neha Hospital, Kottakkal 974437313014 Dr. Shanty Sebastian P.G Hospital, Nilambur 944656998215 Dr. Sabna Al-Mas Hospital, Kottakkal 960550696916 Dr.Sini Francis Al-Mas Hospital, Kottakkal 949562500717 Dr.Jessy Joy Prasanthi Hospital, Manjeri, Malappuram 944774833818 Dr. Kadija P.A Amina Hospital, Perinthalmanna 493322091219 Dr. Rani B Chittoor Vengara Nursing Home 9645715397

24th & 25th August 2013, MALAPPURAM List of delegates

30

26th & 27th October 2013, KOTTAYAMList of participants

Doctors from Private hospitals1. Dr.Annamma Alexander Matha Hospital, Thellakom, 94468205832 Dr.Betty Jose Carmel Medical Centre, Pala 9048010126,

drbettyjose@gmail.com3. Dr.Meena Soman Chazhikattu Hosp, Thodupuzha, Idukki 9447221622,

meena.6z@gmail.com4. Dr.Vijayakumari.R Sanjeevani Hospital, Changanasseri 9447770541,

drvijayakumari@gmail.com5. Dr.Moly John St.Thomas Hospital, Kurishummoodu P.O.,

Changanasseri, Johnmolly68@yahoo.com 9495193588,6. Dr.Sobha Elizabeth Varghese Suresh Nursing Home, Perunna.P.O,

Changanasseri, sobhaliz@gmail.com 9495081270,7. Dr.Santhamani.M.K. Little Lourde Hospital, Kidangoor 9447791601,

drsanthamani@gmail.com8. Dr.Afshana Sidhik Pushpagiri Medical College, Thiruvalla 9846096008,

afshana84@gmial.com9. Dr.R.P.Mythreyi Archana Hospital, Thodupuzha 9847044711,

mythreyi.archana@gmail.com10. Dr.Priyanka Viswanath Pushpagiri Medical College, Thiruvalla 7736629829,

priyanka.visw@gmail.com

Govt. Doctors1. Dr.K.G.Letha Civil Surgeon, BPHC, Uzhavoor P.O, Kottayam 94460676402. Dr.Rajesh.G General Hospital, Kanjirapally, KTM 98464104415,

rajeshgkk79@gmail.com3. Dr.S.Nalini Dept. of Physiology, Govt. Theni Medical College 9443825260,

nalini.santhalingam@gmail.com4. Dr.Sibimol Aji THQH, Thodupuzha 8281803413,

drsibimol@yahoo.com5. Dr.Anjali Prem District Hospital, Kottayam 9446024970,

anjalina-prem@yahoo.co.in6. Dr.Divya Sara Rajin GH, Pala 98959271567. Dr.Letha kumara.L Govt. General Hospital, Changannasseri 9495200849

lethamanmohan@gmail.com8. Dr.Rani Lakshmi.S District Hospital, Kottayam 9446588339

ranilakshmis@gmail.com9. Dr.Shiny.V.S District Hospital, Mavelikkara 9446068977

shinyvasudevan@yahoo.co.in10. Dr.S.Anithakumari W&C Hospital, Alappuzha 9447569049

sanitha.dr.@gmail.com11. Dr.Sheena Mathew THQH, Pampadi 9447813407

sheenaahil@gmail.com12. Dr.Geetha Cherian W & C , Alappuzha 984656524513. Dr.Mariya Jerome MCH, Kottayam 9567959210

3131

P.G Students1. Dr.Jisha Jayaprakash THQH, Haripad 9495124932,

drpsharush@yahoo.com2. Dr.Kala.K District Hospital, Kottayam 9447573904,

arunpr79@gmail.com3. Dr.Jeeva.P.Bal MCH, Kottayam 9447128122

jeevapbal84@gmail.com4. Dr.Nisha.S MCH, Kottayam 9497879146

nisha.shamsudeen@gmail.com5. Dr.Jincy Jacob MCH, Kottayam 9847249185

jincy-86@yahoo.com6. Dr.Aysha.K.M MCH, Kottayam 9495956346

ayshayasmin@yahoo.com7. Dr.Remya.M MCH, Kottayam 9496114662

remya0432@gmail.com8. Dr.Hitha Sabu MCH, KTM 9495767216

drseban77@gmail.com9. Dr.Anjana Balachandran MCH, KTM 940047542

dranjanab@gmail.com10. Dr.Divya Vishnu MCH, Kottayam 9995754392

vishnudivya@yahoo.com11. Dr.Seeja.P. THQH, Vaikom 8156874257 12. Dr.Fiji Raj MCH, Kottayam 9497272716

fijiraj@yahoo.co.in

FacultyNo: Name Hospital Address1 Dr. Kunjamma Roy Kottayam Medical College2 Dr. Sathy M.S Kottayam Medical College3 Dr. Bindu Sajith Kottayam Medical College4 Dr. V.P Paily Mother Hospital, Thrissur5 Dr. Bindu Menon JMMCH6 Dr. Jayaraj JMMCH7 Dr. Siju JMMCH8 Dr. Kashyap C.K JMMCH9 Dr. Jyothy Calicut Medical College10 Dr. Smitha Calicut Medical College11 Dr. Ajith Pariyaram Medical College12 Dr. P.V Jose Pariyaram Medical College13 Dr. Mrudulla W&C, Mangattuparamba, Kannur14 Dr. Cynthia DH, Kannur15 Dr. Dilnath Paediatrics, Thalassery16 Dr. HariParasad Taliparamba17 Dr. Arun Mathur Kannur Medical College18 Dr. Smitha Rajiv Co-Operative Medical College, Kannur

11th & 12th January 2014, KANNUR

32

Govt. Delegates1 Dr. Thankamani DH, Kannur2 Dr. M.R Reshmi W&C Hospital, Mangattuparamba, Kannur3 Dr. Anupa R W&C Hospital, Mangattuparamba, Kannur4 Dr. Suja Ajith General Hospital, Thalassery5 Dr. Bindu Mol DH, Kannur6 Dr. V Preman P.H.C Mattool7 Dr. Aruna K.N Taluk Hospital, Thaliparamba8 Dr. Thufail W&C Mangottuparamba, Kannur9 Dr. Madhu Soodhanan Taluk Hospital, Payyannur10 Dr. Poornima Prabhu GH, Thalassery11 Dr. C.K Rajmohan Taluk Hospital, Thaliparamba12 Dr. Appu Susheel Govt Medical College, Calicut13 Dr. Mrudula M.P W&C Mangottuparamba, Kannur

