Dr. Megan Thùy Vũ is a global surgery resident at Baylor College of Medicine in Houston, Texas. In addition to the five-year clinical general surgery program, she has two additional years dedicated to cross-training in other specialties, including point-of-care ultrasound, orthopedics, and OBGYN. Her professional interests include global pediatric surgery, trauma in combat and austere settings, and global surgical training and educational program development. Dr. Vũ sent us this report about the International Pediatric Specialists Alliance for the Children of Vietnam (ISPAC-VN) and the role ultrasound plays in trauma healthcare.
ISPAC-VN is a philanthropic organization founded in 2009 by Dr. AiXuan Holterman, Professor of Surgery and Pediatrics and Co-Director of Pediatric Global Health at the University of Illinois, College of Medicine. For more than a decade, Dr. Holterman has organized international clinicians and support personnel to collaborate with local Vietnamese healthcare providers to enhance the care of the children in Vietnam in a sustainable fashion through partnership and institutional capacity building. In addition to clinical and research support, the cornerstone of IPSAC's mission includes education. IPSAC provides educational and training exchanges, equipment and academic support, and delivery of outreach surgery. Our team makes twice-yearly visits to Vietnam for program developments at major children’s hospitals throughout Vietnam.
Educating Clinicians about Trauma
The World Health Organization has recognized trauma as the leading cause of death for children worldwide, with a disproportionate burden of fatalities in low- and middle-income countries such as Vietnam.1 Additionally, more than 1.7 billion children lack access to surgical care today.2 With this in mind, Dr. Holterman developed the Pediatric Acute Surgical Support (PASS) course in 2016 to address the need for improved trauma and emergent surgical care. To date, the course has taught 121 participants, including 35 nurses. Participants include providers from the fields of surgery, emergency medicine, critical care, general pediatrics, and anesthesiology.
Adopting a “Train the Trainers” approach, the course has been initiated at the referral children hospitals to identify local champions who will ultimately spark the transfer of PASS skills and knowledge throughout the rest of the country. The expert local champions will identify new champions at the provincial hospitals, thus propagating the wave of education.
Pediatric Acute Surgical Support Course a Success
During the most recent course in November 2019, five local Vietnamese champions worked in conjunction with the IPSAC team to teach the PASS course to 21 new learners. The course was held at the newly founded City Children’s Hospital in Ho Chi Minh City. Located adjacent to the high-traffic thoroughfare entering and exiting the main part of the city, this hospital receives a high volume of trauma.
The PASS course program was developed in partnership with the Vietnamese providers to ensure context appropriate education for pediatric trauma and emergent surgery topics. The program included team-based, interdisciplinary simulation case testing. The instructors utilized mannequins with vitals monitoring and radiographs adjusted by instructors depending on the decisions of their students.
Debriefing for learning and reflection was performed after each case in both individual teams and the larger class setting. The day also featured interactive, discussion-based case scenarios to emphasize teaching points. Additionally, participants also practiced at multiple skills stations, such as airway, C-spine, spine and pelvic fracture, chest tube, rapid cycle primary and secondary survey, and ultrasound.
Sonosite Edge II Enables Hands-On FAST Practice
The Sonosite Edge II ultrasound provided by Fujifilm Sonosite enabled 2019 to be the inaugural year that our team could teach hands-on practice for the Focused Assessment with Sonography for Trauma (FAST) exam. Post-course feedback highly praised the sonography skills station, with multiple providers remarking that they felt empowered to use the ultrasound in their practice. With variable resource settings throughout the country, this skill can be lifesaving for children. We sincerely thank Sonosite for lending us the Edge II, which has forever changed the lives of these medical professionals and every child they care for in the future.
1World Health Organization. Disease and burden and mortality estimates. https://www.who.int/healthinfo/global_burden_disease/estimates/en/. Accessed February 1, 2020.
2National Institutes of Health. Estimates of number of children and adolescents without access to surgical care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438256/. Accessed February 1, 2020.