Doctors from Portugal Shared Their Practical Experience with Ukrainian Colleagues

For six days, on February 28 – March 5, 2023, experienced doctors from Portugal shared their experience with Ukrainian doctors. The meeting was hosted by the simulation training centre of I. Horbachevsky Ternopil National Medical University. The team included Vitor Almeida (physician at Tondela Hospital, Viseu), Carolina Mogos (physician at Centro Hospitala Tamega e Sousa), Ulyana Pidhirna (University Clinic of Faro (University of the Algarve)), Olena Berezovska-Lorenzo (physician of the network of outpatient clinics in Ustuariu do Tagus, Central Administration of the Lisbon Region).

The training course is designed for two days for one group of participants. More than 20 specialists in emergency medicine from several regions of Ukraine, who are participants in another project (training instructors of educational and training departments of emergency medical care and disaster medicine centres) received new knowledge and practical skills. It should be reminded that this program has been implemented for several months on the basis of the simulation training centre of TNMU as one of the stages of a large-scale educational project in the emergency medical care system, which is organized by the Ministry of Health of Ukraine with the support of the World Bank.

In addition, military doctors, who are directly engaged in the evacuation of critical patients (wounded soldiers) on the front line and provide them with assistance, completed the training course. And the third group of participants included the representatives of emergency medical care centres working in liberated territories and front-line zones, scientists and lecturers in disaster medicine and emergency medicine at medical universities in Ternopil, Kyiv and other cities.

A training course in simulation medicine from doctors from Portugal covers such issues as organizational and legal aspects of medical transport of a critical patient; medical transportation of critical patients: safety and peculiarities; aeromedical transportation of critical patients; complications and conflicts during medical transportation of critical patients; medical transportation of critical paediatric patients.

“The educational and practical course on interhospital transportation, which Vitor Almeida and his team conducts for 6 days, is quite important in Ukrainian realities. We are glad that this course was launched on the basis of the simulation training centre and was the first to be mastered by the participants of the program for training instructors of the departments of emergency medical care and disaster medicine centres, which was organized by the Ministry of Health of Ukraine with the support of the World Bank. Among them are representatives of Kharkiv, Mykolaiv, Donetsk, Chernivtsi, Ivano-Frankivsk and other regions. These are twenty people who will become qualified instructors in pre-hospital care and will organize training for others. These are precisely the people who are engaged in the transportation of patients,” said the head of the simulation training centre Halyna Tsymbaliuk.

She also emphasized the relevance of such training courses, because there is no legislative framework in Ukraine that would regulate the process of transporting critical patients. Moreover, there is a great need to create a number of regulatory documents and checklists, because in their daily activities, emergency medical care teams carry out many transportations of critical and severely injured patients.

“During these days, they thoroughly mastered the skills that ensure efficient and adequate transportation of patients in critical conditions. They learn what it takes to do this, because a critical patient needs to be transported from one hospital to another in the same condition as when they were taken in. Accordingly, checklists or regulatory documents are needed for the emergency team. In Ukraine, there is only an order that concerns the transportation of pregnant women, women in labour and women after childbirth. There are no documents that would regulate the transportation of critical patients. We hope that this course will be a start for the development of a regulatory framework in Ukraine. With the help of the participants, the organizer of the course, Vitor Almeida, will create a sample of such a document, taking into account the Ukrainian specifics of the emergency service. This document will take into account what should be taken with, how to check and prepare the vehicle for transport, how to calculate the amount of medicine and oxygen to be able to transport the patient over different distances, how to admit the patient, legal responsibility. We hope that it will be possible to change the situation, because we really need this today,” Halyna Tsymbaliuk added.

One of the trainers, Olena Berezovska-Lorenzo, said that they wanted to contribute to the fact that as many Ukrainian soldiers as possible returned alive and with the least damage to their health, so that the victims in the front-line zones were saved. “The purpose of the course is to facilitate communication within the team and with medical institutions, to teach how to properly organize transport, to ensure the transportation of the patient to the medical institution with the least losses to their health. We also came to learn a lot from the Ukrainians, because despite all the complexity of the situation in the country, our people show their courage and intelligence, which are highly appreciated in Europe,” shared Mrs. Olena.

Vitor Almeida said that he and his team have close contacts with Ternopil National Medical University, which contributed to the organization and implementation of the educational and practical course. “We understand that many hospitals in Kherson, Kharkiv and other regions have been destroyed and continue to be destroyed as a result of Russian aggression, as well as the fact that there are many victims in many cities of Ukraine, so we decided to share our experience and knowledge regarding the transportation of critical patients from one hospital to another. I would like to note that the centre of simulation training of  Ternopil Medical University has created all the conditions for conducting such courses. It really corresponds to the European level. We also saw a high level of preparation on the part of the participants, and it is nice to note their motivation,” Vitor Almeida concluded.

TNMU Press Secretary, Yanina Chaikivska.

Photographs by Mykola Vasylechko.