Delegates from private hospitals1 Dr. Gopinathan P Kannur Medical College, Anjarakandy2 Dr. Philomina George Kannur Medical College, Anjarakandy3 Dr. Chaithra Gowde Kannur Medical College, Anjarakandy4 Dr. Reshmi V.P Pariyaram Medical College5 Dr. Meera iruveetil Medical Centre6 Dr. Mini Balakrishnan Co-Operative Hospital, Thalassery7 Dr. Sr. Louice Josgiri Hospital, Thalassery8 Dr. Bhargavi P Shemi Hospital, Talassery9 Dr. Susan Joseph St. Vincent de Paul, Ollur, Thrissur10 Dr. Shyamala Mukundan Meenakshmi Amma Memorial Hospital, Payyannur11 Dr. Sonita Shramsh Lourde Hospital, Taliparamba12 Dr. Viswan V Saba Hospital, Payyannur13 Dr. Praveen Gopinath Mukunda Hospital, Payyannur14 Dr. Sindhu Prasanth Ashraya Hospital, Mattannur15 Dr. Simi Kurian Pariyaram Medical College16 Dr. Sreedevi Binu Koyili Hospital, Kannur

P.G Students1 Dr. Rabeeh V Pariyarm Medical College2 Dr. Divya Louis Pariyarm Medical College3 Dr. Nishi Kailash Pariyarm Medical College4 Dr. Blessy Mary Pariyarm Medical College5 Dr. Jisha R Raju Pariyarm Medical College6 Dr. Shony Thomas Pariyarm Medical College

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Govt. DoctorsName & Address1 Dr. Jaya LalMohan State Training Consultant, NRHM, Kerala

9446778822 jayalalmohan@gmail.com2 Dr. Renuka Leslie W &C Hospital, Thycaud, Trivandrum

9349321276 renukaleslie@gmail.com3 Dr. Geetha G Nair District Model Hospital, Peroorkada

9447068783 sdilipnair@hotmail.com4 Dr. Rakhi Chandran W & C Hospital, Thycaud, Trivandrum

9847204178 rakhichandran89@yahoo.com5 Dr. Aganes R SATH, Medical College,Trivandrum

04712293369(Resi) christabelhome@gmail.com6 Dr. M. Shanthi CHC Kanyakulangara 9495043830 7 Dr. Thanooja S SAT Hospital, Trivandrum

9495950183 thanoojarias@gmail.com8 Dr. S. Sreelatha SAT Hospital, Trivandrum

9847181632 ssreelatha28@yahoo.com9 Dr. Tanya Salim SAT Hospital, Trivandrum

9447342786 drtanyasharmal@gmail.com10 Dr. Sajith Mohan R W & C Thycaud, Trivandrum

2893340 drsajithr@gmail.com11 Dr. Ambili Kumari S Taluk Hospital, Chirayinkeezhu

944675247512 Dr. Lissa Prabhakaran Govt. W & C Hospital, Thycaud, Trivandrum

2540465(Resi) 13 Dr. Sobha Kumari O W & C Hospital, Thycaud,

9447141252 sobhashelly91@gmail.com14 Dr. Sreekala Devi S Junior Consultant W & C, Thycaud, Trivandrum

0471 2323457(Hos) drsreekaladevi@gmail.com

P.G Students

1 Dr. Parvathy Das SAT Hospital, Trivandrum9496323161 drparvathydas@gmail.com

2 Dr. Amy Jose SAT Hospital, Trivandrum9400744347 jose.amy@gmail.com

3 Dr. Parvathi S SAT Hospital, Trivandrumparvathi.parvathiS6 @gmail.com

4 Dr. Anupama S SAT Hospital, Trivandrum9946614948 anupamasasidharan22@yahoo.com

15th & 16th June 2013, TRIVANDRUMList of participants

34

Staff Nurse

1 Suja Nair J.S Staff Nurse, W & C Hospital, Thycaud, Trivandrum9446512769

2 Lekshmi S Nair Staff Nurse Govt. W & C Hospital, Thycaud, Trivandrum8281568154, 0471 2323458

3 Rejani S Taluk Hospital, Chirayinkeezhu0474 279550004702646666(Hos)

4. Sreeja S Staff Nurse W & C Hospital, Thycaud TrivandrumMob: 8606802591 04712323458(Hos)

5 Rajith Dev Staff Nurse W & C Hospital, Thycaud Trivandrum04712323458(Hos) 8547576361

6 R. Sasikala Staff Nurse Thycaud04712323458(Hos)9995969332

7 Jessy K Lukose Staff Nurse, C.H.C, KanyakulangaraMob: 9847784657

8 Bindu V.P Staff Nurse DMH, Peroorkada,TVM04712432071(Hos) 9388138021

9 Preetha Kumari K.R Staff Nurse DMH, Peroorkada, TVM04712432071(Hos) 9400276397

10 Lekha Kumari S Staff Nurse THQH, ChirayinkeezhuPh: 0470 2646666(Hos)

3535

KFOG is acutely aware of the need forempowering nurses and nursing assistants intackling emergencies in obstetrics as they areusually the only ones available at the scene ofan emergency when it strikes. However, it is notpossible for KFOG to undertake this training forall nursing personnel. Hence it was proposed totrain the senior and middle level nursing faculty

especially from nursing college and schools withthe hope that they in turn will train the nurses andnursing assistants. The initial plan was toconduct two such ‘training the trainers’ courses.However, after the launch of the quality standardstwo more training sessions were conducted forthe staff of SAT Thiruvananthapuram andGeneral Hospital Ernakulam. A brief report of thetraining programme is given below.

EMOCALS Training of Trainers for NursesThe ScheduleDate Venue Local organisers8th,9th Dec 2012 Togs Academia,Kizhakke Dr.Deepthy Muraly,

Suryagramam, Behind Bishop Palace, Mob: 9447267794East Fort, Thrissur -5 Dr.Betsy Thomas,

Mob:989557907723rd, 24th Feb 2013 Togs Academia, Kizhakke Suryagramam,

Behind Bishop Palace, East Fort, Thrissur -5

1st Course The first training module for the trainers ofEMOCALS-N was conducted at TOGSacademia, Kizhakkumpattukara on Dec 8th and9th 2012. A total of 45 delegates attended theprogramme. The participants were nursesmainly from government sector. They were fromThrissur, Alappuzha, Kottayam, Idukki &Ernakulam districts. The observer was Mrs.Ancy Mathew, Associate Professor, School ofNursing, Kottayam.Registration started at 8 am. The participantswere given a kit of bag, pen, writing pad,programme copy and copy of 2 books-.1. Why Mothers Die-Kerala, 2nd edition2. The Protocol book prepared by KFOG.The programme started with introduction of theprogramme and outline by Dr.V.P.Paily. He

stressed on the need of these types of trainingprogrammes for staff nurses and nursingassistants who will be carrying out the activitiesof labour room. It was followed by a test whichhad 20 questions on the practical aspects. Thefirst session was BE PRESENT AND BEPREPARED. A pre-test was given before thelectures. The lectures were more of interactive sessionswith ample time for discussion and suggestionsfrom the delegates. All the lectures weresupported by power point presentations. Postlunch sessions were workstations wheredelegates were divided into small groups andwere given hands on training on various drillsand practical procedures. The first day’sprogramme was concluded by 5.30 pm.Second day started with recap of first day’sactivities. Sessions were taken by gynecologists,anesthesiologists, and neonatologist. After the

