ACCES NEWSLETTER – Fall 2023
In this issue
CE Week 2023 Winner
Nominate CE of the Year
CMBES Call for Papers
Spotlight Article – CR-OP’s Rwanda Mission – Part 1
News from our Members - SNB CE Week Celebrations Report
News from our Corporate Members
Well, here we are in the midst of our Fall season - my how the Summer flew by! I have a few exciting things to mention since our last newsletter.
We are currently gearing up for our ACCES26 Annual Atlantic Canada Clinical Engineering Society’s Educational Seminar and Trade Show taking place in 2024. Our ACCES26 chairman, John Inch, is putting together his committee and we are working with Sarah at HANS to help organize this event. So, stay tuned and check our website for updates on this. In Planning ahead, we are looking at a potential joint venture with CMBES for our ACCES27 Trade Show in 2025. As we open dialog with CMBES we will update our membership on any progress we make on this joint venture.
Some of you have yet to receive your Membership Gifts for this year and I apologize for that. We are currently working on distributing the remaining gifts and we thank you for your patience.
As you are aware our Director of Finance position has been open since May this year. I have good news in that Daniel Theriault, a retired Biomedical Technologist from SNB, NB has stepped up to the plate and accepted the nomination for this position. Daniel brings a wealth of experience in the Biomed/Clinical Engineering field and comes with experience in the finance field as well, so he will be a welcome addition to our ACCES team. Please join me in welcoming Daniel to his new role.
In closing I hope everyone will have a pleasant fall. I look forward to corresponding with you in our next ACCES newsletter in the winter season.
President - Atlantic Canada Clinical Engineering Society
In what has become a popular Clinical Engineering week tradition, departments from across Atlantic Canada came together to celebrate the National Biomedical and Clinical Engineering week held this past May. In celebration, ACCES once again held its annual photo contest where the guidelines included capturing the essence of CE week celebrations, as well as featuring the ACCES logo in each photograph.
As always, the judges looked forward to combing through the applicants and determined that the winner for the 2023 CE Week Photo Contest was Moncton Hospital! Way to go Moncton and thank you for the great submission! On behalf of ACCES, we’d like to that you for your creativity and will present you with a cheque for $200!
Do You Know an Outstanding Clinical Engineering Professional?
We invite members of the ACCES community to submit nominations for the prestigious 2023 "ACCES Clinical Engineering Professional of the Year Award". These distinguished accolades will be presented at the conference in Halifax in May 2024.
For a comprehensive list of past awardees, kindly visit https://accesociety.org/awards. Additional information about the awards can be found at https://accesociety.org/awards/84-awards/463-award-details. All nominations must be submitted through this website no later than March 1st, 2024.
Welcome to this year's Canadian Medical and Biological Engineering Conference (CMBEC) and the Clinical Engineering Society of Ontario (CESO) 2024 event. This conference is a significant gathering for professionals in the field of biomedical engineering, and CMBEC46/CESO 2024 will take place in Toronto, Ontario from May 28 to May 30, 2024.
We invite you to submit your short papers (2-4 pages) or 1-page abstracts on a wide range of topics related to biomedical engineering. Our conference will feature two paper competitions, one for Outstanding Research and the other for Student Papers, offering cash prizes to recognize the authors of the highest-rated papers.
The deadline for submissions is December 15, 2023. For comprehensive information and to access the active link to the PKP online paper management system, please refer to the official Call for Papers.
We eagerly anticipate your contributions to this year's CMBEC46/CESO 2024 conference in Toronto, Ontario.
Introducing CR-OP's Transformative Mission: A Beacon of Hope in Cardiac Surgery
In the heart of Halifax, Nova Scotia, a remarkable initiative known as CR-OP is quietly unfolding. This independent group of dedicated medical professionals hails from diverse corners of Canada and as far away as Poland, uniting under the leadership of Dr. Keir Stewart. Their vision is to provide essential support for Rwanda as it endeavors to build its first autonomous cardiac surgical program.
Starting in the fall of 2020, and since then, the CR-OP has conducted three life-changing surgical missions, with the most recent taking place in May 2023. Each mission represents a unique blend of expertise, commitment, and collaboration, symbolizing a significant step toward Rwanda’s cardiac surgical independence.
The May 2023 mission was a resounding success, with seven open-heart procedures and four pacemaker implants carried out. It's a testament to the dedication and compassion of the CR-OP team, with participation from 20 dedicated volunteers who offer their time and expertise. Funding for these missions is made possible through the generosity of individuals, industry partners, and various arms of Dalhousie University.
CR-OP's overarching mission rests upon four pillars of commitment, each representing a vital facet of their journey. These commitments include delivering clinical care to Rwandans with complex cardiac conditions, supporting the establishment of an autonomous cardiac surgical program, educating Rwandan professionals in cardiac surgery, and remaining open to research opportunities for collaboration with Rwanda.
ACCES’s own Brendon McKenna was lucky enough to join the May mission and was key to having this article published.
