BRUSSELS/LVIV, Ukraine, March 17, 2022—On March 13 and 14, a surgical team from Doctors Without Borders/Médecins Sans Frontières (MSF) visited the 750-bed Okhmatdyt pediatric hospital in central Kyiv to provide training and advice related to trauma surgery and the management of mass casualty events.
An experienced MSF vascular surgeon assisted in the operating room and advised surgeons about approaches to war-trauma surgery.
“Our surgeon did one quite delicate operation, and straight afterwards the surgeons in the hospital came and proactively asked to be trained on those techniques,” said Anja Wolz, MSF emergency coordinator in Ukraine. “Most of the surgeons in this hospital are specialists but they do not have trauma surgeons. So they have not had experience doing significant debridement [wound cleaning] which is essential for bullet and shrapnel wounds. If a bullet or shrapnel wound is not dealt with quickly or correctly infection can set in fast and it requires some experience to know how to approach this type of surgery—to ensure the wound is effectively cleaned and will heal properly, and to avoid further infection.”
With curfews, frequent bomb-alert sirens and staff sheltering in bunkers and having difficulties to travel to the hospital, the hospital's usual 2,000 personnel has reduced to a core team of around 200. The hospital has discharged or referred elsewhere most of the former patients and the staff are focused on the treatment of people with trauma wounds. At the time of the MSF team’s visit, the hospital staff was receiving several wounded patients per day and expected the numbers to increase.
To help the hospital prepare for mass casualty events— the simultaneous arrival of multiple trauma patients—an MSF emergency room doctor provided classroom training for 40 of the hospital’s staff. The training included best practices such as changes to the way patients are received by the hospital in the event of a large influx.
While assisting in the operating room, MSF’s vascular surgeon provided hands-on training in rapid lifesaving trauma stabilization and surgery, such as removal of bullets or shrapnel, preventing internal bleeding, effective wound-cleaning and other core essentials of trauma-surgery.
The hospital requested advice on how to manage their supply lines and organization of the essential supplies to be able to manage high numbers of war-trauma patients over an extended period. The MSF team assessed the quantities of supplies the hospital has, and made recommendations about continued supply of war-trauma essentials.
“We intend if possible to return soon to build on what we could do in the first short visit,” said Wolz. “We have not been able to fully finalize the mass casualty training and there is more to do to help map out the best patient pathways in case of simultaneous arrival of large numbers of casualties. We also want to continue looking into the hospital’s supply chains. These are some of the principal things that the hospital has asked for. We would also like to do more hands-on training and advice for the surgeons—practical bedside and operating theater training.”
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