Basic Life Support in Pakistan
Results of a Pilot Study

Nadeem Afridi, MD

Introduction:
Pakistan in many ways is a land of opportunity for the prepared. Although the basic health care delivery system is quite extensive, major gaps exist in basic life support systems. No structure exists in the country for formal training of basic life support (BLS) in Pakistan such that hundreds of lives are lost due to lack of know how and equipment.

Initial survey done by APCNA (Association of Pakistani Cardiologist of North
America), APPNE (Association of Pakistani Physicians of New England) with
the support of DMC (Disaster Management Center) in Abbott abad, reviled
the following information. 1. Basic Life support is not taught in most public
(Government) hospitals including large teaching hospitals due to lack of trained
staff . 2. No code 99 protocols exist in most large public hospital. 3. Due to the
lack of resources and infrastructure to produce training equipment for BLS, it
is beyond the approach of most public hospitals in the country to name a few
impediments.

APCNA along with the APPNE and DMC created a model in which two central
areas were selected as teaching centers, one in Abbott abad and the other in
Muzaff arabad. These areas also had an advantage of having a very receptive
audience due to the recent disaster. Medical students, doctors, homeopathic
students, nurses, paramedics and even house wives and children were att racted to these BLS courses.

BLS equipment was donated through APCNA and APPNE, and training CD’s
form the AHA’s BLS courses were used for demonstration. Hands on training
was provided by AHA certifi ed staff and students were tested for there skills on
mannequins. A writt en test was administered along the lines of AHA certifi cation for BLS.

So far 5 trainers have been trained to administer BLS. 174 individuals have been
certifi ed, including 16 young adults, 105 women and 73 men from 3 medical
schools, and 3 hospitals.

APCNA has now obtained a certification agreement from AHA to give BLS
credentialing cards to successful trainees in Pakistan. Interestingly, small
organizations and NGO’s have taken a notice of the usefulness of this program
and are beginning to provide funding to the DMC in Abbott abad to conduct more
BLS training courses at various sites.

Moral of the story is that with litt le motivation, persistence and few thousand
dollars, similar programs can be initiated in teaching hospitals throughout the
country and many lives may be saved by simple interventions.

Nadeem Afridi, MD FACC
BLS Pilot Project.