MRC Annual General Meeting President’s Report

Dr. Mario Zerafa MD, FRCA, DEAA Chairperson, Malta Resuscitation Council

31st January, 2007

1. Introduction

The Malta Resuscitation Council (MRC) has just completed its second year of existence. They have been an eventful two years and at the same time they showed us how much more scope there is for further action in this field.

The first 11-member executive committee of the MRC was elected in October 2004. It immediately applied for European Resuscitation Council (ERC) affiliation and the formal association agreement was signed in Malta during the First Resuscitation and Emergency Medicine Symposium held on 20 February 2005 when the signatory was the guest speaker Dr David Zideman, Chairman of the ERC. This and other activities organised in the first seven months were described in more detail in the first MRC newsletter published in July 2005 (see attached).

2. Activities

2.1 Resuscitation courses

2.1.1 Basic Life Support/Automated External Defibrillation (BLS/AED) Courses

The first ERC-approved BLS/AED course was organised at the Institute of Health Care on the 9/2/06 where 30 candidates successfully completed the first (in Europe) course run under the newly published November 2005 guidelines. The next day, 10 February 2006, these candidates followed an Instructor’s course under the coordination of Ms Sian Davies.

Another 2 courses were organised on the 16th and 17th June 2006 at Capua Palace and 2 back to back courses at the IHC on the 18th November 2006. Thus these courses produced another 96 successful BLS / AED providers from a wide range of specialties.

2.1.2 European Paediatric Advanced Life Support (EPLS) Course:

This course which has been organised approximately once a year for the last six years, was last done in May 2005 with the Malta centre being given independent status by virtue of the ERC/MRC affiliation; (previously it was organised in partnership with Great Ormond Street Hospital for Children under the auspices of the UKRC). The EPLS course was not run in 2006 because the course material with the new 2005 guidelines had not yet gone into print.

2.1.3 In November 2006 the first European Trauma Course (ETC) was held in Malta at the Corinthia San Gorg Hotel, St Julian’s. This was a joint project by the Association of Surgeons of Malta (ASM) and the Association of Anaesthesiologists of Malta (AAM) who were successful in their joint bid to be granted European Social Fund funding. The MRC wholeheartedly approved and supported this project and was glad to certify the successful candidates. The course was again oversubscribed and 24 candidates were chosen from a wide variety of hospital specialties. The teaching faculty consisted of 11 specialists, 3 local and the rest form UK, Holland, Belgium, Italy, Germany and Portugal. The co-directors were Dr. Peter Driscoll and Dr. Carl Gwinnutt. The candidates’ success rate was over 87% and the feedback was very positive from both the candidates and faculty. It is hoped to repeat this course regularly in the future.

2.2 Scientific meeting

In February 2006 the MRC organised a one-day scientific meeting to introduce the new 2005 resuscitation guidelines to as wide an audience as possible. This was attended by over 200 delegates who heard talks on various aspects of resuscitation from leading Maltese experts. The guest speaker was Ms Sian Davies, a leading Council member of both the UKRC and the ERC.

2.3 MRC website: www.resus.org.mt

Through its website, managed by MRC council member Dr Tonio Piscopo, the MRC keeps its members and the public informed of its activities but more importantly up to date with the latest resuscitation guidelines and other educational issues related to resuscitation. It is also an easy link to the ERC and other countries’ resuscitation councils and their activities.

2.4 Meetings – Local

Since its setting up, the MRC has held meetings with various important stakeholders in the delivery of healthcare in Malta.

2.4.1 A delegation led by the chairperson paid a courtesy visit on the Minister of Health, Dr Louis Deguara, on the 3 October 2005. The MRC had the opportunity to outline to the Minister its set-up, activities up to that point, its projects in the pipeline and its needs and aspirations. The Minister was very enthusiastic about our work and pledged his support.

2.4.2 A delegation from the MRC also met the CEO of the Foundation for Medical Services (FMS), Dr Kenneth Grech, in late May 2005 where once more we outlined our work, our future projects and areas where we needed support.

2.4.3 The MRC also took the initiative to hold a meeting with a lawyer to acquire guidance on legal issues that may be of interest to providers of resuscitation in Malta. Since the funds of the MRC are very limited, we were very grateful that Dr Alex Perici Calascione agreed to give this advice gratis.

2.5 Meetings – Overseas

2.5.1. As part of its affiliation with the ERC, the MRC is invited and expected to participate in the ERC executive committee. Meetings are held at least every 6 months, with ad hoc meetings as needed. Since its inception, the MRC was represented at the ERC executive committee meetings in May and November 2006 in Brussels by Dr Dianne Tabone. Dr Mary Rose Cassar attended the December 2006 meeting.

2.5.2 In January 2006, a special meeting was organised in Brussels for resuscitation course directors to introduce the 2005 resuscitation guidelines and discuss their implementation in future courses. The MRC was represented by Dr Mario Zerafa (ALS), Dr Mary Rose Cassar (BLS/AED) and Dr Tanya Esposito (EPLS).

