Dr. David Chaparro - Bringing clarity in the most difficult environments

June 15, 2021

 

Dr. David Chaparro, in addition to working as an emergency doctor at the San Carlos Clinical Hospital in Madrid, also participates in humanitarian aid projects in some of the poorest countries in the world, treating patients, training other professionals in the use of bedside ultrasound (POCUS), and demonstrating how it improves patient care in the most difficult settings:

“I was lucky to discover ultrasound quite early in my career, now I use it every day in my daily work. It is a fundamental tool that complements the anamnesis and the physical examination, guiding the request for complementary tests from the beginning of the evaluation of the patient. I have found that using this approach I need to order fewer additional tests and I can start treatments much earlier, since I have much more relevant clinical information. "

His first experience as a humanitarian doctor came after the Haiti earthquake in 2010:

“It was overwhelming to find myself suddenly working in an area of great need, with very little equipment at my disposal. Since then, I have worked in Nicaragua, the Sahara Desert in Algeria, Cameroon and Uganda; sometimes traveling as an independent doctor, other times as part of an NGO medical team. During these visits, being able to train other professionals is one of the most valuable activities of my time. It is very satisfying to show those who are not yet using POCUS how you can improve your daily work.”

In 2018, Dr. Chaparro traveled alone to a small town in an English-speaking region in Cameroon to deliver a SonoSite ultrasound at the medical centre, train the local team of doctors so that they could evaluate and treat their patients with the help of the himself, and help in patient care:

“The services were basic, there were no radiological facilities, so POCUS was the only way to assess the patient with an image and to guide the diagnosis. Local doctors were familiar with ultrasound, but mainly in obstetrics. We work on the use of the equipment to know the ultrasound examination, what pathologies to look for in emergency medicine and how to recognise and identify these situations from the ultrasound images. Once the medical team was trained in the use of ultrasound, the speed and precision of the diagnosis were significantly improved and, consequently, the start of the treatments began to be carried out faster and more fluidly, especially on the days of greatest job. The quality of care provided to the patient improved, despite the scarcity of resources.”

In January 2020, he continued to carry out his work in a new destination:

“I moved to the Bidibidi refugee camp in northwest Uganda, where a large group of people from South Sudan, devastated by the war, now lived in the different villages that made up the camp. I was collaborating with 2 Spanish NGOs to form a home care service for patients who could not move, with the help of an ambulance we were able to establish a mobile clinic and attend them at the door of their homes.”

POCUS was used daily in the ambulance to guide clinical examinations and treatment decisions:

“POCUS helped to identify pathologies in seriously ill patients, (something that was very difficult there due to the scarcity of resources), to be able to start treatment immediately and to avoid a transfer allowing to do better medicine at the same door of each home where assistance was provided. The resource was so positive that we were invited to come back with the idea of training our own local staff.”

Dr. Chaparro predicts that the benefits of ultrasound in emergency medicine will be even more important in the next 20 years:

"Systems technology will inevitably advance, the use of POCUS will become widespread, and it is hoped that ultrasound training will become a staple during college. Personally, I would like to see increased use of POCUS at the point of entry to hospitals, performed by medical and nursing professionals alike. Comprehensive training programmes will pave the way for qualified doctors, at all levels of experience, not to consider conducting a complementary test in the Emergency Department without the prior use of bedside ultrasound.”