11 results on '"Burke, Thomas F."'
Search Results
2. Shock progression and survival after use of a condom uterine balloon tamponade package in women with uncontrolled postpartum hemorrhage.
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Burke, Thomas F., Danso ‐ Bamfo, Sandra, Guha, Moytrayee, Oguttu, Monica, Tarimo, Vincent, and Nelson, Brett D.
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UTERINE hemorrhage , *PUERPERAL disorders , *PREGNANCY complications , *BLOOD pressure , *PSYCHOLOGY of women , *DISEASE progression - Abstract
Objective: To examine the outcomes of women in advanced shock from uncontrolled postpartum hemorrhage (PPH) who underwent placement of an Every Second Matters for Mothers and Babies Uterine Balloon Tamponade (ESM-UBT) device.Methods: In a prospective case series, data were collected for women who received an ESM-UBT device at healthcare facilities in Kenya, Senegal, Sierra Leone, and Tanzania between September 1, 2012, and September 30, 2016. Shock class was assigned on the basis of recorded blood pressures and mental status at the time of UBT placement.Results: Data for 306 women with uncontrolled PPH from uterine atony across 117 facilities were analyzed. Normal vital signs or class I/II shock were reported for 166 (54.2%). In this group, one death occurred and was attributed to PPH (survival rate 99.4%). There were no cases of shock progression. One hundred and eleven (36.3%) were in class III shock and 29 (9.5%) in class IV shock; the respective survival rates were 97.3% (n=108) and 86.2% (n=25).Conclusion: The ESM-UBT device arrests hemorrhage, prevents shock progression, and is associated with high survival rates among women with uncontrolled PPH from uterine atony. [ABSTRACT FROM AUTHOR]- Published
- 2017
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3. Evaluation of a ketamine-based anesthesia package for use in emergency cesarean delivery or emergency laparotomy when no anesthetist is available.
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Burke, Thomas F., Nelson, Brett D., Kandler, Taylor, Altawil, Zaid, Rogo, Khama, Imbamba, Javan, Odenyo, Stella, Pinder, Leeya, Lozo, Svjetlana, Guha, Moytrayee, and Eckardt, Melody J.
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KETAMINE , *SURGICAL emergencies , *ABDOMINAL surgery , *ANESTHESIA , *CESAREAN section , *LONGITUDINAL method - Abstract
Objective: To assess the safety of a ketamine-based rescue anesthesia package to support emergency cesarean delivery and emergency laparotomy when no anesthetist was available.Methods: A prospective case-series study was conducted at seven sub-county hospitals in western Kenya between December 10, 2013, and January 20, 2016. Non-anesthetist clinicians underwent 5days of training in the Every Second Matters-Ketamine (ESM-Ketamine) program. A database captured preoperative, intraoperative, and postoperative details of all surgeries in which ESM-Ketamine was used. The primary outcome measure was the ability of ESM-Ketamine to safely support emergency operative procedures.Results: Non-anesthetist providers trained on ESM-Ketamine supported 83 emergency cesarean deliveries and 26 emergency laparotomies. Ketamine was administered by 10 nurse-midwives and six clinical officers. Brief oxygen desaturations (<92% for <30s) were recorded among 5 (4.6%) of the 109 patients. Hallucinations occurred among 9 (8.3%) patients. No serious adverse events related to the use of ESM-Ketamine were recorded.Conclusion: The ESM-Ketamine package can be safely used by trained non-anesthetist providers to support emergency cesarean delivery and emergency laparotomy when no anesthetist is available. [ABSTRACT FROM AUTHOR]- Published
- 2016
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4. A review of postpartum hemorrhage in low‐income countries and implications for strengthening health systems.
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Borovac‐Pinheiro, Anderson, Priyadarshani, Preeti, and Burke, Thomas F.