2.5.3 In May 2006, in Stavanger, Norway, there was the eighth European Resuscitation Council’s Scientific Congress. The MRC was very ably represented by Dr. Mary Rose Cassar and Dr. Anna Spiteri who manned the stand allocated to us superbly. They took the opportunity to promote both the MRC and Malta in general by distributing printed matter, items of Maltese delicatessen and giving out small filigree gifts to selected delegates. All of these were very well-received and undoubtedly paved the way for the enthusiastic support we received in organising the first European trauma course later in the year.

2.6 Logo competition

In May 2005, the MRC launched a public competition for the design of an official logo. The winning entry was submitted by Dr Marius Grima and Dr Tonio Piscopo and has since been adopted on all official MRC communications. The winners were rewarded with a book token and a commemorative certificate.

2.7 Correspondence

2.7.1 The Director IHC asked the MRC for a list of suggested books/journals of resuscitation interest for the IHC library. This was a very welcome and appreciated gesture and a list of such publications was forwarded in March 2006.

2.7.2 Gozo Channel Co Ltd. had written to the MRC requesting the latter’s views on the topic of installing AEDs and other resuscitation issues relating to their fleet. Dr Mary Rose Cassar wrote back with a detailed report on all these queries.

3. Future Plans

3.1 The most immediate activity is an election to fill the 7 MRC executive committee positions which become vacant after 2 years of office. This will held during January / February 2007.

3.2. The EPLS course is planned for March /April 2007.

3.3 Further BLS/AED courses to meet the ever-increasing demand.

3.4 Holding an Advanced Life Support (ALS) course as per ERC format.

3.5 Holding an Immediate Life Support (ILS) course as per ERC format.

The ILS is a course intended mainly for hospital staff who are not expected to have an advanced level of medical knowledge. It incorporates BLS but includes also other procedures that can easily be achieved by most staff working in a hospital environment until the CPR team arrives on the scene.

4. Future needs

4.1 Premises

At present, the MRC has no fixed office. It operates from various ad hoc rooms and with the ever-increasing amount of documents in its possession, acquisition of manikins, AEDs and other teaching equipment, it is becoming very difficult to operate without our own office and storage space. A room/s allocated for our specific use at the new Mater Dei Hospital would be ideal.

4.2 Secretarial support

The MRC is always striving to increase its membership and its activities. This inevitably leads to huge demands on secretarial work – typing of documents, distribution and mailing of documents, letters, circulars, processing of application forms, drafting of certificates and more. The services of a part-time secretary would be a huge help.

4.3 Acquisition of teaching material

4.3.1 Manikins - these are essential in resuscitation training but they are very expensive. So far, the MRC has been lucky in being able to borrow/hire manikins from other entities e.g. IHC, Anaesthetic Department at SLH. However if we are to seriously plan ahead, we would have to have our own set of manikins – adult, paediatric, neo-natal. (Last Nov. 2006, the MRC bought 4 BLS manikins (torsos) from its own funds and these have already been used for teaching/training.)

4.3.2 Resuscitation training also involves other equipment like AED simulators, demo defibrillators, self-inflating bags, masks, oral airways and myriad other items. The MRC would need help with the purchase of all of theses.

4.4 Sponsoring of overseas instructors

ERC-affiliated courses follow a well-established set pattern where instructors have to be ERC certified. The MRC has at its disposal a number of certified ERC instructors for EPLS, BLS/AED and trauma courses. But we lack totally instructors for ALS and ILS courses. To set the process going, the MRC would need to repeat what has been done successfully for EPLS, BLS/AED and start by importing the teaching faculties for the first few courses from abroad. Then, over a period of several years, we would train sufficient ALS and ILS providers to become instructors in their own right until we become self-sufficient.

Since the instructor/candidate ratio is very high for resuscitation courses, we need to bring over up to 6 instructors at a time for 3 to 4 days. In order to keep the course fees reasonable, the MRC would need financial help with the expenses involved in the overseas instructors’ airfares and accommodation.

5. Thanks:

Finally I cannot end this report without thanking a number of people who have in various ways supported the set-up of and organisation of projects by the MRC. First of all I wish to thank you the members for showing trust in this venture, joining it and participating in its events. Secondly a big thank you to all the members of the first executive committee especially those who are now at the end of their first term. I must include also those members who were on the executive committee and had to leave mostly due to work commitments abroad (Dr Wojciek Sawicki, Dr Dianne Tabone, Dr Dennis Vella Baldacchino). We have had a very hard working team and the results speak for themselves. Among the many from the Health Division, I thank the Minister of Health, Dr John Cachia, Dr J. Zarb Adami (special support in the procurement of manikins), the A&E consultants (use of their premises, cooperation to cover for absences). We also had sponsors among whom I mention Technoline for their donation of 2 AED simulators.

Dr. Mario Zerafa MD, FRCA, DEAA Chairperson, Malta Resuscitation Council

31st January, 2007

Development: Marius Grima | Updates: Mario Fleri Soler | Supported & hosted by Alert Communications