EMOCALS –NREPORT OF THE TRAINING OF THE TRAINERS

36

post lunch workstations a post test wasconducted with the same questionnaire usedfor pre-test which showed a markedimprovement of scores. A sample score of thefirst course is shown below. Mark Pre test Post test

5 0 06 1 07 3 08 4 09 2 1

10 1 011 8 212 2 013 2 314 6 215 2 916 5 417 2 718 1 519 1 220 0 3

Certificates, TA/DA as per governmentnorms, softcopy of study materials, and a copy ofgroup photo of delegates were given to allcandidates by Dr. V.P.Paily. The meetingconcluded at 4.30 pm. On both days breakfast,coffee, and lunch were served. Accommodationwas provided on twin sharing basis on Saturday.The suggestions from the feedback forms fromthe delegates were as follows :1. All appreciated the content and presentationof the programme, and wanted more frequenttraining sessions, preferably on week days.2. Most appreciated sessions were on PPH,Eclampsia, Asepsis, Sterilisation, and Neonatalresuscitation. 3. Most of them were keen to start antenatalclasses in their set up and to arrange emergencytrolley.

2nd courseThis was conducted in a similar pattern at TOGSAcademia. There were 23 nurses participatingfrom different districts.

List of delegates (1st course)1 Santhakumary N.V THQH,Chengannur2 Ashalatha P.R THQH,Harippad, Alappuzha3 Sreelatha K.N Nursing tutor,School of Nursing,Ernakulam4 Ushakumariamma Dt.H,Mavelikkara5 Elsy Thomas THQH,Kodungallore, Thrissur6 Dhanya M.R Dt.H,Kottayam7 Nishi Punnan Dt.H,Kottayam8 Usha M.V. Nursing Tutor,School of Nursing, Ernakulam9 Alphonsa George THQH,Adimali, Idukki10 Soumiya T.S MCH,MGKavu, Thrissur11 Preeja P.S MCH,MGKavu, Thrissur12 Shiny C.R THQH,Perumbavoor, Ernakulam13 Khadeeja V.M THQH,Kothamangalam, Ernakulam14 Blessy Skaria THQH,Vaikom, Ernakulam15 Rani Paul THQH,Vaikom Ernakulam16 Beena T.John Nursing Tutor,School of Nursing,Ernakulam17 Carmel Andrews W&C Hospital,Mattancherry, Ernakulam18 Ushakumari.P.K THQH,Thodupuzha19 Jerusela George PHC,Kumaramangalam20 Christy Samuel CHC Muttam, Thodupuzha21 Jasmine Jose THQH, Nedumkandam22 Sheemol P.K DH,Cheruthoni,Idukki23 Saly N.J Nursing Tutor, Govt School of Nursing, Thrissur

3737

Sl. Name Working Station Place1 Jessy V.M Govt. School of nursing Kannur2 TijiMol N Thomas Govt. School of nursing Kasargod3 Chitra P.A Nursing Tutor Govt. School of nursing Alappuzha4 Giggy John Asst.Professor,GovtCollege of Nursing Thrissur5 Chitra Chandran Lecturer,govt college of nursing Thrissur6 Sunitha Koopilakkal Govt School of Nursing Manjeri, MPM7 Mary Devassy KMK Hospital Aluva - Private8 Sigi Baby KMK Hospital Aluva - Private9 Bindu K Sankar Govt School of Nursing Wayanad10 Sobhana Ramakrishnan Govt College of Nursing TVM11 Sona P.S Asst Professor Govt College of Nursing TVM12 Reena A Thankaraj Asst Professor Govt College of Nursing TVM13 Anu S.O Lecturer Govt College of Nursing TVM14 Rasiya K.K Asst Professor Govt College of Nursing MCH, Calicut15 Babitha C.K Asst Professor Govt College of Nursing Kozhikode16 Molly Thomas Govt School of Nursing Calicut17 Thresiamma John Nursing Tutor F.H.S.T.S, Malaparambu Kozhikode18 Shyma P Nursing Tutor Govt School of Nursing Palakkad19 Binu Sadanandan Nursing Tutor Govt School of Nursing Ernakulam20 Rema T.U Govt School of Nursing Kottayam21 Beena Rani S Nursing Tutor Govt School of Nursing Asramam, Kollam22 Sindumol T Asst Professor Govt College of Nursing Kottayam23 Latha Sukumaran Nursing Tutor Govt School of Nursing Kottayam

List of participants

2nd course at TOGS Academia

24 Shaji P.I Govt.school of Nursing, Thrissur25 K.V.Rosily THQH,Chavakkad, Thrissur26 Mary.P.O THQH,Chalakkudy, Thrissur27 Siby Antony Dt.H,Aluva, Ernakulam28 Sheela.N.F Dt.H,Thrissur29 Omana.T.D School of Nursing,Thrissur30 Nitha Premnath W&C,Hospital,Alappuzha31 Priya.P.K. THQH,Cherthala, . Alappuzha32 Manjumol.M Ernakulam33 Sheeba Chacko Nursing School,Kottayam34 Reena Thomas Nursing School,Kottayam35 Jooly Verghese Nursing School,Kottayam36 Rev.Sr.Roscilla Jubilee Mission H,Thrissur37 JayasreeK.G “38 Joicy.C.V “39 Saly Thomas Jubilee Mission H,Thrissur40 Divya.K Westfort Hitech Hospital,Thrissur41 Suseela.V Mother Hospital,Thrissur42 Lissy John Mother Hospital, Thrissur43 Soudamini.V.T Westfort Hospital,Thrissur44 Shibi.T.B Westfort Hospital,Thrissur45 Mary Joseph Govt MCH, , Thrissur

38

Timing Presentation Presenter TimeDay 1 8 th December

8.00- 8.30 Breakfast

8.30-9.00 Registration

9.00- 9.10 Introduction and breaking the ice Prof. V P Paily 10’

9.10- 9.20 Outline of the workshop Prof. V P Paily 10’

9:20-9:30 Pretest 10’

Session 1 –9:30 – 10:10 Be present and be preparedAntenatal care, antenatal class,

danger signals Prof. V P Paily 10’

Setting up labour room –Stages 1,2,3

and Neonatal corner Dr. Nishi 10’

Instruments, Packs, emergency trolley Dr. Deepthy 10’

Interaction and Recap Prof V P Paily 10’

Session 2 – 10:10 – 10:45 Companion and Communicator

Communication with patient,

relatives and doctors Prof Rajasekharan Nair 10’

Companionship in labour Dr. Deepthy 10’

Managing crowd in emergencies Dr. Betsy 5’

Documentation Dr. Resmi 5’

Interaction and Recap Prof Rajasekharan Nair 5’

10:45 – 11 :00 Coffee breakSession 3 –11:00-11:50 Emergencies during Labour

I stage with NST Dr.Deepthy 10’

