SCCM Trains Ukrainian Clinicians on Critical Care Ultrasound

It was a unique and worthwhile teaching opportunity as the U.S. group taught over several days in an underground bunker with air raid sirens going off and power flickering. SCCM member Vadim Gudzenko, MD, clinical professor of anesthesiology and critical care at the University of California Los Angeles, is originally from Ukraine. “When war started, obviously it was a shock for everyone,” he said, “but watching from outside was very difficult to see. My first idea was, ‘How can we help?’” Critical care ultrasound knowledge and skills help save patients’ lives every day in the United States, Dr. Gudzenko said. “I really wanted to give back to doctors in Ukraine so they can actually save more lives, especially in such a critical event.”

SCCM volunteer Aliaksei Pustavoitau, MD, MHS, FCCM (left) teaches ultrasound in Lviv.

SCCM held the free ultrasound training courses at Lviv Territorial Medical Union, Multidisciplinary Clinical Hospital of Emergency and Intensive Care, from March 16 to 24, 2023. The program was coordinated through SCCM’s Global Health programs and supported by the humanitarian aid organization Direct Relief, which provided a $750,000 grant. Direct Relief is one of only three charities approved by the Ministry of Health of Ukraine to coordinate delivery of medications and supplies.

The trip was led by José L. Díaz-Gómez, MD, FCCM, an SCCM Council member and recognized expert in POCUS. Dr. Díaz-Gómez is the medical director of cardiothoracic, mechanical circulatory support, and transplant critical care and director of critical care echocardiography at Baylor St. Luke’s Medical Center in Houston, Texas. When SCCM approached him, Dr. Díaz-Gómez accepted the mission because of his children. “My two kids are 17 and 14; they are American and they said, ‘Dad, you cannot have doubt about it; we’re Americans, we need to support Ukraine,’” he said. “They are only adolescents, but they still know democracy is the way to move forward.”

SCCM organized the course with the Association of Anesthesiologists of Ukraine and the First Lviv Medical Association. Organizers worked closely with the Ministry of Health of Ukraine to select clinicians from across the region who would benefit most from the free training.

 

SCCM volunteer Susanna Rudy, ACNP, DNP, AG-ACNP (right) with trainees at a workstation.

SCCM’s ultrasound courses provide the realistic training needed to perform and interpret ultrasound imaging and increase diagnostic skills and scanning proficiency. Four ultrasound courses were taught during the mission—three basic and one advanced—with multiprofessional students, including physicians and nurses. Combat medics were also selected from active military operations so they could gain new skills to better respond to battlefield injuries using portable ultrasound machines.

The advanced course was a train-the-trainer course that will allow Ukrainian clinicians to continue to teach these skills and knowledge, Dr. Díaz-Gómez said. “They will become very proficient in critical care ultrasonography and, because of that, they will be able to train other Ukrainians moving forward.”

First Deputy Minister of Health of Ukraine Sergii Dubrov, MD, supported the courses and took part in them. “The course is very cool,” he said during the training. “Two hours of lectures and then most of the training in practical classes on living people. This is an opportunity to learn in real mode with real people. They are all different; they have their own anatomical features.”

Many of the ultrasound course materials, such as handouts and presentations, were provided in Ukrainian. Students also received access to online course materials, including pre- and posttests and lectures with Ukrainian subtitles. SCCM donated 150 iPads containing the course materials, which had been translated into Ukrainian. Students also received a two-year membership to SCCM that includes access to the journal Critical Care Medicine, SCCM educational materials, and more.

During the training, the students used handheld, portable ultrasound devices provided by Butterfly Network. After the training, SCCM donated Butterfly devices to 80 of the Ukrainian trainees. “We’re hoping that they become the teachers moving forward and bring critical ultrasound to Ukraine,” said Lisa Rapoport, MD, MS, staff intensivist and emergency medicine physician at Kaiser Permanente in Santa Clara, California. “They will be able to use the Butterfly devices and share them with other people in their workplace and in their department, it could be operating room, emergency room, ICU, or even on the regular floor. It’s so great.”

SCCM Global Health programs support humanitarian efforts worldwide, delivering free training and educational resources, as well as supplies, medications, equipment, and volunteer clinicians to low-resource and crisis-affected areas. This is not the first time SCCM has partnered with Direct Relief. In May 2022, SCCM received a grant to provide 12 frontline hospitals in Ukraine $50,000 each to purchase needed supplies to keep their hospitals and ICUs operational.

 

Left to right: Sergii Dubrov, MD, First Deputy Minister of Health of Ukraine, Natalia Matolinets, MD, deputy medical director for anesthesiology of the Lviv First Territorial Medical Union, and José L. Díaz-Gómez, MD, FCCM, SCCM Council member and lead volunteer.

Ukrainian physician Kateryna Bielka, MD, associate professor of the department of surgery, anesthesiology, and intensive care at Bogomolets National Medical University, took part in the training. She said, “The unique part of this course was the opportunity to perform the transesophageal ultrasound, as in Ukraine we don’t have this opportunity to teach our anesthesiologists to perform it by hand on the mannequin.” After practicing on the mannequins, the students were also able to practice transesophageal ultrasound on human volunteers. “Usually the anesthesiologist in Ukraine can’t do this; they have not enough knowledge to perform this investigation,” Dr. Bielka said.

Natalia Matolinets, MD, deputy medical director for anesthesiology of the Lviv First Territorial Medical Union, summed up the experience: “The best of the best Americans have arrived, and they work with the best of the best Ukrainians.”