Ninety-five percent of fire-related deaths occur in low- and middle-income countries. This project seeks to mitigate this profound global health inequity by transforming how bedside care is approached in Uganda’s only specialized burn treatment ward at Kiruddu National Referral Hospital. 

This 18-month implementation study addresses a critical safety gap at the hospital, where the absence of physician anesthesiologists and dedicated recovery nurses often leads to unmonitored anesthesia and delayed recognition of post-operative complications. Led by Stanford Anesthesiology trainees in partnership with ReSurge International, this project will implement the Essential Emergency and Critical Care Vital Signs Directed Therapy model. 

The initiative combines a mixed-methods needs assessment with a trainee-led virtual and in-person curriculum that links specific vital signs to immediate clinical protocols.

“We hope this research significantly reduces perioperative morbidity and mortality in Kiruddu Hospital’s burn unit, which serves an incredibly vulnerable population consisting of largely pediatric patients,” said Dr. Tiffany Kung, co-principal investigator. 

She added that the team is excited to implement Vital Signs Directed Therapy as an evidence-based framework designed to shift how providers approach clinical problems in low-resource settings. 

“By embedding this model through a collaborative, peer-to-peer training led by Stanford anesthesia trainees and fellows, we are teaching local bedside providers to understand why it is important to monitor vital signs and exactly how to actively respond to and treat clinical abnormalities, moving them beyond passive observation,” she said. “This project establishes a foundational framework for independent clinical reasoning, teaching local bedside providers to make life-saving interventions the moment a physiological danger sign appears.”

Principal Investigators:

Tiffany Kung, MD, Clinical Assistant Professor and Resurge Consulting Anesthesia Safety Officer

Mark Singleton, MD, Clinical Professor

James Chang, MD, Professor and Chief of the Division of Plastic and Reconstructive Surgery at Stanford University and ReSurge Consulting Medical Officer

Funders:

Stanford Center for Innovation in Global Health

Stanford Department of Anesthesia, Perioperative, and Pain Medicine