II stage with delivery Prof Paily 10’

3rd stage and 4th stage Dr. Resmi 10’

Labour monitoring with examples

from CRMD Dr. Betsy 10’

Interaction and Recap Prof. Paily 10’

Session 4 –11:50-12:20 Role play

Acute collapse, Em.trolley Dr. Deepthy 10’

PPH, PPH Box Dr. Resmi 10’

Eclampsia, Eclampsia Box Dr. Betsy 10’

EMOCALS - N Training the Nursing TrainersSAMPLE PROGRAMMEDecember 8th and 9th 2012TOGS Academia,Thrissur- 680005

3939

Session 5– 12:20 – 1:00 The Killers

Antepartum hemorrhage –

how to pick up Prof Rajasekharan 10’

Management of AFE Dr. Resmi 10’

How to prevent VTE Dr. Betsy 10’

Interaction and Recap Dr.Rajasekharan 10’

1.00- 2.00 Lunch Break

2.00-3.30 Workstations 15’ each

1 Partogram Dr. Ambujam

2 Conduct of labour Prof. Paily

3 Shoulder dystocia Dr. Resmi

4 AMTSL Dr. Nishi

5 Condom tamponade Dr. Deepthy

6 Cervical inspection Dr. Betsy

3:30-4:00 Tea Break

Session 5 - 4:00 – 4:45 Operative DeliveriesCesarean Prof Paily 10’

Forceps Dr.Ambujam 10’

Ventouse Dr.Nishi 10’

Breech Dr. Ambujam 10’

Interaction and recap Prof Paily 5’

Day 2 9 th December8.00- 8.30 Breakfast

8:30 – 8:40 Recap of the first day Prof V P Paily 10’

Session 68.40-9.20 Asepsis in labour room

Autoclaving and sterilisation Prof.V P Paily 10’

Segregation and disposal of waste Dr.Betsy 10’

Cleaning the Labour room Dr. Deepthy 10’

Interaction and Recap Prof.V P Paily 10’

Session 7 9:20-10:00 Miscellaneous

Patient transfer and Emergency number Dr. Lola 10’

Maintenance of instruments -Oxygen

cylinder, Sterilizer, Cautery,Suction a

pparatus etc Prof. Paily 10’

Handling of HIV and HBsAg patients Dr. Betsy 10’

Interaction and Recap Prof .VPP 10’

10:00 – 10:30 Coffee Break

40

Session 810.30-11:20 Against infections

Wound management Dr. Deepthy 10’

Sepsis Prof. VPP 10’

Antibiotic policy Dr. Lola 10’

Anaphylaxis Dr. Betsy 10’

Interaction and recap Prof. VPP 10’

Session 911.20- 12.00 The Killers

Hypertensive disorders of pregnancy –

definition, classification Dr. Lola 5’

Management of hypertension Dr. Deepthy 10’

Management of eclampsia Prof. V P Paily 5 ‘

HELLP syndrome, DIC Dr.Lola 10’

Interaction and recap Prof. VPP 10’

Session 10 12:00- 1:00 Drugs and fluids

Important Drugs and administration Dr. Geetha A P 10’

I V fluids Dr. Lola 10’

Blood and blood products Dr. Geetha A P 10’

Interaction and recap Prof. VPP 10’

General overview of resuscitation Prof.A.K.Unnikrishnan 10’

Outline of neonatal resuscitation Dr.Raveendravarma 10’

1.00-2.00 Lunch

2.00-3.30 Workstation 15’ each

1 ECG Dr. Sudhakaran

2 I V access Dr. Lola

3 Neonatal resuscitation Dr. Raveendra Varma

4 Cardiac compression Dr. Asish

5 Airway Dr. Shamshad, Dr. Vilasu

6 Monitors Dr. Anju

3:30 – 4:30 - Post test , Feedback and Conclusion

4141

Two additional courses were conducted for nurses to helpwith the quality standards project.

1. Training at Thiruvanandapuram on 6&7th July 20132. Training at General Hospital, Ernakulam on 13th & 14th July 2013

Delegates who attended training at GH Ernakulam

Sl.No Name of delegates Designation Institution Phone No:1 Nisha Antony Staff Nurse General Hospital, EKM 98461755782 Chinnamma PU Head Nurse General Hospital, EKM 94461252883 P.M Lissy Head Nurse General Hospital, EKM 94468959834 M.I Valsamma Head Nurse General Hospital, EKM 98463131525 Selvi K Varkey Staff Nurse General Hospital, EKM 94460176256 Geetha T.V Head Nurse General Hospital, EKM 91420225887 D Vanajamma Head Nurse General Hospital, EKM 94950174498 Sheena mole S Staff Nurse General Hospital, EKM 9 Padmini Kumaran Staff Nurse General Hospital, EKM 944661276910 Arundhathi K.K Staff Nurse General Hospital, EKM 944641620611 Suni T.V Staff Nurse General Hospital, EKM 944671867212 P.K Geethakumary Head Nurse General Hospital, EKM 999535520013 K.S Molly Head Nurse General Hospital, EKM 949542515714 Lysa Thomas Head Nurse General Hospital, EKM 924989607915 Vijayakumari C.D Staff Nurse General Hospital, EKM 989512539516 Komalavally V.C Staff Nurse General Hospital, EKM 854717597317 Shiny Antony Staff Nurse General Hospital, EKM 949744379518 Alice P.G Staff Nurse General Hospital, EKM 944773369619 Carmel Mary Staff Nurse General Hospital, EKM 989564630420 Vilasini A.K Head Nurse General Hospital, EKM 944794096121 Sandhya N Namboothiri Staff Nurse General Hospital, EKM 944736672722 Nancy Xavier Head Nurse General Hospital, EKM 949796227823 Mini C.N Staff Nurse General Hospital, EKM 984777781224 Preetha S Staff Nurse General Hospital, EKM 949551926825 Jayanthimol K.S Staff Nurse General Hospital, EKM 949599003226 Victoria Mathew Staff Nurse General Hospital, EKM 944643736127 Jacklin C Joseph Staff Nurse General Hospital, EKM 984729107428 Anupama P.U Staff Nurse General Hospital, EKM 854750465029 V.D Lissy Nursing Suptd General Hospital, EKM 944767287630 Thara K.N Staff Nurse General Hospital, EKM 938763932131 Selma N.M Staff Nurse General Hospital, EKM 999518381632 Saritha K.K Staff Nurse General Hospital, EKM 828103058433 P.M Mary Head Nurse General Hospital, EKM 944793031534 Sudha P John Staff Nurse General Hospital, EKM 974633530135 Raji M.K Staff Nurse General Hospital, EKM 984733658536 Tintu M.M Staff Nurse General Hospital, EKM 9497280285

