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ISLAND STYLE | Stroke care training in the Caribbean

Mexico

Making landfall via Zoom, Angels consultants from Mexico journeyed to the Caribbean to set in motion a chain of knowledge sharing among stroke care providers from five island nations.

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As Covid-19 shut down borders and shuttered offices during 2020, some of the world’s most exotic destinations announced plans to welcome the new cohort of remote workers to their shores. While the have-laptop-will-travel generation contemplated waiting out the pandemic on a tropical beach somewhere in the Caribbean, five islands in the region were preparing to welcome visitors on a different mission.

A small group of Angels consultants from nearby Mexico were about to make landfall via Zoom. Their purpose? To offer training in stroke care to a multi-disciplinary group of healthcare providers (HCPs) who would afterwards return to their hospitals to share the learnings with their teams.

This Train-the-Trainer intervention came about as a result of an invitation issued to the Angels Initiative by Mission Thrombectomy 2020, Mexico team leader Armando Sanchez explains. MT2020 is a global coalition under the umbrella of the Society of Vascular and Interventional Neuroradiology in the US. Their mission is to accelerate access to mechanical thrombectomy for treating stroke caused by large vessel occlusion.

With a high incidence of stroke-related disability and death and only 14 stroke-ready hospitals across the region, stroke care in most Caribbean countries has plenty of ground to make up. But with WSO stroke centre certification for all 14 hospitals as the eventual destination, the journey sets off from correct stroke identification, accurate reading of CT scans, optimal therapeutic decision-making and the courage to treat.

In March and July 2021, Angels consultants Cecilia Gonzalez and Ulises Gloria from Mexico provided training in the four phases of stroke care to more than 85 neurologists, emergency physicians and nurses drawn from hospitals with the capacity to perform thrombolysis. Coverage of the hyperacute phase included a neuroimaging workshop lead by Armando, with Body Interact and WOW CT Imaging workshops affording trainees an opportunity to test and hone their decision-making skills in an interactive setting on the final day.  

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The first round of training was conducted in English and attended by 25 HCPs from Bermuda, Jamaica and Trinidad in March. In July it was the turn of over 60 of their Spanish-speaking colleagues from Puerto Rico and Dominican Republic to undergo training that they would subsequently replicate in their own hospitals.

Two key learnings emerged from the training, Armando says, namely that commencing and optimizing stroke treatment primarily required organization and a disposition to treat. “They realized it wasn’t that difficult. You just need to get organized and to have a little will.”

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Following the training, around 300 HCPs from the region have registered on the Angels website to take advantage of elearning programmes such as Stroke Nurse Certification and ASLS. Furthermore, overwhelmingly positive feedback from both trainees and MT2020 representatives who attended the sessions means the groundwork has been laid for future co-operation between Angels Initiative and stroke care providers in one of the most enchanting places on earth.