March 2006

Phase II of a three year plan successfully completed utilizing specialists from a global network.

A short summary of the individual acts of heroism and tremendous kindness, often under emotional and physical duress in the volunteers who participated – or the many other volunteers and benefactors who contributed their time, monetary donations and equipment, prior to the mission from in their own country is not possible..

Mission Director, Mrs. Janine Henson, RN BSN CCRN, assisted by six local Peruvian CardioStart volunteers, led a 15 member team to Arequipa, Peru in March 2006 (03/18/06-04/01/06) to carry out Phase 2 of the cardiac surgical program development project. Included were specialists from Boston, Chicago, Florida, Italy, and the UK.

Phase 1, completed in September 2005, donated basic nursing care management and introduced essential heart surgery equipment. A permanent heart surgery unit in Arequipa to serve the poor, to give structure to nursing educational development, to help local teams manage intensive care of peri-operative cases, and to give general assistance to tertiary care management in related specialties was provided.

The local Arequipa medical team deserves much credit for the final result. A container dedicated to this mission was donated, with essential heart surgery equipment for the long-term development of the specialty.

Specific project accomplished:

1. New cardiac intensive care unit. A new CICU was built in three weeks, utilizing separated circuits, monitoring, oxygen supply and suction for five beds.

2. New dedicated operating room (OR) & Perfusion Room. The local hospital team built a new, dedicated, low infection room with a dedicated electrical circuit. This unit was successfully tested on 15th March with a historic operation for a mitral valve disease patient who underwent repair and did well.

3. Assessment and development of a new angiographic suite. CardioStart’s volunteer cardiologist gave recommendations for the layout, structural requirements and optimal ward design for a future suite to be implemented on a future mission. Anticipating the later development of pediatric cardiac surgery some simple non-bypass pediatric congenital corrections were also carried out.

4. Intensive Care and ward nurse education. A two week intensive nurse education program was introduced, stethoscopes and other supplies donated and cd-rom teaching material in Spanish provided in daily three hour interactive teaching sessions each afternoon. These sessions were supplemented by practical bed-side nursing instruction when clinical post-operative management began.

5. Perfusion education. CardioStart’s volunteer perfusionist assisted in the development of this capability, gave daily practical guidance of the donated heart-lung equipment during each operation, and provided dedicated forms and instruction for procedural guidelines.

6. Respiratory therapy. CardioStart’s volunteer respiratory therapist provided bed-side instruction and set up the existing ventilator circuit for clinical use in post-operative care. Several respiratory care nebulizer treatments were initiated and taught to assist the post-operative clinical recovery of the heart patients.

7. Biomedical evaluation & repair.CardioStart’s volunteer biomedical engineer provided essential testing and evaluation of all equipment used in the heart surgery program and carried out comprehensive testing of the circuits used in the OR, ICU, and other high intensive care areas of the hospital. Certified instruction was also provided for a week of training to the local biomedical engineering team.

8. Surgical teaching. Each patient receiving operation was the focus of teaching throughout the intra- and post-operative period involving fully the local surgical team. The local cardiac surgery team performed a mitral valve replacement procedure under CardioStart’s volunteer surgical supervision.

9. Anesthetic teaching. CardioStart’s volunteer anesthesiologist guided the preparation of patients for operation under general anesthesia despite equipment limitations. Arterial and central venous line access procedures were taught and demonstrated on each patent and refinements in anesthetic technique for cardiac anesthesia using newer donated anesthetic medications were introduced.

10. International Database update. Using the skills and support of the accompanying volunteer medical student, the database was updated and implemented in its newest and most comprehensive format.

11. CardioStart’s outreach programs. Supplied byvolunteers who are medical or non-medical, provide community support. The La Joya clinic, 50 miles outside Arequipa, was visited. Progress made in water sanitation filtration system, provided during the previous CardioStart mission in September 2005, was video-recorded. An equipment list for a new emergency room, being built, was drawn up for the next mission Sept. 2006.

12. Orphanage and Women’s shelter. This center was visited to provide donations and discuss developing a future program of direct assistance. The women’s shelter deals with the victims of spousal abuse and such facilities are very rare in Peru, although the problem is widespread. Initial support was provided including 2 sewing machines and supplies to support their own needs and possible fundraising projects. A $400 cash for corrective surgery was donated by a U.S. private benefactor to treat a child with severe scarring from child abuse.

Next mission: September 2006, specific dates to be announced. info@cardiostart.com