Assessment of surgical teleconsultations in a developing country: two years of experience in Djibouti

Bertani, Antoine; Menguy, P; Delmas, J.M.; Launay, Franck; Mathieu, L.; Candoni, Philippe; Dulou, R.; Rongièras, Frédéric

doi:10.1684/mst.2012.0112

Cited by 5 publications

(7 citation statements)

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“…2+ A role 2 unit with CT imaging and sonography. 3 This field hospital includes additional capabilities, including specialist diagnostic resources, specialist surgical and medical capabilities, preventive medicine, food inspection, dentistry, and operational stress management teams. Care is pursued to complete stabilization before air medevac.…”

Section: Damage Control Principlesmentioning

confidence: 99%

“…They will guide and validate this first procedure before approving the medevac (depending on the injury severity) to a role 4 unit in France by the mobile neurosurgical team. 3,7,10 While waiting for the air medevac on a medically equipped Falcon aircraft, the patient undergoes neuroresuscitation in the theater of warfare. During the flight, the patient is monitored by an intensivist who has at his or her disposal ultrasound imaging with transcranial Doppler, and sometimes an intracranial pressure sensor.…”

Section: Nonneurosurgical Far-forward Damage Controlmentioning

confidence: 99%

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Acute neurosurgical management of traumatic brain injury and spinal cord injury in French armed forces during deployment

Dagain

Aoun²,

Sellier

et al. 2018

Neurosurgical Focus

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This article aims to describe the French concept regarding combat casualty neurosurgical care from the theater of operations to a homeland hospital. French military neurosurgeons are not routinely deployed to all combat zones. As a consequence, general surgeons initially treat neurosurgical wounds. The principle of this medical support is based on damage control. It is aimed at controlling intracranial hypertension spikes when neuromonitoring is lacking in resource-limited settings. Neurosurgical damage control permits a medevac that is as safe as can be expected from a conflict zone to a homeland medical treatment facility. French military neurosurgeons can occasionally be deployed within an airborne team to treat a military casualty or to complete a neurosurgical procedure performed by a general surgeon in theaters of operation. All surgeons regardless of their specialty must know neurosurgical damage control. General surgeons must undergo the required training in order for them to perform this neurosurgical technique.

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Section: Damage Control Principlesmentioning

confidence: 99%

Section: Nonneurosurgical Far-forward Damage Controlmentioning

confidence: 99%

Acute neurosurgical management of traumatic brain injury and spinal cord injury in French armed forces during deployment

Dagain

Aoun²,

Sellier

et al. 2018

Neurosurgical Focus

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“…While interventions that involve training, education, or resource building lend themselves to long-lasting impact, these efforts do not always build long-term capacity in the LMIC. One example is a telemedicine consultation program that trained the local community on the use of teleconferencing technologies, which was subsequently removed upon termination of the effort; 10 such training, while integral to the operation of the effort, is unlikely to lead to building capacity. Conversely, the fact that an effort is discontinued does not preclude it from being a capacity-building initiative.…”

Section: Discussionmentioning

confidence: 99%

Global neurosurgery: a scoping review detailing the current state of international neurosurgical outreach

Fuller

Barkley

et al. 2021

Journal of Neurosurgery

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OBJECTIVEGlobal neurosurgery is a rapidly emerging field that aims to address the worldwide shortages in neurosurgical care. Many published outreach efforts and initiatives exist to address the global disparity in neurosurgical care; however, there is no centralized report detailing these efforts. This scoping review aims to characterize the field of global neurosurgery by identifying partnerships between high-income countries (HICs) and low- and/or middle-income countries (LMICs) that seek to increase neurosurgical capacity.METHODSA scoping review was conducted using the Arksey and O’Malley framework. A search was conducted in five electronic databases and the gray literature, defined as literature not published through traditional commercial or academic means, to identify studies describing global neurosurgery partnerships. Study selection and data extraction were performed by four independent reviewers, and any disagreements were settled by the team and ultimately the team lead.RESULTSThe original database search produced 2221 articles, which was reduced to 183 final articles after applying inclusion and exclusion criteria. These final articles, along with 9 additional gray literature references, captured 169 unique global neurosurgery collaborations between HICs and LMICs. Of this total, 103 (61%) collaborations involved surgical intervention, while local training of medical personnel, research, and education were done in 48%, 38%, and 30% of efforts, respectively. Many of the collaborations (100 [59%]) are ongoing, and 93 (55%) of them resulted in an increase in capacity within the LMIC involved. The largest proportion of efforts began between 2005–2009 (28%) and 2010–2014 (17%). The most frequently involved HICs were the United States, Canada, and France, whereas the most frequently involved LMICs were Uganda, Tanzania, and Kenya.CONCLUSIONSThis review provides a detailed overview of current global neurosurgery efforts, elucidates gaps in the existing literature, and identifies the LMICs that may benefit from further efforts to improve accessibility to essential neurosurgical care worldwide.

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“…Seven observational studies [37, 48-50, 68, 70, 80] and four case studies [69,83,96,108] described the implementation of telehealth for physician decision support. Telehealth was employed to address the shortage of physicians resulting from their migration from conflictaffected countries such as Syria [69,83], and the shortage of specialists in low resource settings such as Djibouti [48,49]. Other purposes of telehealth included supporting local staff in wartorn countries such as Somalia [68,80,108], supporting a family medicine education program in Sudan [37,70], and assessing the feasibility of tele-ophthalmology within the Lebanese setting [50].…”

Section: Telehealth For Providers Decision Supportmentioning

confidence: 99%

Digital health in fragile states in the Middle East and North Africa (MENA) region: A scoping review of the literature

et al. 2023

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Introduction Conflict, fragility and political violence, that are taking place in many countries in the Middle East and North Africa (MENA) region have devastating effects on health. Digital health technologies can contribute to enhancing the quality, accessibility and availability of health care services in fragile and conflict-affected states of the MENA region. To inform future research, investments and policy processes, this scoping review aims to map out the evidence on digital health in fragile states in the MENA region. Method We conducted a scoping review following the Joanna Briggs Institute (JBI) guidelines. We conducted descriptive analysis of the general characteristics of the included papers and thematic analysis of the key findings of included studies categorized by targeted primary users of different digital health intervention. Results Out of the 10,724 articles identified, we included 93 studies. The included studies mainly focused on digital health interventions targeting healthcare providers, clients and data services, while few studies focused on health systems or organizations managers. Most of the included studies were observational studies (49%). We identified no systematic reviews. Most of the studies were conducted in Lebanon (32%) followed by Afghanistan (13%) and Palestine (12%). The first authors were mainly affiliated with institutions from countries outside the MENA region (57%), mainly United Kingdom and United States. Digital health interventions provided a platform for training, supervision, and consultation for health care providers, continuing education for medical students, and disease self-management. The review also highlighted some implementation considerations for the adoption of digital health such as computer literacy, weak technological infrastructure, and privacy concerns. Conclusion This review showed that digital health technologies can provide promising solutions in addressing health needs in fragile and conflict-affected states. However, rigorous evaluation of digital technologies in fragile settings and humanitarian crises are needed to inform their design and deployment.

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Assessment of surgical teleconsultations in a developing country: two years of experience in Djibouti

Cited by 5 publications

References 0 publications

Acute neurosurgical management of traumatic brain injury and spinal cord injury in French armed forces during deployment

Acute neurosurgical management of traumatic brain injury and spinal cord injury in French armed forces during deployment

Global neurosurgery: a scoping review detailing the current state of international neurosurgical outreach

Digital health in fragile states in the Middle East and North Africa (MENA) region: A scoping review of the literature

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