Our colleague in Cameroon is a trained obstetrician with decades of experience delivering babies. His is a local non-profit with the mission of saving lives amongst the poorest in Cameroon. This blog tells the story of the first woman the team saved with the NASG.
GOD'S Foundation focuses on the training of midwives and nurses to serve the indigenous Ndian Community and the those of the "Oroko" - ( a common linguistic cultural group which extend from Ndian to Meme Division of the Anglophone South West Region with a common sociocultural and geographical similarities).
As our colleague sought to create a maternity service, he was stymied by the lack of access to a blood bank, or even a refrigerator to hold blood supplies. He found out about the Non-pneumatic anti-shock garment, not through the government or an academic journal or a meeting-- but wonderfully, like so many others, through an online search of obstetric innovations.
The NASGgave the team faith, that even in the absence of blood banks, a viable maternity service could be started.
The first use case of the NASG occurred when a 31 year old woman arrived in the active phase of labor, delivering after an episiotomy, a healthy 2.8kg female newborn with an APGAR score of 8 in the first minute and 10 by the fifth minute (around 2:30 pm).
The placenta was delivered, a bimanual examination was given along with fundal massage, with now and five minutes later the repair of an episiotomy began, with IV in place, as is customary in this facility, with 10 units oxytocin provided.
After the episiotomy, the sanitary pads were removed from the uterus (these had been placed to allow episiotomy repair) and postpartum hemorrhage was diagnosed, stemming from a cervical tear which was clamped and repaired.
The mother's pulse was hardly detectable and the pulse noted as 'thready.' Imminent hypovolemic shock and PPH were diagnosed, and the NASG device was applied while blood was ordered and the woman began transfer to Bonasama District Hospital, stabilized by the NASG.
By 6:30 pm the woman had been given 1.5 L saline and once 1000 cc of blood was collected she was transfused.
By 10 pm the blood pressure and pulse had stabilized and the NASG was removed section by section, every 15 minutes over the course of the next several hours, until by 1 am the next day the NASG was removed. At this point hemoglobin was 8.5 g/dL and the patient was stable.
In this case, it appears that the NASG stabilized this woman while she was transferred to a hospital 30 minutes away and while she awaited saline and eventually blood transfusion. The NASG was worn in full for approximately 8 hours, and then gradually removed over the next four hours while blood pressure and pulse stabilized.
The results do speak for themselves, and we'll be sharing three more cases from GOD'S Foundation in Cameroon.
This case was recorded and the clinical care overseen by the Founder of the clinic,
Jean M. Bouquet, DO, is an Assistant Professor of Family Medicine and Co-Director of the Urban Underserved Track at the Rocky Vista University College of Osteopathic Medicine. He is the founder of the Bouquet Speculum, an innovative and FDA-cleared medical device that helps to screen women for cervical cancer. Dr. Bouquet also started the Cure Cervical Cancer nonprofit. The following blog post was written by Dr. Bouquet about his journey to creating the Bouquet Speculum.
Dr. Daniel Kimani is a trained and licensed medical officer in Kenya, holding a Bachelor of Medicine & Surgery, and a post-graduate certificate on basic oncology training. Dr. Kimani is the founder of the Global Cancer Care and Research Institute, and is an expert in clinical colposcopy — a procedure to examine the cervix, vagina, and vulva.