WFSA Regional Anaesthesia Fellow - Dr. Victoria Ikaha Hien
Dr Victoria Hien, is an anaesthesiologist working in the University Hospital of Tengandogo in Ouagadougou, Burkina Faso. From June to September 2019, Dr Hien completed a three month Regional Anaesthesia Fellowship at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Victoria was particularly interested in learning the principles, techniques, limitations and complications of commonly used US-guided regional anaesthesia techniques.
What did you enjoy most about your fellowship?
Prior to the WFSA Fellowship I had never done any nerve blocks on my own. I had seen a few cases but they did not work. We usually did general anaesthesia for upper limb surgery and when possible spinal anaesthesia for lower limbs. Regional Anaesthesia can allow us to safely offer anaesthesia to patients who cannot undergo general anaesthesia.
Over the course of this fellowship, I independently administered over 60 nerve blocks across both upper and lower limbs. I quickly learnt how to implement most of the blocks by observing anaesthesiologists in the hospital and the practicing these techniques myself.
I also enjoyed attending non-clinical activities during my fellowship such as raining workshops on ultrasound guided nerve blocks. Lectures were delivered by visiting US-based anaesthesiologists on topics ranging from regional anaesthesia to femoral nerve block ultrasound guided.
How will you implement the skills you learned in your home institution?
We have ultrasound equipment in my hospital in Burkina Faso but while the applications of regional anaesthesia are numerous, the equipment remains underutilised due to a lack of knowledge and training in regional anaesthesia. This fellowship has been a great experience for me because I had the opportunity to perform many different types of blocks. It was amazing when I first returned to my hospital after my fellowship because I finally had the confidence to perform my own blocks. I have already started sharing the knowledge I learnt through this fellowship with some of my colleagues and we are trying to introduce regional nerve blocks into our routine practice. The residents are excited about learning nerve blocks.
Health workers in Burkina Faso have been on strike from July 2019 and as such we have only been able to do emergency cases. I have only been able to practice two blocks since I returned but I am eager to improve my skills and practice once normal surgical activities restart. Many of the anaesthetists in my hospital are also eager for me to teach them about the blocks I learnt.
I hope I will be able to soon report that I have shared my experience of regional anaesthesia in my hospital and beyond.
B.E, 35 years, ASA. I booked for an open reduction and internal fixation (ORIF) for a left old elbow dislocation under nerve block
Together with the senior anaesthetist we decided to use an infraclavicular block. After we assessed the patient, I was able to perfom the block effectively and efficiently. I then sent the patient to the theatre and set up the monitoring. However, after the surgery commenced the patient started complaining they were experiencing pain. To remedy this, I provided general anaesthesia.
|What did you learn from the case?||
After the surgery, I spoke with another senior anaesthetist who explained that in her experience a supraclavicular block is better that a infraclavicular block for elbow surgery when the incision is high. I also learnt that knowing the exact site/level of incision by discussinf it wih a surgeon is important when choosing a nerve block. I have to make sure that the block works well before bringing the patient in the theatre.
|How would you use this learning in the future?||
I will not hesitate to contact the surgeon to get as much information about the surgery as possible in order to perform a successful nerve block.
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