The group had only a couple of weeks to put together their mission. They were able to get several surgeons, anesthesiologists, and nurses to volunteer, as well as numerous donations of surgical products and anesthesia supplies. Several medical equipment companies were very generous in providing equipment and supplies; however, their requests to borrow an ultrasound system to help facilitate performing regional anesthetics were turned down.
They had almost resolved to do without one, when a last-minute connection with a Terason customer provided the contact information they needed. Terason was honored to help such a great cause.
Dr. Edmondson received a brief in-service on the Terason t3000 Ultrasound System on the eve of their departure. Said Dr. Edmondson, “While I have performed many ultrasound-guided regional blocks, I do not consider myself particularly facile as a ‘knob-ologist’. Fortunately for me, the Terason was simple enough to use with only this brief introduction.”
Tells Dr. Edmondson, “I carried the machine to Haiti in my backpack. On arrival, I secured it to the cross bar of a double IV pole with surgical tape, and used this set up as a rolling regional workstation.”
Many of the operations performed were on severely injured arms and legs. With the overwhelming workload, shortage of manpower (especially for postoperative care), and the often less-than-ideal anesthesia environment, regional anesthesia offered significant advantages for patient safety in these types of procedures.
Dr. Edmondson’s team felt the images obtained with the Terason ultrasound were easily obtained, and were of very high quality. “We were able to successfully image the sciatic and femoral nerves for lower extremity anesthesia.
We also were able to image the brachial plexus well enough that I performed a supraclavicular approach on a seven-year-old for repair of a wrist fracture, an anesthetic that I would not have attempted with a “blind” approach. We were able to perform this expeditously enough that she didn’t require any sedation for the injection, adding another layer of safety to the procedure (and proving the stoicism of the Haitian children that we saw on many occasions).”
“The machine proved especially valuable for one group of patients. Many of our cases were revisions of amputations. While the older technique of nerve stimulation to perform regional blocks can be quite reliable, the use of that technique is almost impossible on an amputated limb (especially when a language barrier prevents the patient from describing understanding or describing a “phantom” muscle twitch).”
Despite some fairly brutal treatment, the Terason system was returned in working condition, and will again serve the team on their return trip in April.
Dr. Edmondson said, “Perhaps by then, we will learn to use all of its many features – can you really surf the net with it as well?“
Photos courtesy of Donald Edmondson, M.D.
Chairman, Department of Anesthesiology
Duke Raleigh Hospital