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SPA Newsletter

.

Quentin Fisher, MD

The Committee for International Education and Service held a brief meeting to discuss several projects and review issues for voluntary medical services abroad. The committee has been functioning as a working group, and does not restrict participation: all of our programs welcome participation by all SPA members.

Mobile Teaching Program: Paul Samuels and Raz Samandari are supervising a project to develop a library of mini-lectures to be made available for SPA members traveling abroad or to be sent to colleagues abroad for local use. It has been the experience of many of the international travelers that brief talks on basic issues in Pediatric Anesthesia are generally welcomed and promote educational discussions. While each of us may have a small catalog, the collective resources of SPA should be quite substantial. If you have materials that could be used to build this library (all slides will be returned after scanning), please contact Raz (Raz_samandari@hms.harvard.edu) or Paul (paul.samuels@chmcc.org)

Directory of Voluntary Medical Services Abroad: Quentin Fisher reported that this should be ready this spring for posting to the SPA Website. The database will include information about US-based organizations seeking all types of volunteer medical professionals. If you have worked for an organization that might not be listed, please let Quentin know at fish5q@radix.net. The Committee also discussed the possibility of providing an information booth at annual meetings to help promote pediatric anesthesia expertise for voluntary surgical services that treat children.

Book and journal contributions. At last year's meeting 71% of participants said they would agree to spend $20 to send a year's journal volume to a needy hospital abroad. Those who have traveled to the developing world know how desperately our colleagues want current information about our discipline. Recent texts, journals, or web access are simply not to be found in many locales. Our problem is matching hospitals with donors, as well as monitoring to be sure the donations are consistent and repeated. We are interested in what publications SPA members have available for donation, as well as the names of hospitals where such donations would be well-appreciated. Contact persons for this project are Sanatham Suresh (ssuresh@nwu.edu), Joe Tobias (tobiasj@health.missouri.edu), or Paul Samuels (paul.samuels@chmcc.org).

The committee again discussed the usefulness of developing recommendations for the perioperative milieu for agencies that send volunteers abroad. This would serve several purposes:

1. provide guidance for volunteers and agency administrators about what we think are important issues;
2. provide back-up for anesthesiologists concerned about safety when they need to confront indifferent administrators; and
3. highlight the importance of safety in austere circumstances.

It has already been emphasized that anesthesia for such programs is different from anesthesia in the developing world. The patients are different than those regularly operated on, the volume and rapid turnover are different, the surgeries are largely elective, and the practice attempts to incorporate the safe practices of the visiting team. Basic principles of safe practice are universal, and practices need to be adapted to the nature of the program and site.

The committee grouped the issues into several general areas:

1. Boundaries and limitations;
2. Team composition, credentials, and structure;
3. Preoperative evaluation, patient selection, and NPO guidelines;
4. Infrastructure, site evaluation, communication, and emergency preparations;
5. Supplies and equipment, including reuse of disposables;
6. Perioperative management, team roles, useful agents, pain control;
7. Follow-up, managing complications, quality assurance.

SPA members with interest in any of these issues are welcome to contribute! Contact Quentin at fish5q@radix.net. In the next several months we hope to have a draft of recommendations, ready for presentation to the SPA membership for review and comment by next winter's meeting.

The Committee will meet again at the SPA 14th Annual Meeting, October 13, in San Francisco.

Quentin Fisher, MD
Baltimore, MD