“I taught Ukrainian nurses damage control”

• Angeline, 42, is director of nursing care in a clinic in Monaco and a volunteer for the Red Cross.

• She went to Ukraine for a week in June for the NGO Doc4Ukraine, to train nurses in disaster care.

• On site, Angeline explained life-saving gestures and "damage control" to more than 200 nurses preparing to go to the front.

Angeline Pena Prado, director of nursing care at the private hemodialysis center in Monaco, of the Elsan group, had already left with the Red Cross for humanitarian missions in Chad, Pakistan… But this is the first time that she has traveled to a country at war.

From June 12 to 19, she went to Ukraine with the NGO Doc4Ukraine.

His mission ?

Preparing Ukrainian nurses to care for war wounded.

Angeline tells

about her passion, her encounters and her discoveries.

Why did you decide to go to Ukraine?

I was contacted via Linkedin by the president of the NGO Doc4Ukraine, because I passed two diplomas: one in resuscitation and the other in disaster nursing.

She offered me to go on a mission to Ukraine, I immediately accepted.

The place seemed pretty safe to me.

If it had been in the Donbass, I would probably not have said yes, because I am 42 years old and have three children.

Exactly, where were you?

I can't give you the exact location for security reasons.

Humanitarian workers can be the target of attack, espionage, kidnapping.

But I can tell you that it was in the east, in the second line.

What were your missions?

The team from France was made up of three caregivers: an orthopedic trauma surgeon, a doctor and me.

I took care of the nursing training to treat adults, but also children.

For a week, I did 3 classes of 2 hours a day, with between 15 and 40 nurses.

In all, we trained 257 nurses who came from all over the country, which is enormous.

Were these nurses used to the front?

No, I had to quickly adapt the training.

They are of all ages, between 22 and 65, all physical conditions, and often work in scheduled care, medicine or surgery.

If they go to the front – on a voluntary basis – they find themselves on a battlefield with wounds they have never seen.

Manual pressure points or the lateral safe position (PLS) were things they knew in theory, but not in practice.

In France, because of the attacks of November 13, disaster medicine has been developed for more than six years.

We have all heard of the tourniquet, developed white plans in hospitals, reflex sheets according to professions.

The police, the fire brigade, the hospital are prepared to face a massive attack.

In Ukraine, they didn't have that culture at all.

What did you teach them?

I reviewed some basic things with them and learned damage control.

It is a technique that saves the patient in the first 5-15 minutes on a disaster site.

And a protocol that was put in place by the US Navy during World War II.

They were inspired by boats: when they were bombed, the idea was not to repair the hull, but to seal it to reach the port.

Modern medicine has been inspired by it.

We're going to focus on three things: stopping the bleeding, clearing the airways and fighting the tension pneumothorax.

When a lung has collapsed on itself, we will insert a needle to bring out the air between the pleura and the lung and allow the patient to breathe.

And thus wait 20 minutes to have a chest drain at the hospital.

Find our file on Ukraine

Why is it important to learn damage control?

During my course, I ask two questions: “Do you know how long it takes for a wounded soldier to die”?

In general, they respond “right away”.

But in reality, 40% will die immediately, 25% in less than 5 minutes and 15% between 5 and 30 minutes.

The first twenty minutes are therefore essential for the latter.

However, they had no concept of triaging patients.

Second question: "what kills?"

They think more of the haemorrhage than of the pneumothorax.

And their questions showed that they were not used to care in degraded mode.

For example: “Which side do I have to turn the injured person to put him in PLS?

» I answered : « we don't care, we have to turn it quickly to save it!

»

What do you remember from this humanitarian journey?

I retain very brave people.

Even though we were in a non-combat zone, there were daily bombing alerts.

When they are in the process of operating, providing care, they do not let go of the patient.

Once, we had to move training down a hallway at a nursing school to get away from the windows during an alert.

They were very happy and grateful to have outside help.

A Ukrainian friend, our field coordinator, wrote me a note that sums it all up: “In dark times, right people are clearly visible”.

I felt useful.

At first, the nurses were a bit tired and doubtful.

But they were packed.

And then it was a moment for them, apart from the care service, the tension.

We have had such success that the NGO has had many requests to continue these training courses throughout the country.

But I insist: the personnel who go to Ukraine must be experienced, have an emergency doctor profile… The day-to-day care, they do, is really the specific side of disaster medicine that you have to be able to provide them.

Is there a common point between your experiences in humanitarian work?

We realize the resilience of human beings.

We see societies completely destructured, due to a natural disaster or a war.

Even under the bombs, the Ukrainians remain calm, do not complain, are not aggressive.

What stands out is a lot of mutual aid, a desire to do well, a gift of oneself for one's profession, one's country.

Do you plan to go back there?

I would love !

But the association is looking for donors, partners to send medical equipment, food aid and teams.

It is a question of means and not of desire.

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