The Class of 2017’s Nehal Naik.
A Friday evening in Ecuador gave the Class of 2017’s Nehal Naik a first-hand view on how a break down in emergency communications can impact patient care.
As an M1 observer, he was slated to spend time that evening in the city of Cuenca’s 911 call center as well as at Hospital Vincente Corral Moscoso, the region’s only trauma center. So he was on hand when the call came for an ambulance in the aftermath of a motor vehicle collision.
“En route, the patient was determined to be a critical trauma patient,” Naik recounted in a first-person essay published by The Academic Surgeon, the official blog of the Association for Academic Surgery.
“Little communication had been made to either the dispatchers or the receiving hospital, so the trauma team I was working with found themselves with a critical head trauma and no prior preparation. Despite the best efforts of the trauma surgeons at HVCM, the patient died from the traumatic head injuries. Many on the trauma team felt that if the patient had arrived earlier, with adequate preparation she may have been saved.”
Naik’s road to Ecuador began nearly three years ago when he joined the International Trauma System Development Program as a first-year student in the VCU School of Medicine. That opened an opportunity to visit Ecuador and study the South American country’s emergency response system.
His unforgettable Friday evening as an M1 observer was just the first day of his summer experience, and it laid a foundation for a quality assessment and improvement project on trauma communication between Cuenca’s pre-hospital and hospital providers.
Working with him on the project was the Class of 2016’s Michael Rains and four medical students from Liga Académica de Trauma y Emergencias. The work began with a close look at the Richmond Ambulance Authority, a model EMS system in Richmond, Va.
But, Naik points out, “Like many global development projects, it was imperative to have local leaders guide the mission of new projects.” So he and his collaborators also met with Ecuadorian EMS and 911 teams as well as hospital staff to better understand the problems they faced.
While Naik initially struggled with professional level of medical Spanish spoken by his peers and mentors, their patience, local language classes and the Latin-rooted medical jargon he knew from medical school filled the gaps in his proficiency.
His team’s partnership reached beyond the research they performed. “We shared on-call nights in the emergency department learning basic emergency care. During down time, we had impromptu lessons from our trauma surgery mentors.”
Naik also joined his teammates at events where they taught basic first aid and trauma care to non-medical students, churchgoers and even driving school participants.
While in Ecuador, Naik worked with students from the Liga Académica de Trauma y Emergencias to teach basic first aid and trauma care to non-medical students, churchgoers and even driving school participants.
The Ecuadorian student group’s commitment to service and teaching have inspired Naik to emulate their programs on the MCV Campus. Students involved with VCU’s International Trauma System Development Program are modeling offerings after what Naik saw in Ecuador, with programs like a hands-only CPR class for locals.
Naik reconnected with his teammates last August at the Panamerican Trauma Society 2015 Congress in Bolivia where they presented their findings. They also discussed continuing the project and what opportunities there might be for further collaboration.
The experience has convinced Naik how valuable international experiences are for networking with likeminded student leaders in other countries. “Future physicians in nations that face a growing burden of disease from trauma and other surgical diseases can benefit from a global network for exchange and collaboration.”
Naik is chair of the student subcommittee of the Panamerican Trauma Society. He hopes to pursue a career in emergency medicine and continue working in global health, focusing on sustainable development of emergency health infrastructure, especially in low- and middle-income countries.
By Erin Lucero