ADDITIONAL COURSES

42

37 Neethu Mol Mohanan Staff Nurse General Hospital, EKM 960518582938 Shalu Sasi Staff Nurse General Hospital, EKM 963377893639 Vanija Varghese Staff Nurse General Hospital, EKM 903754156140 Geetha P.G Head Nurse General Hospital, EKM 944639160941 Ajitha P.T Staff Nurse General Hospital, EKM 984617546042 Bindu K Kumar Staff Nurse General Hospital, EKM 996157042943 Nirmala Head Nurse General Hospital, EKM 949779393843 Ramla P.M Staff Nurse THQH, Kothamangalam 994771274144 Sigy T.H Staff Nurse THQH, Kothamangalam 812951501145 Santha M.I Staff Nurse THQH, Fort Kochi 965613104146 Sany M.V Staff Nurse THQH, Fort Kochi 944781930747 Lisy A.D Staff Nurse THQH, Paravoor 984699510248 Mary K.G Staff Nurse THQH, Paravoor 940094421449 N.A Daisy Staff Nurse W&C, Mattancherry 949593391550 Anna Susy V.A Staff Nurse W&C, Mattancherry 996130205851 Deepa Mathew Staff Nurse THQH, Perumbavoor 994785581352 Liji K Mathew Staff Nurse THQH, Perumbavoor 999502932653 Shijimol P.J Staff Nurse THQH, Thripunithura 940071059854 Jissy Mathew Staff Nurse THQH, Thripunithura 949576449555 M.K Prasanna Staff Nurse G.H, Muvattupuzha 964585127056 Radhamany P.T Staff Nurse G.H, Muvattupuzha 954451619157 Sr. Liza grace Staff Nurse Dhanya Mission H, Potta 271027158 Sr. Liya Staff Nurse Dhanya Mission H, Potta 271027159 Jolly Francis Staff Nurse Medical Centre, EKM 949517433260 Sunitha mol N.O ANM, Pvt Medical Centre, EKM 9142693670

Sl.No Name of delegates Designation Institution Phone No:1 Pushpa Joseph Nursing Assistant General Hospital, EKM 90486850882 Omana P.R Nursing Assistant General Hospital, EKM 96057160143 Mani N.B Nursing Assistant General Hospital, EKM 97441498334 Cheruvaumma P.K Nursing Assistant General Hospital, EKM 96567783735 M.K Vinu Nursing Assistant General Hospital, EKM 96569313036 Valsala V.S Nursing Assistant General Hospital, EKM 82812610747 Money K.S Nursing Assistant General Hospital, EKM 97473113048 Tansi Jose K Nursing Assistant General Hospital, EKM 99469517619 Bhadra Devi T.K Nursing Assistant General Hospital, EKM 960560377910 A.K Shyla Nursing Assistant General Hospital, EKM 974482092711 Lalitha T.N Nursing Assistant General Hospital, EKM 994652752412 Ramla T.U Nursing Assistant General Hospital, EKM 994627813913 K.I Anjana Mallika Nursing Assistant General Hospital, EKM 984628614714 Anila K.S Nursing Assistant General Hospital, EKM 994678415215 K. Valsamani Nursing Assistant General Hospital, EKM 949676817016 Sarada C.K Nursing Assistant General Hospital, EKM 994716873117 Navya P.T Staff Nurse City Hospital, EKM 828160067218 Ranjini S Staff Nurse City Hospital, EKM 906174380319 Shijina P.B Staff Nurse City Hospital, EKM 9645583668

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1 Anuja S E SATH2 Rekha SATH3 Jaya S SATH4 Renuga E SATH5 Nisha SATH6 Sunaja A S SATH7 Suja A P SATH8 Aswathi R SATH9 Hani Raj W & C Thycaud10 Resmi G SATH11 Nimisha S SATH12 Shammela m H SATH13 Arathi S Nair SATH14 Leela K SATH15 Sherly G L DMH Peroorkada16 Jaya S Govt College of nursing17 Jeethu R Govt College of nursing18 Anitha T SATH19 Prema V R SATH20 Manjumol V J SATH21 Bijula M R W & C Thycaud22 Kairali K M W & C Thycaud23 Suja T N W & C Thycaud24 Sindhu T G W & C Thycaud25 Sudha M THQ Chirayinkezhu26 Sreedevi S THQ Chirayinkezhu27 Jansy John W & C Thycaud28 Lini K Govt College of nursing29 Rincy Aruja Govt College of nursing30 Lini K Govt College of nursing31 ArunPriya T L Govt College of nursing

List of participants

Emocal N Training of Staff Nurses 6th & 7th July 2013, Trivandrum

Emocal N Nursing Assistant on 6th July 1. Sreekumri L SATH 2. Usha Kumari C SATH 3. Usha Kumari g SATH 4. Kumari Rama SATH 5. Jayalakshmi SATH 6. Vijaya Kumari SATH 7. Hemalatha SATH 8. Radha SATH 9. Asha Kuamri SATH 10. Pushpavall SATH 11. Girija SATH 12. Vasantha Kumari SATH 13. Sheela Thankachi SATH 14. Shalini D SATH 15. Sujatha S SATH

44

In 2012, the Kerala Government invited theUK organization, NICE international, tostudy the state of maternal and infant healthcare in Kerala and suggest any steps to reducethe maternal and infant mortality rate. Thiswas a sequel to the realization that these ratesremained almost static in the last decade.Even though these Kerala rates were belowthe millennium development goals set forIndia, the Government was concerned thatthere were still avoidable maternal and infantdeaths in the state. A team from NICE headed by its seniorofficials paid several visits to the state andhad discussions with the health secretary andother officials and the Kerala Federation ofOBS &Gyn. They studied the document“Why Mothers die - Kerala” prepared by theKerala Federation of Obstetrics andGynecology on the basis of confidentialreviews of maternal deaths. The NICE teamfelt that to reduce maternal deaths further,the two leading causes, namely hemorrhageand hypertension should be addressed.Standard of obstetric care has to be improved.Five steps each in the management wereidentified to prevent haematological andhypertensive deaths. After extensive groupdiscussions it was decided to pilot these stepsof quality standards in 6 Government and 2private Hospitals in the state. The 10 steps,known as quality standards were as fallows.

A. To prevent PPH death1. Practice active management of third stage

of labour in every delivery2. 4th stage management- observe every

woman after delivery for two hours3. Give blood transfusion to everyone who

developed BP fall in spite of IV fluids4. Observe in the ICU/HDU, everyone who

received blood transfusion.5. Insist on ultra sound scan at 32 weeks for

every woman pregnant after previouscesarean to identify potential cases ofplacenta previa accreta

B.To prevent deaths due to hypertension1. Increase the pickup of pre eclampsia cases

by insisting on urine examination forprotein in every antenatal case once in 1st

and 2nd trimesters and during all visits after34 weeks.

2. Start antihypertensive treatment for everypregnant woman with BP above 140/90

3. Start parenteral antihypertensives for everywoman with BP above 160/100.

4. In every woman with high BP, check bloodfor liver enzymes and platelets and ifidentified to be having HELLP, considerexpedited delivery.