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POSTPARTUM hemorrhage , *LOW-income countries , *CONTINUUM of care , *DIAGNOSIS , *MATERNAL mortality - Abstract
Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. Disparities in PPH‐associated survival between high and low‐/middle‐income countries reflect an imperative for low‐resource countries to improve strategies for rapid diagnosis and treatment. A review of current PPH diagnosis, prevention, treatment, and access to care in low‐income countries has been used to understand, extract, and report the challenges that public health systems face in trying to solve the marked global disparity in PPH outcomes. Improvement in PPH survival begins with holistic strengthening of each step along the continuum of care in health systems and should include performance feedback measures and quality‐of‐care research. Synopsis: Improvement in postpartum hemorrhage survival requires holistic strengthening of each step along the continuum of care and should include performance feedback measures and quality‐of‐care research. [ABSTRACT FROM AUTHOR]
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- 2021
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5. Feasibility and impact of a postpartum hemorrhage emergency care package using a bundle approach in Migori County, Kenya.
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Gonte, Madeleine R., Peifer, Hannah G., Meara, Grace, Otieno, Brenda, Oguttu, Monica, and Burke, Thomas F.
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POSTPARTUM hemorrhage , *HEALTH facilities , *JUDGMENT sampling , *SEMI-structured interviews , *FEASIBILITY studies - Abstract
Objective: To investigate the impact of the PPH Emergency Care package (PPH EmC)—a holistic intervention that uses a bundle approach that has been implemented in Kenya, India, Nepal, Bangladesh, and Central America—in a low‐resource setting. Methods: The feasibility and impact of PPH EmC implementation in Migori County, Kenya was studied using a qualitative research design. In March and April 2022 key informants were identified using purposive sampling. Semi‐structured interviews were conducted over Zoom from March to May 2022 until thematic saturation was reached. Interviews were transcribed, coded, and analyzed for emerging themes. Results: PPH EmC has positively impacted facility and health system preparedness, referral coordination, teamwork and communication, and overall capacity to provide quality PPH emergency care. Participants reported that PPH EmC is sustainable because of its low cost and support from local partners. Conclusion: Implementation of PPH EmC in Migori County, Kenya was feasible and positively impacted PPH emergency care. Synopsis: Implementation of the Postpartum Hemorrhage Emergency Care Bundle (PPH EmC) in Migori County, Kenya was feasible and positively impacted postpartum hemorrhage emergency care. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Every Second Matters ‐ uterine balloon tamponade implementation across ten medical colleges in Maharashtra and Madhya Pradesh in India: A qualitative study.
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Posever, Natalie, Sipahi, Sevgi, Shivkumar, Poonam Varma, and Burke, Thomas F.
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MEDICAL schools , *POSTPARTUM hemorrhage , *MATERNAL mortality , *QUALITATIVE research , *SEMI-structured interviews - Abstract
Objective: To understand facilitators, barriers, and perceptions of the Every Second Matters uterine balloon tamponade (ESM‐UBT) package implemented across 10 medical colleges in India, 3 years after the program was introduced. Methods: Semi‐structured interviews were conducted until thematic saturation in March 2020. Multiple provider cadres, including nurses, Obstetrics/Gynecology residents, professors, and program leads, were eligible. Interviews were transcribed and thematically coded using an inductive method. Results: Sixty‐two obstetric providers were interviewed. Facilitators of implementation included recurrent training, improved teamwork and communication, strong program leadership, and involvement of lower‐level facilities. Barriers to implementation included administrative hurdles, high staff turnover, language barriers, and resources required to reach and train lower‐level facilities. Overall, the majority of clinicians viewed the ESM‐UBT package as a useful intervention in aiding efforts to reduce maternal deaths from postpartum hemorrhage. Conclusions: Among 10 medical colleges in India the ESM‐UBT package is seen as a beneficial intervention for managing refractory atonic postpartum hemorrhage, and for reducing maternal morbidity and mortality. Identified facilitators of and barriers to implementation of the ESM‐UBT package in India should be used to guide future implementation efforts. Identified facilitators to implementation of the Every Second Matters uterine balloon tamponade should be leveraged for future implementation in other low‐resource settings. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Qualitative study of the role of men in maternal health in resource-limited communities in western Kenya.
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Brubaker, Kathryn, Nelson, Brett D., McPherson, Heather, Ahn, Roy, Oguttu, Monica, and Burke, Thomas F.