The primary objective of our May 2023 mission in Kigali was to provide valuable assistance to Rwandan medical personnel in conducting cardiac surgeries on as many patients as the situation permitted. Simultaneously, our team was dedicated to offering comprehensive education, combining theoretical knowledge and practical experience. The ultimate goal was to contribute to the establishment of an independent cardiac surgical program in Rwanda. This mission, expertly guided by CR-OP Director Dr. Keir Stewart, took place from May 22nd to May 26th, 2023, with King Faisal Hospital (KFH) in Kigali serving as the central hub for teaching and surgical activities.
Overall, 7 total cases took place during the mission, including a double valve, small atrial septal defect (ASD), large ASD and right atrial appendage (RAA) amputation and closure, mitral valve replacement, pericardiectomy, two double valves, and a triple valve.
Education, Training and Research Report
Anesthesia, CVICU and perfusion involved considerable didactic and practical educational efforts and collaboration between the CR-OP team and their Rwandan counterparts. All formal classroom secessions were well attended by the Rwandan Healthcare Staff.
Throughout the week of surgeries there were considerable didactic and practical educational efforts and collaboration between the CR-OP team and their Rwandan counterparts. These involved everything from bedside/procedural education and training up to formal classroom secessions with PowerPoint presentations. Below is a list of educational secessions presented during the week of the mission. An electronic copy of the presentations can be made available upon request.
Some of the practical education/training sessions included:
- Anesthesia education
- Even though there was minimal Rwandan anesthesia input, it did provide an opportunity to demonstrate proper standards of practice for this critical role. Anesthesia was provided by our 3 Polish members of the mission team. During the procedures, Rwandan Health Care Staff were educated on the procedures at every opportunity.
- Perfusion Education
- Throughout the week of surgeries our dedicated CR-OP perfusionist team took significant time out of their days demonstrating safety concerns and proper standards of practice for the discipline of Cardiac Surgery Perfusion. During the surgical procedures, the position of Lead Perfusionist was handed off to the one participating Rwandan perfusionist who completed the procedure under the supervision of our perfusion team supporting them.
Cardiac OR nursing Education/training sessions:
For the most part the Cardiac OR Nurses had a pretty good handle on what was expected of them. However, the learning doesn’t stop just because you have a good foundation. There are always subtle practices that can be encouraged to improve the standards of practice.
Post-Op Care Education/training sessions:
Post-Op care education was mostly practical education/training at the bedside. The Rwandan team was improving although not yet ready for independence. With this in mind our team of Nurses and Intensivists took every opportunity at the bedside to educate the Rwandan team on best standards of practice. This was supported by multiple formal presentations on this discipline. Along with the nursing aspect, there certainly were opportunities for our Respiratory Therapist to review patient ventilation practices with multiple disciplines within the Post-Op Care program as well.
Topics included but not limited to the following:
- Art line management, removal, drawing blood and ABG’s, removal
- PA catheters: management, checking for placement, zeroing, Cardiac numbers, CVP on PA catheter, how to draw mixed venous gases.
- Chest tube management, stripping every hour post op, checking for leakage
- Pacing: inserting ground needle, different modes, dressings, teaching based on PowerPoint.
- Mobilization: importance of mobilization and DB&C post op, use of heart pillow post op.
- Code management: Defibrillation & Cardioverting different lethal rhythms. Meds used in code situation.
- Teaching on inotropes and vasopressors used in this patient population.
- Prioritizing based on what is most important in the current situation.
- Medication dosing, conversion, and administration (not using ARTLINE for meds)
- Best practices for patient ventilation
Didactic education/training sessions:
Presentation 1: Basic Outline of a Start-up Cardiac Surgery Program, presented by Dr. Keir Stewart, attendees were Surgeons, Administration and Administration Support Staff.
Presentation 2: Pulmonary Vasodilators, presented by Dr. Romuald Lango, attendees were Surgeons, Lead Healthcare Staff, OR Nurses, ICU nurses.
Presentation 3: Pathophysiology of Aortic stenosis and Mitral Stenosis, presented by Dr. Wojtek Karolak, attendees were Lead Healthcare Staff, OR Nurses, ICU nurses
Presentation 4: AVR, MVR, CABG post-op care, presented by Dr. Dominique De Waard.
- Presentation to nurses on Postoperative Course Following Cardiac Surgery.
- Resident informal teaching:
- ICU rounds approach (system-based approach with plan created after full handover and review of blood work)
- Chest tube management
- Epicardial pacing wire management
- Skin closure in the operating room
Presentation 5: Mechanical ventilation/Extubation and basic oxygen therapy, presented by Jill O’ Brien.
Presentation 6: Cardiopulmonary Bypass, presented by Alison Holt.
Presentation 7: Inotropic Medication, presented by Dr. Monika Rosinski.
Seven patients had open-heart surgery, with excellent results. All aspects of patient care had different levels of active input from Rwandan professionals, including pre-op assessments by Dr. Ahma in conjunction with Dr. Adam Clark. All operations were led by Dr. Karolak and most procedures were assisted by Dr. Yayu.
On top of the 7 Open Heart Surgery procedures, Dr. Adam Clarke and Dr. Amha performed 4 pacemaker procedures as well.