5. Use Magnesium sulphate as the first lineanti convulsant in the standard dose forevery case of eclampsia and impendingeclampsia.

It was decided that before starting the pilot,baseline data from the pilot hospitals had tobe collected. The hospitals had to improvethe infrastructure and staffing pattern. Thestaff had to be trained to improve the careand incorporate the required changes in themanagement. KFOG agreed to conduct thepreliminary training of staff of differentcategories- Obstetricians, nurses andnursing assistants. Funds were allotted toKFOG to conduct the training and supply of

Quality standards in Obstetric Care

4545

instruments required for improvedmanagement of labor and post partum period.The instruments were later to be used in thedepartment for patient care. The NationalRural Health Mission agreed to be thefunding agency and as per order No:(NRHM)1293/M&E(QA)/2013/SPMSUDt.29-03-2013 allotted rupees Nine lakhsTwenty eight thousand Five hundred andForty four(9,28,544/-) from the RS 49 lakhsallotted earlier for the EMOCALS project.This amount was for conducting the trainingand providing the training equipment andinstruments to the pilot hospitals under theGovernment sector. The details of trainingsessions, instruments and equipment’ssupplied to the hospitals are included in thisreport.

The pilot Hospitals were:1. W& C Hospital,

Thycaud,Thiruvananthapuram2. SAT Hospital, Thiruvananthapuram3. CHC Kanyakulangara,

Thiruvanandapuram4. Thaluk Headquarters Hospital,

Chirayankeezhu, Thiruvananthapuram5. Government Hospital ,Perurkada,

Thiruvananthapuram6. Government General Hospital,

Ernakulam

The prelaunch training was conducted duringMarch 2013 in the following places:-

1.W & C Hospital, Thycaud -on 7th& 8th March 2013.

2. SAT Hospital, ThiruvananthapuramOn 9th& 10th March 2013

3. General Hospital , ErnakulamOn 22nd March 2013

4. Mother Hospital,ThrissurOn 23rd March 2013

By December 2013, it was felt that theQuality Standards should be expandedfurther to include new hospitals wherelarge number of deliveries took place. Itwas decided to recruit the followinghospitals.

1. Victoria Hospital, Kollam2. District Hospital, Palakkad3. Tribal Specialty Hospital, Attappady4.W&C Hospital, Kottapparambu, Kozhikode5. District Hospital, Mananthawady6. District Hospital, Manjeri

The proposal was to train the staff in theserespective hospitals on data entry first, withoutimplementing the quality standards, so thatbaseline data will be available and then onlyask them to start practising quality standards.Accordingly Dr.V P Paily visited all thesehospitals to give them training in data entry.However, the implementation did not happen.

7. SUT Hospital, Thiruvananthapuram8. Mother Hospital, Thrisur

Dr.V.P.Paily was appointed as KFOG’srepresentative to the quality standards project

Training was imparted to the labour room staffof pilot hospitals, as an introduction to theway the labour room practices have to bechanged on the basis of quality standards.

of Kerala.

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8.00 -8.30 Registration,Overview of Quality standards - what are they,purpose and how to implement VP PailyDiscussion on each of the first 5 quality standards V P PailyDiscussion of last 5 points of Quality Standards Rajasekharan NairConduct of labour in the light of quality standards, Vasanthi JayarajSetting up labour room, Sample delivery set, H/N SuseelaHow to reduce episiotomy, SeethaCompanion in labour – how practical, what problems? Kunjamma RoyCommon pitfalls in aseptic practice, keeping labour room tidy VP PailyDay to day running of labour room Suseela/ShinyPreparations for labour, cesarean, giving enema, shaving Suseela/ Shiny

Interactive sessionLunch 1.00 – 2.00pmPost lunch workstations. Coordinator –V P Paily (Each station 15 mts )1. When bleeding occurs – how to tackle, PPH chart,

Condom tamponade, PPH Box VJ/Hasta/Anuja2. When high BP occurs, what to look for, How to reduce BP, MgSO4 Use, Eclampsia Box VRS/Hema/ Regi3. Third and 4th stages, blood loss measurement – .

During vag delivery, during CS Lalkshmiammal/Bindu Thomas/Arathy

4. When the patient suddenly collapses, what first aid,how to proceed, BLS, Cardiac compression Anesthetist, Sujatha/

LecturesData Entry in Labour Register VPPailyManual Data collection monthly Hasta / AnujaA/N class – purpose, who should conduct,what should be taught VasanthiInduction of labour – different methods, video support VasanthiBasics of instrumental deliveries VP Paily

How to reduce c.section ratesInteraction and FeedbackConclusionsModel labour sets, cervical inspection sets and extra amniotic saline(EAS) sets were issuedto the participant hospitals. Contents of each set issued is given

SAMPLE PROGRAMMEQuality Standards- prelaunch staff training

(Coordinator – Morning Session: Dr.Rajasekharan Nair)

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Contents of Model labour setSteel tray to be used as baby tray 19"x13"x4" onePlacental bowl 8.5" oneSmaller bowl 4" oneSponge holder forceps oneEpisiotomy scissors 6" oneCord scissors 4" oneCord clamp – steel twoArtery forceps 6" twoNeedle holder oneThumb forceps one

Contents of cervical inspection setSingle bladed large speculum ThreeLong, broad sponge holder Three

Contents of Extra amniotic saline setS S Tray rectangular oneSmall bowl (stainless steel) twoSpecial Allis forceps oneSponge holding forceps oneLong straight artery forceps oneArtery forceps oneSpecial cusco’s speculum one

Details of the instruments supplied

Name of the institution: W & C Hospital, Thycaud, Thiruvananthapuram

Baby Tray 18 x13 : 21Placental bowl : 21Small bowl for cotton swabs : 31Straight scissors 6" : 33Straight scissors 7" : 32Thumb Forceps 7” : 24Dissecting forceps 6” : 3Sponge holding Forceps : 37Curved Artery 6" : 53Straight Artery 8" : 55Needle Holder : 30EAS Tray : 5Allis Forceps : 5Cuscos Speculum : 5Obstetric forceps : 1Cervical Inspection set 2Single Blade Speculum : 6

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2 Allis Forceps : 2 3. Sponge holding forceps : 6

PV Pack 2. S.Small bowl :2 artery forceps :2Name of the Institution: S.A.T Hospital

Baby Tray : 26Placental bowl : 26Small bowl for cotton swabs : 36Straight Scissors 6" : 42Straight Scissors 7" : 40Thumb Forceps 6” : 30Dissecting forceps 7” : 06Sponge holding forceps : 45Curved Artery 6 “ : 65Straight Artery 8" : 72Needle Holder : 40EAS Tray : 5Allis Forceps : 05Cuscos Speculum : 05Obst.Forceps : 02Common iliac artery clamp : 02Cervical Inspection set : 03 Single Blade Speculam : 09 Sponge holding Forceps : 09