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MATERNAL health , *PUBLIC health , *BELIEF & doubt , *MEDICAL education , *QUALITATIVE research - Abstract
Objective: To better understand the beliefs of men and women in western Kenya regarding the appropriate role of men in maternal health and to identify barriers to greater involvement.Methods: Between June 1 and July 31, 2014, a cross-sectional qualitative study enrolled lay men, lay women, and community health workers from Kisumu and Nyamira counties in western Kenya. Semi-structured focus group discussions were conducted and qualitative approaches were utilized to analyze the transcripts and identify common themes.Results: In total, 134 individuals participated in 18 focus group discussions. Participants discussed the role of men and a general consensus was recorded that it was a man's duty to protect women during pregnancy. When discussing obstacles to male involvement, female participants highlighted gender dynamics and male participants raised financial limitations.Conclusion: There was considerable discrepancy between how men described their roles and how they actually behaved, although educated men appeared to describe themselves as performing more supportive behaviors compared with male participants with less education. It is suggested that interventions aimed at increasing male involvement should incorporate the existing culturally sanctioned roles men perform as a foundation upon which to build, rather than attempting to construct roles that oppose prevailing norms. [ABSTRACT FROM AUTHOR]- Published
- 2016
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8. Provider experiences with improvised uterine balloon tamponade for the management of uncontrolled postpartum hemorrhage in Kenya.
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Natarajan, Abirami, Alaska Pendleton, Anna, Nelson, Brett D., Ahn, Roy, Oguttu, Monica, Dulo, Lidu, Eckardt, Melody J., and Burke, Thomas F.
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HEMORRHAGE treatment , *HYSTERECTOMY , *OBSTETRICIANS , *MEDICAL care , *DESCRIPTIVE statistics - Abstract
Objective: To understand healthcare providers' experiences with improvised uterine balloon tamponade (UBT) for the management of uncontrolled postpartum hemorrhage (PPH).Methods: In a qualitative descriptive study, in-depth semi-structured interviews were conducted between November 2014 and June 2015 among Kenyan healthcare providers who had previous experience with improvising a UBT device. Interviews were conducted, audio-recorded, and transcribed.Results: Overall, 29 healthcare providers (14 nurse-midwifes, 7 medical officers, 7 obstetricians, and 1 clinical officer) were interviewed. Providers perceived improvised UBT as valuable for managing uncontrolled PPH. Reported benefits included effectiveness in arresting hemorrhage and averting hysterectomy, and ease of use by providers of all levels of training. Providers used various materials to construct an improvised UBT. Challenges to improvising UBT-e.g. searching for materials during an emergency, procuring male condoms, and inserting fluid via a small syringe-were reported to lead to delays in care. Providers described their introduction to improvised UBT through both formal and informal sources. There was universal enthusiasm for widespread standardized training.Conclusion: Improvised UBT seems to be a valuable second-line treatment for uncontrolled PPH that can be used by providers of all levels. UBT might be optimized by integrating a standard package across the health system. [ABSTRACT FROM AUTHOR]- Published
- 2016
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9. Provider experience of uterine balloon tamponade for the management of postpartum hemorrhage in Sierra Leone.
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Natarajan, Abirami, Kamara, Jennifer, Ahn, Roy, Nelson, Brett D., Eckardt, Melody J., Williams, Anne Marie, Kargbo, Samuel A., and Burke, Thomas F.
