Activity report from anesthesiologist Dr. Sonoko Fujii
We have received a report from Dr. Sonoko Fujii (Assistant Professor of Anesthesia and Perinatology, Ehime University Graduate School of Medicine, Director of the NPO Heart Saving Project), who participated in the catheter treatment support activity team in May 2023.We would like to introduce it to you.
Activity Report 2023.5
Spring Holiday in May 2023 will be my first overseas trip in a while after the coronavirus pandemic. There was quite a gap between my local activities as part of the Heart Saving Project. I listened to stories from the president of the board who traveled there this spring, and while I was surprised by the unpredictable situation there, I prepared for the trip with confidence.
At the National Center for Maternal and Child Health of Mongolia, anesthesiologists work in pairs with anesthetist assistant nurses. When we travel abroad, patients scheduled for surgery are often decided on the day before or after, and Mongolian anesthesiologists immediately provide preoperative examinations and instructions to patients who are suddenly scheduled for surgery. They gave me a thorough pre-surgical examination, typical of a children’s hospital, and we were able to avoid some difficulties thanks to their suggestions.
Regarding anesthesia for the surgery itself, as pediatric heart surgery is not currently performed in Mongolia, anesthesiologists are not familiar with the unique anesthesia management. In this field of anesthesia, there are cases where things that should be done in normal anesthesia are contraindicated, and the anesthesiologist is required to have very specific knowledge and experience, especially in the case of severe diseases. I have heard that textbooks are difficult to obtain locally, so there seems to be a limit to individual desk study.
The plan for this trip was to focus on educating doctors, so I used notes, limited English, and diagrams, and sometimes get help from interpreter of Heart Saving Project Mongolia’s member and I explained everything from understanding basic hemodynamics to the importance of regulating pulmonary blood flow, the pros and cons of administering anesthetics and oxygen, and precautions for anesthesia during various catheter interventions.
I also explained that in the current situation where only local doctors perform test catheters, accurate test results can only be obtained if the anesthesiologist also learns the unique anesthesia management techniques. I had a different anesthesiologist in charge every day, but I was actually grateful for the opportunity to talk with so many doctors.
Many medical dispatch teams from other countries other than our Heart Saving Project also work at the National Center for Maternal and Child Health of Mongolia, and in some cases Mongolian anesthesiologists provide anesthesia together with the team’s anesthesiologists, and in others, only a surgeon is dispatched and they provide anesthesia.
I hope that this experience will be of use to anesthesiologists when they are in charge of pediatric cardiac anesthesia.
Finally, I would like to thank everyone at Heart Saving Project and Heart Saving Project Mongolia for giving me this valuable opportunity to participate.