Anesthesia, as well as the Post-Op care, was led by our 3 Polish contingents of the CR-OP mission team.
Perfusion had one Rwandan actively involved.
Cardiac OR nursing was handled mostly by the Rwandan OR Nurses.
Post-Op care was a blended Rwandan and CR-OP nurse effort.
Challenges: All missions strive to maintain the proper balance between patient safety, and practical education. I believe we achieved this balance.
Conclusions: The May 2023 mission was a great success, with 7 successful open heart operations and 4 pacemaker operations, a week of didactic and practical education/training on all aspects of cardiac surgery, and a tremendously enjoyable experience for both Canadian and Rwandan participants. We are very encouraged with and thankful for a successful mission, now our 3rd such mission. This is yet another small but significant step towards an autonomous Rwandan cardiac surgical program.
On behalf of ACCES, we extend our heartfelt gratitude to Brendon and the dedicated CR-OP team for their invaluable contribution to this remarkable cause. Your unwavering dedication and support have made a profound difference in the mission to enhance cardiac care. Thank you, Brendon and the CR-OP team.
SNB CE WEEK CELEBRATION REPORT:
FOSTERING UNITY AND CREATIVITY THROUGH ENGAGING ACTIVITIES
By Sreekala Kuzhikkattipurath
During CE Week, our department organized a week-long celebration dedicated to Clinical Engineering (CE). From May 14th to May 20th, we came together to foster teamwork, ignite creativity, and honor our collective passion for the field. Let’s explore the highlights of this unforgettable event!
The festivities commenced on May 15th with a thrilling game called “Guess the Number.” Using Mentimeter, we challenged ourselves to estimate the number of components in an uploaded image. The enthusiasm and participation were overwhelming, creating an atmosphere filled with excitement and friendly competition.
On May 16th, we delved into the captivating world of puzzles with “Let’s Play Sudoku.” Armed with pen and paper, our team members enthusiastically embraced the intricate Sudoku grids. The response to this task was remarkable, as individuals wholeheartedly immersed themselves in solving the puzzles. The sense of accomplishment and shared joy that followed fostered a strong sense of collective achievement among our participants.
The following day, May 17th, we engaged in a captivating visual challenge called “Spot the Difference.” This activity involved presenting two seemingly identical images from the Chalmers Hospital ICU along with a random image. This exciting activity not only heightened their observational skills but also provided an opportunity to appreciate the meticulous details that can make a significant difference in our work.
As CE Week progressed, we shifted our focus to introspection on May 18th with the activity titled “What Do You Like Most About CE ?”. This interactive session created a space for team members to openly express their thoughts, share their experiences, and highlight their personal connections to the field of clinical engineering. The activity served as a meaningful platform for appreciating the diverse perspectives and unique stories of our colleagues, fostering a profound sense of unity and admiration for the invaluable work we collectively undertake. Let us now explore some of the inspiring thoughts shared by our esteemed colleagues:
The pinnacle of CE Week arrived on May 19th with “The Mega Quiz.” The atmosphere buzzed with anticipation as we tested our knowledge and quick thinking. The quiz encompassed a broad spectrum of topics, ranging from medical equipment and their inventors to the intricate connections between signals and human anatomy. This spirited competition not only showcased the depth of our collective expertise but also fueled our passion for continuous learning, resulting in an unforgettable day of fun and friendly rivalry.
Yet, the celebration did not end there! Throughout the entire week, our department engaged in the grand activity called “Scrap to Sculpture.” Guided by our collective creativity, we transformed discarded electronic parts, cables, and components into awe-inspiring works of art. Each team poured their heart and soul into crafting unique sculptures, showcasing their ability to find beauty and innovation even in unexpected materials. These stunning sculptures not only showcased our team’s exceptional talent but also conveyed profound messages through their intricate designs. Allow us to present the sculptures, accompanied by their captivating explanations, as a testament to the immense creativity and ingenuity within our department.
“The “CE Flyer.” Our inspiration behind the model is that we find planes astounding and we think they will always be cool no matter what our age. Really, we are all still just big kids here in CE and love to tinker. We disassembled some old video tower components that were being discarded to assemble our creation. A fan from an obsolete light source is the plane’s propeller and two broken otoscope handles are the planes dual guns. Sydney Moores, (our tech mastermind behind the model) has never been on an airplane. Now working with CE, he will get that opportunity, when this coming October when he attends a dialysis training in Toronto. Our message is “Always aim for the skies and you will go places in life.” Another famous quote of mine stolen from Henry Ford, “Whether you think you can, or you think you can’t – you’re right,” emphasizes how much attitude determines success or failure. This is true for most projects you take on and certainly for technology initiatives.”
CE Week proved to be an unequivocal success, leaving us with cherished memories of laughter, collaboration, and a reinvigorated sense of unity. As we reflect upon this joyous celebration, let us carry the spirit of CE Week in our hearts throughout the year. Let us continue to collaborate, innovate, and inspire one another, working together for the betterment of patient care and the continual advancement of our profession. Until the next CE Week, may we always treasure the memories and achievements, continuously striving for excellence in everything we do.
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