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UTERINE diseases , *HEMORRHAGE complications , *MATERNAL mortality , *PREGNANCY complications , *UTERINE hemorrhage , *HEMORRHAGE treatment , *MEDICAL education , *PUERPERAL disorders , *COMPARATIVE studies , *SURGICAL hemostasis , *INTERVIEWING , *RESEARCH methodology , *MEDICAL cooperation , *MEDICAL protocols , *RESEARCH , *DISEASE management , *QUALITATIVE research , *EVALUATION research , *THERAPEUTICS - Abstract
Objective: To understand healthcare providers' experience of incorporating uterine balloon tamponade (UBT) into the national postpartum hemorrhage (PPH) clinical pathway after UBT training.Methods: In a qualitative study, semi-structured interviews were undertaken with healthcare providers from 50 centers in Freetown, Sierra Leone, between May and June 2014. All eligible healthcare providers (undergone UBT training, actively conducted deliveries, and treated cases of PPH since UBT training) on duty at the time of center visit were interviewed.Results: Sixty-one providers at 47 facilities were interviewed. Bleeding was controlled in 28 (93%) of 30 cases of UBT device placement. Participants reported that UBT devices were easy to insert with only minor challenges, and enabled providers to manage most cases of uncontrolled PPH at their own facility and to refer others in a stable condition. Reported barriers to optimal UBT use included insufficient training and practical experience, and a scarcity of preassembled UBT devices. Facilitators of UBT use included widespread acceptance of UBT, comprehensive and enthusiastic training, and ready availability of UBT devices.Conclusion: UBT-used either as a primary endpoint or en route to obtaining advanced care-has been well accepted and integrated into the national PPH pathway by providers in health facilities in Freetown. [ABSTRACT FROM AUTHOR]- Published
- 2016
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10. Provider experiences with uterine balloon tamponade for uncontrolled postpartum hemorrhage in health facilities in Kenya.
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Natarajan, Abirami, Chavez, Jean, Ahn, Roy, Nelson, Brett D., Eckardt, Melody, Dulo, Liddy, Achieng, Emmaculate, Oguttu, Monica, Tester, Kristina, and Burke, Thomas F.
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PUERPERAL disorders , *HEMORRHAGE treatment , *CARDIAC tamponade , *MEDICAL balloons , *HEALTH facilities , *MATERNAL mortality , *FEASIBILITY studies , *MEDICAL education , *ATTITUDE (Psychology) , *DELIVERY (Obstetrics) , *MEDICAL personnel , *SURGICAL hemostasis , *QUALITATIVE research , *TREATMENT effectiveness , *EQUIPMENT & supplies , *THERAPEUTICS , *PSYCHOLOGY - Abstract
Objective: To understand provider perceptions and experiences following training in the use of a condom-catheter uterine balloon tamponade (UBT) as second-line treatment for uncontrolled postpartum hemorrhage (PPH) in health facilities in Kenya.Methods: As part of a qualitative study, interviews of facility-based providers who had managed PPH following comprehensive PPH training were conducted between February and April 2014. Facilities were purposively sampled to represent a range of experience with UBT, facility size, and geography. Interviews continued until thematic saturation was achieved. Interview transcripts were analyzed for themes.Results: Overall, 68 providers from 29 facilities were interviewed, of whom 31 reported experience with UBT placement (25 midwives, 2 clinical officers, 4 medical officers). Qualitative analysis revealed several major themes. Providers used UBT appropriately within the PPH algorithm, although the timing and clinical severity of patients varied. UBT was most commonly used when bleeding was unresponsive to uterotonics, hysterectomy was unavailable, and referral times long. Providers reported that bleeding was arrested following UBT use in all except one patient, who had a suspected coagulopathy. Most providers described UBT as technically easy to use, although three described initial balloon displacement.Conclusion: UBT has been readily accepted by providers at all levels of training and is being incorporated into the existing PPH management algorithm in Kenya. [ABSTRACT FROM AUTHOR]- Published
- 2015
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11. Emergency hysterectomy for uncontrolled postpartum hemorrhage may be averted through uterine balloon tamponade in Kenya and Senegal.
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Pendleton, Anna Alaska, Natarajan, Abirami, Ahn, Roy, Nelson, Brett D., Eckardt, Melody J., and Burke, Thomas F.
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EMERGENCY contraceptives , *HYSTERECTOMY , *POSTPARTUM contraception , *UTERINE surgery , *MATERNAL mortality , *WOMEN , *HEMORRHAGE treatment , *PUERPERAL disorders , *COMPARATIVE studies , *SURGICAL hemostasis , *INTERVIEWING , *RESEARCH methodology , *MEDICAL cooperation , *MEDICAL emergencies , *RESEARCH , *EVALUATION research , *TREATMENT effectiveness , *THERAPEUTICS - Published
- 2016
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