Name of the institution: CHC Kanyakulungara

Baby Tray 18x13 : 04Placental bowl : 04Small bowl for cotton swabs : 08Straight Scissors 6" : 04Straight Scissors 7" : 04Thumb Forceps : 04Sponge holding Forceps : 06Curved Artery 6" : 10Straight Artery 8" : 08Needle holder : 04EAS Tray : 02Allis Forceps : 03Cuscos Speculum : 02

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Cervical Inspection set : 01 Single blade Speculum : 03 Sponge holding forceps : 03

PV Pack : 02 Small Steel Bowl : 02

Name of the institution: Thaluk Head Quarters Hospital, Chirayinkeezhu

Baby Tray 18x13 08Placental bowl 08Small bowl for cotton swabs 12Straight Scissors 6" 08Straight Scissors 7" 08Thumb Forceps 08Sponge holding forceps 10Curved Artery 6" 18Straight Artery 8" 16Needle holder 08EAS Tray 02Allis Forceps 03Cuscos Speculum 02Obst .Forceps 01

Cervical Inspection set 1.Single Blade Speculum : 03 2.Sponge holding forceps : 03 PV Pack-2 Steel small bowl : 02 7" Artery Forceps : 02

Name of the institution: Govt. Hospital Perurkada

Baby Tray : 08 Placental bowl : 08Small bowl for cotton swabs : 14Straight Scissors 6" : 08Straight Scissors 7" : 08Dissecting Forceps : 08Sponge holding Forceps : 11Curved Artery 6" : 19Straight Artery 8" : 16Needle holder : 08EAS Tray : 03Allis Forceps : 03

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Cuscos Speculum : 03Obst. Forceps : 01

Cervical inspection set : 01 1. Single blade Speculum : 03 2. Allis Forceps : 01 3. Sponge holding forceps : 03

PV Pack -2 Small bowl : 02 Artery Forceps 7" : 02

Name of the institution: General Hospital, Ernakulam

Baby Tray 18 x 13 : 16Placental bowl : 16Bowl for cotton swabs : 22Straight Scissors 6" : 23Straight Scissors 7" : 22Dissecting Forceps : 15Sponge holding forceps : 22Curved Artery 6" : 36Straight Artery 8" : 39Needle holder : 24EAS Tray : 03Allis Forceps : 04Cuscos Speculum : 03Obst. Forceps : 01artery forceps 7” : 09thumb forceps 7” : 02

Cervical inspection set: 01 1.Single blade Speculum : 03 2.Sponge holding Forceps : 03

PV Pack - 02 Small Steel bowl : 02 Artery Forceps 7" : 02

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1 Dr. V.P Paily KFOG2 Dr. Sunimol S RMO3 Dr. K.M Chandini Devi Chief anaesth.4 Dr. Mayadas consultant5 Dr. Sajith Mohan Asst. Surgeon6 Dr. Vimaladevi J Head Nurse7 Saroja J Head Nurse8 Jayasree B.S Head Nurse9 Ushakumari K Head Nurse10 Sulochanadevi A Nursing Suptd11 Sheela Many Head Nurse12 Syamalakumari Nursing Suptd13 Geetha Kumari R Staff N urse gr 114 Dr. Nissa Beegum K Jr Consultant15 Dr. Jeeja Beegum Jr Consultant16 Dr. Ambily consultant17 Dr. Shaila Das Jr Consultant18 Dr. Shirli consultant19 Dr. Thankam consultant20 Dr. Nirmala consultant21 Dr. Giji Gynaecologist22 Dr. V Rajasekharan Nair KFOG23 Dr. Vasanthi Jayaraj KFOG, TCR24 Dr. Shanthi Gynaecologist

Staff training on 07/03/2013 & 8/3/13 at W & C Hospital, Thiruvananthapuram25 Dr. D Leela Consultant O & G26 Dr. Thankam Consultant27 Dr. Renuka Consultant, W&C28 Sajitha R.B Supervioser, KIMS29 Vimaladevi J Head Nurse30 Sailaja Kumari S H/N31 Saraswathy Nursing Assistant32 Saradadevi P N/A33 Dany George Staff Nurse34 Sreeja S S/N35 Shilpa S S/N

Quality Standards Staff Training List – 2013Sensitization meeting at thiruvananthapuram on 16/02/2013

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36 B. Sujakumari S/N37 Suja T.N S/N38 Leshmi S Nair S/N39 Sasikala Amma P S/N40 Sheela S/N41 P. Radha S/N42 Girijakumary C.L H/N43 Bindu S S/N44 Remadevi C H/N45 Valsala P H/N46 Thankamani T GR 1147 Latha M.V GR 1148 Lalitha R N/A49 Dr. Sam John Varghese Consultant O & G50 M. Pankajam N/A51 Sudha N S/N THQH52 Jayasree B.S H/N W&C Hosp., TVM53 Ajithakumari S/N W&C Hosp., TVM54 Aswathy R Nair S/N W&C Hosp., TVM55 Suma S S/N W&C Hosp., TVM56 Ajesh dev Ag S/N W&C Hosp., TVM57 Rithugami S S/N W&C Hosp., TVM58 Sathikumari N/A W&C Hosp., TVM59 Aswathy G WH W&C Hosp., TVM60 Sr. Dona S/N W&C Hosp., TVM61 Dr. Sreekala Jr. Consultant W&C Hosp., TVM62 Dr. Rejitha Devi Jr. Consultant W&C Hosp., TVM63 Dr. Mayadas W&C Hosp., TVM64 Dr. Lini Prabhakaran Jr. Consultant65 Dr. Anuja PG Student Mother Hosp., Olari66 Dr. Vasanthi Jayaraj Consultant Mother Hosp., Olari67 Dr. Syad Consultant68 Dr. Geetha G Nair Consultant,DMH Peroorkada

Staff training on 22/03/2013 at General Hospital, ErnakulamName Designation

69 Prof. V.P Paily Consultant Mother Hospital70 Dr. Vasanthy Jayaraj Consultant Mother Hospital71 Dr. Bindu Varghese Consultant O&G Mother Hospital72 Dr. Kunjamma Roy HOD of O&G Medical College, Kottayam73 Dr. Sathi M.S Asst.professor Medical College, Kottayam

