Ultrasounds Offer Pacific Is'ers Swift Diagnosis
14 September 2005
‘Battlefield’ Ultrasounds Offer Pacific Islanders Swift Diagnosis
Portable ultrasound machines are invaluable diagnostic tools for surgeons working in the Pacific Islands and other areas where medical resources are poor.
Surgeon Semisi Aiona says that despite their cost and problems in training and maintaining skill levels the machines are a boon to people in Pacific Island, third world and even rural New Zealand with little access to specialist radiology services.
Mr Aiona is presenting a paper entitled “Utility of Surgeon-Performed Ultrasound in Samoan at the Royal Australasian College of Surgeons’ Scientific Meeting in Hamilton this week.
Developed by the military, as diagnostic tools in battlefield trauma medicine, portable ultrasound machines are particularly useful in situations where speed of diagnosis is important. Worth around $30,000 each some machines are small enough to fit in one hand.
Mr Aiona studied the use of the machines while working in Apia’s Tupua Tamasese Meaole Public Hospital between September 2003 and April 2004.
Although common in New Zealand hospitals there are only two portable ultrasound machines at Tupua Tamasese Meaole Public Hospital and one stationary machine.
Mr Aiona reviewed 190 scans of patients ranging in age from seven months to 92 years, 79 of which were emergency admissions. He compared the scanner results and initial assessments with subsequent treatment to determine the effectiveness of each diagnosis.
His study showed that a surgeon using the portable ultrasound machine could make rapid, accurate diagnoses aiding prompt treatment and efficient use of scarce resources. It can also be used to guide lifesaving procedures such as inserting drains for a blocked kidney.
Mr Aiono grew up in Samoa, before training in Medicine and Surgery at Otago University. He became interested in the potential for surgeons using the machines in emergencies while training in Britain. In the English-speaking world (United States, Britain and Canada) ultrasounds are traditionally performed by radiologists who, once trained become experts by experience. Finding time to maintain skills and build the necessary experience can be major obstacles for busy surgeons.
American College of Emergency Physicians guidelines recommend 150 supervised examinations if practitioners are to develop and maintain adequate interpretive skills.
“Despite these problems using portable ultrasounds to obtain quick, accurate diagnosis in poor or remote areas of the world can definitely improve the quality of care surgeons give patients,” Mr Aiona says.
He says he has received generous help from radiologist colleagues from the United Kingdom, Australia and Samoa.
The Royal Australasian College of Surgeons is an internationally recognized organization representing more than 6,300 members, including 1,700 trainees in nine different specialties in New Zealand and Australia – 90 per cent of surgeons in both countries have been trained and examined by the College. Seven hundred New Zealand surgeons are members of RACS.
The key roles of the college are in advocacy, education, professional development and membership support. The nine specialist areas represented by RACS are: general surgery, neurology, urology, otolaryngology, paediatrics, plastic and reconstructive surgery, vascular surgery and, cardio-thoracic surgery.
The conference – to be held at the Novatel Tainui, in Hamilton, will run from Tuesday September 13 to Friday September 16.