The Problem

Kanti Children’s Hospital is the only government-run children’s hospital in Nepal and admits a large number of very sick children with medical and surgical conditions. For many years, the hospital did not have a defibrillator and there were no advanced life support skills in the hospital. The mortality rates were high.

Advanced Paediatric Life Support (APLS) is a 3-day course that teaches all staff concerned with ill, injured or collapsed children, a systematic approach to follow – treating and managing the life threatening problems in priority order to give the best outcome. All the practices are evidence based and updated regularly. The practical aspects of the course provide instruction in some advanced life saving skills – intubation, defibrillation, pericardiocentesis, thoracocentesis, and umbilical catheterization amongst others.

APLS is the standard approach for all western hospitals and Kanti were keen to pursue the course to raise standards and quality of care in the hospital.

Our Activities

In November 2006, Pete Arrowsmith, STCML Trustee and former resuscitation training officer at Alder Hey, visited Kanti with Kate Denning, a medical educator to liaise with Nepal staff and set up the initial Advanced Paediatric Life Support (APLS) course in Kanti Children’s Hospital, providing course materials and books. The participants to the courses are usually a mix of junior and senior doctors.

The course in Kanti was called NEPALS and within a few years was being taught twice a year and become core to the junior doctors’ training at the hospital.Over several years, Pete and other Alder Hey colleagues have provided additional equipment and worked with Kanti doctors to train additional local faculty to become instructors in APLS and he has carried out annual visits to support the courses and ensure that high quality teaching is maintained (funded by ALSG).

It is a great achievement that the course in Kanti has been recognized by the APLS Group and that Kanti staff are able to deliver this course to other practitioners from across Nepal. STCML has funded some of the UK faculty who continue to support APLS in Kanti.

We would particularly like to thank Ajit Rayamajhi Consultant Cardiologist (pictured), without whom, the courses would never happen. Ajit has worked tirelessly to ensure the APLS courses are a success.