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74 Anula Shanmugham S/N GH, EKM75 Soumya Varghese S/N GH, EKM76 Ajitha Jolly A S/N GH, EKM77 Raji M.K S/N GH, EKM78 Ambika M.P GR 11 GH, EKM79 Asma K.M N/A GH, EKM80 Cicily Thomas P N/A GH, EKM81 Pathukutty N/A GH EKM82 Sumathykutty K.R S/N GH,EKM83 Dr. Hasta Kusthe P.G Mother Hospital84 Minu Paulson S/N Mother Hospital85 Aswathy V.B S/N Mother Hospital86 Dincymol M.D S/N Mother Hospital87 Suseela V H/N Mother Hospital88 Riaji N Mohan S/N GH EKM89 Nasee Bai P.D H/N GH ,EKM90 Sini M.N JPHN91 C.X. Philomina H/N G.H, EKM92 Shaini N.K S/N93 Remya K.V S/N94 M.I Valsamma H/N95 Jollyamma Thomas H/N96 Prameela V.T N/A97 Sheela K.R GR 1198 Tojo Thomas S/A99 Suseela MK GR 11, Attender100 Sandhya N.D JPHN PHC, Thiruvaniyoor101 Bindu K.V JPHN CHC, Kechery102 Bindu mol C.D GR 11, Attender EKM103 Shyji K.J S/N, GR 11 G.H, EKM104 Sheenamole S S/N, GR 11 G.H, EKM105 Komalavally D N/A G.H, EKM106 CarmelMary S/N G.H, EKM107 Dr. V Moshan Das Gynaecologist G.H, EKM108 Vasanthi M.K S/N G.H, EKM109 Dr. Nergis S Consultant O&G THQH, N. Parur110 Dr. Girija V Consultant O&G G.H, EKM111 Dr. Kala Senior Consultant112 Dr. Anju B Nambiar House Surgeon G.H, EKM113 Veena S.R Staff Nurse G.H, EKM114 Rajamma P.K Head Nurse G.H, EKM115 Vanajamma H/N G.H, EKM116 Shibi Paul Raj S/N G.H, EKM117 Ronny M.P H/N G.H, EKM118 Anu Joseph S/N G.H, EKM

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119 Kanchana A.V S/N G.H, EKM120 Chinnu K.C H/N G.H, EKM121 Saramma I Mathai H/N G.H, EKM122 Many A.P S/N G.H, EKM123 Sibi K.R S/N G.H, EKM124 Seenath T.B N/A G.H, EKM125 Asmabeevi K.S N/A G.H, EKM126 Meeramma Fernandez H/N G.H, EKM127 Joly Joseph H/N G.H, EKM128 Radhamani K.T Gr 11 G.H, EKM129 Nalini K N/A G.H, EKM130 K.H Shajitha N/A G.H, EKM131 Lucy Joseph H/N G.H, EKM132 Nirmala K H/N G.H, EKM

Staff training on 9 & 10 March 2013 at SAT, TrivandrumFaculty

Dr.Paily V PDr.Rajasekharan Nair VDr.Vasanthy JayarajDr.Arathy V LDr.SujathaDr.Sujamol JacobDr.Sreelatha

Participants1 Dr.Anita V Asst professor SATH2 Dr.Bindu Asst professor3 Dr.Uma T Asst professor SATH4 Dr.Tanyalal Asst professor5 Dr.Vasanthakumari Additional professor6 Dr.Simi A Asst professor SATH7 Dr.Manjula Asst professor SATH8 Dr.Deepa R Nair Junior Consutant9 Dr.Ambili Consultant10 Dr.Lakshmi Asst professor SATH11 Dr.Thanuja Asst professor12 Dr.Sreekumari unit chief O513 Dr.Jamie T Jacob SUT Hosp14 Dr.Lakshmi Ammal SUT Hosp15 Dr.Sheela GH16 Dr.Patsy Verghese SATH17 Dr.Shehida Asst professor18 Dr.Jaithra19 Dr.Neena Chandran PG 1st year20 Dr.Regetha PG 1st year

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21 Dr.Chethana N Senior Resident SATH22 Dr.Shila S professor SATH23 Dr.Rajeena Asst professor24 Dr.Sreekumari Asst professor25 Dr.Priyasree J Associate prof26 Dr.Anu Anna27 Dr.Deepthy B Asst professor SATH

Nursing Staff1 Nisha P2 Renuka E3 Remya4 Usha B5 Mary6 Indies T7 Aswathy V R8 Sajitha T R9 Jessy Beegum10 Mariamma Philipose11 Anjali V12 Nirupama K13 Lekshmi S14 Sudhakumari15 Nadia Amanullah16 Anjal Krishna K L17 Anupam G R18 Divya M S19 Amiya20 Seline21 Sheela A22 Nisa salim23 Prakashini P24 Sreedevi25 Metilda26 Anjumol K O27 Rajanee M28 Shani S S29 Shajitha S SATH30 Saraswathy SATH31 Sreedevi THQ

Nursing Assistants1 Esther 2nd grade2 Sobha 2nd grade3 Thulasi 1st grade4 Sheela D 2nd grade5 Minimol 2nd grade6 Usha Kumari 2nd grade7 Rajan M 1st grade8 Sreelatha 2nd grade9 Jayalakshmi NA10 Vijayakumari11 sasikala12 Vijayamma13 Meharunnisa B14 Shajeha Beevi15 valsala16 Suresh Babu17 Salini18 Nandakumar19 Prabha S20 Vimala21 Hemalatha22 Maya S23 Rema A24 Sreekala25 Pushpalatha26 Molly ANM

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1 Leomon T.B2 Surumi Rahman3 Chinju Mathew4 Nimmi C.J5 Nivya T.P6 Fayis Shabu7 Divya Tony8 Akhil Gijo9 Abin10 Sanoop C.R11 Jinate George12 Sajana Jose13 Nimisha K.H14 Rathika O.15 Litty C.J16 Neethumol K.M17 Silpa K.P18 Riya Scaria19 Seethal K. Paul20 Shiji Edison21 Stephy Paul22 Akhila P.A23 Linda Cherian24 Jasmy Johnson25 Silja T.J26 Tintu Xavier27 Pranaviya K.P28 Anet Paul29 Sudhina Abdullah30 Jintha Raj M.K31 Harsha Vincent32 Dr. Fareena33 Dr. Philo34 Dr. Anitha V. Pai35 Rose Paul T.36 Stephy Clarence37 Sruthi M.P

Staff Training on 23/03/2013, Mother Hospital at Thrissur

38 Nitha Jaison T.39 Muhasina M.40 Nanma V.41 Vipin Sankar M.42 Aneesh Poly43 Sanjay P.44 Vinaya Varghese45 Nismath K.46 Vinaya Varghese47 Anu Binoj48 Shiny Varghese49 Jisha Johnson50 Rosmy Augustine51 Ancy Paskal52 Geetha K.G.53 Vijaya T.V.54 Joicy C.L.55 Geetha Venu56 Jancy57 Elsy58 Reena Anto59 Viji Varghese N.60 Luxy A.L61 C. Jebitta Beny62 K.K Saffiya63 Celin Baby64 Lissy John65 Jeseenta M.L.66 Omana Jacob67 Nini Johnson68 Dhanya K.T69 Sophy Davis70 Jincy Varghese71 Ansi Benny72 Rakhi Raj73 Ancy Ouseph

S. No Name S. No Name

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Planning & Review meetings on different occasions

C M releasing QS with British Health Minister

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Kasaragode

Kollam

Kottayam

Thrissur

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