FUJIFILM Sonosite has once again supplied loan equipment to cardiac teams travelling out to perform life-saving surgery on children in India on behalf of the charity Healing Little Hearts (HLH). HLH was launched as an official registered charity in 2007 to provide free heart surgery to poor children in developing countries. Starting with just occasional trips, the charity now organises regular visits to 19 centres, many in India and, more recently, at sites in Kenya, Tanzania, Mauritius and Malaysia.
A UK-based Consultant in Paediatric Cardiac Anaesthesia and Intensive Care took part in three HLH trips in 2017. She explained: “The HLH teams include a mix of surgeons, anaesthetists, intensivists, perfusionists, intensive care nurses, and scrub nurses. We aim to operate on 10-12 children during each seven-day trip, and our long-term objective is to help the centres to develop their own paediatric cardiac surgery. For example, one of the earliest centres we visited was in Pune in India. There were good, experienced surgeons in place, but they needed help to develop their service, particularly in the fields of anaesthesia and intensive care. Now, after several visits from HLH teams, they have developed an independent paediatric cardiac service. The HLH team is very proud of that.”
She continued: “Ultrasound at the point of patient care plays an important part in paediatric cardiology, both in my day job in the UK and on the HLH trips; it would be difficult to work without it. Not long ago, somebody asked me what was absolutely essential to take on charity trips. I replied, firstly your smile, and then your ultrasound equipment. Even before the surgery, we use ultrasound in pre-assessment clinics. The Sonosite M-Turbo we took last time was robust and ideal to carry out to use in a small village, where we could do basic echos and select the cases to treat. Case selection is a key point on the charity trip. Our first criterion is to choose children who will not require long-term follow-up and medication after the initial surgery, or additional procedures as they grow. We choose children who can carry on and live normal healthy lives afterwards. The second group we try to prioritise are children already admitted to the intensive care unit that would die imminently without surgery.”
The point-of-care ultrasound system is used 24/7 on the HLH trips. She continued: “We’re dealing with a lot of neonates. Even older children are very small for their age because of their cardiac abnormalities. Inserting central and arterial lines in these children is challenging without ultrasound. As we want to extubate them as soon as possible, we use ultrasound for applying paravertebral blocks in order to achieve effective pain relief. On top of these specific procedures, our cardiologists and intensivists use ultrasound for basic echos in the intensive care unit, and to assess pleural effusions and tamponades. Having point-of-care ultrasound available 24/7allows us to assess our patients easily and in a timely manner to achieve optimal care. We are very grateful to FUJIFILM Sonosite for lending us the equipment we require for our trips.”