Bermuda Hospitals Board offers training on jellyfish stings

31 May 2017: A local expert in treating jellyfish stings, and in particular those of the Portuguese-Man-of-War variety, provided training to some first responders this month.

Bermuda Hospitals Board’s (BHB) Dr David Wakely trained more than 20 Marine Police officers and Royal Bermuda Regiment soldiers in the best way to treat burns and stings caused by Portuguese-Man-of-War. A  BHB Emergency Medicine and Hyperbaric and Diving Medicine physician, Dr Wakely sees many cases of jellyfish stings particularly in the spring and summer.

In readiness for the surge in water activities the Bermuda Police Service requested the training to increase the awareness of marine first aid. They invited the members of the Royal  Bermuda Regiment as well as staff from Medical House. The Medical House staff were present to learn what products the Emergency Department recommends victims use to treat their stings.

According to Dr. Wakely most victims do not have to attend the hospital for treatment. Those who know what to do can treat themselves or others who know can help victims. He also advised that hospital treatment should be considered in the case of toddlers, the elderly, those with serious medical conditions, those who have been stung over large areas of their bodies or those who have been stung in sensitive areas like the face, mouth and groin.

What to do in the case of a Portuguese Man-of-War sting

Safety first

• Use gloves
• Keep bystanders back
• Identify the main sail / body parts of the animal
• Look for trailing stinger / tentacles

Remove the tentacles

• Remove main body of the animal from victim if still attached
• Wash affected area with seawater, to flush away any tentacles
• Cover area in shaving foam (stingers are now in the foam)
• Scrape foam off with blunt spatula

Inactivate the stingers

• Soak the area in vinegar for 5 – 10 minutes
• Leave soaking for 5-10 minutes

Treat the pain

• Hot packs on affected area
• Consider putting victim in showers and running shower hot as tolerable
• Keep hot pack / shower on area for 30 minutes

Bermuda Hospitals Board supports Radiation Therapy Unit with equipment upgrade

16 May 2017: On-island radiation therapy is a step closer to being a reality as Bermuda Hospitals Board announces upgrades to one of its CT scanners have been completed. Installation teams from General Electric (GE) and LAP Laser installed the equipment and software earlier this month.

BHB has partnered with Bermuda Cancer and Health Centre to support the Radiation Therapy Unit. As part of that therapy, patients have to undergo a simulation. The upgrades allow the CT scanner to be used for this service. To date, six patients have used the new CT service.

Bermuda Cancer and Health Centre funded the upgrade.

BHB Consultant Oncologist Dr Christopher Fosker’s interview on the new service – Part 1

BHB Consultant Oncologist Dr Christopher Fosker’s interview on the new service – Part 2

Bermudian psychiatrist produces global Prison Public Health Position Statement

4 May 2017: With nearly 11 million people in prisons worldwide, how should countries treat and manage prisoners with health problems? Bermuda Hospitals Board’s  Consultant Forensic Psychiatrist Dr Seb Henagulph was called on to help the World Psychiatric Association develop a standard, which was published in February.

The Prison Public Health Position Statement is useful not only for healthcare providers working in prisons but also governments and those who have responsibility for managing prisons around the world. Dr Henagulph was one of 11 psychiatrists who contributed to the landmark document. It was issued on the 27th anniversary of Nelson Mandela’s release from Victor Verster Prison, South Africa, where he was held for 27 years.

Dr Henagulph was asked by a colleague in the UK, Dr Andrew Forrester, to join a task force on prison health. Dr Forrester, joint chair of the task force and clinical director of the Offender Health Research Network at the University of Manchester, knew of Dr Henagulph’s experience with prisons both in Bermuda and the UK and wanted him on the team.

“It was a virtual group over the last two years, with Dr Forrester and Dr Mary Piper the joint chairs,” said Dr Henagulph. “They approached various psychiatrists with experience in working in prisons, trying to be as international as possible.”

The consultation group included psychiatrists from India, Egypt, Australia, Canada, the UK and Bermuda. The comments, discussions and the various international perspectives were collated and the position paper ratified at a consensus meeting of the World Psychiatric Association in Cape Town, South Africa, in November 2016.

The Statement begins with a quote from Mr Mandela: “Only free men can negotiate. A prisoner cannot enter into contracts.”

While the paper clearly sets out a standard which countries can adopt, Dr Henagulph pointed out that it is not mandatory.

“It’s not legally binding like a UN convention or anything similar,” he said. “It’s more a position statement which the World Psychiatric Association will use to negotiate with governments who are not meeting the standards and encourage them to improve conditions. Psychiatrists in countries with poor prison conditions can also use it to inform their governments of needed changes.

“Prisoners as a whole tend to have chaotic lives with multiple physical, mental and social health issues and can be difficult to engage in treatment in the community. It makes sense from a public health perspective to provide the highest level of care possible while they are incarcerated,” he added.

Dr Henagulph said Bermuda meets most of the standards set out in the paper but noted there is room for improvement.

“More effective rehabilitation services for prisoners and the provision of a fully independent prison healthcare service are two recommendations we could work on in Bermuda,” he said. “The World Health Organisation recommends that providers of prison healthcare should be fully independent from the justice system.”

To further assist jurisdictions that want to improve prison standards, the group also provided the Prisoner Mental & Public Healthcare Curriculum (attached).

WPA Position Statement Prison Policy

WPA Prisoner Mental Healthcare Curriculum