14 September 2005
‘Battlefield’ Ultrasounds Offer Pacific Islanders Swift Diagnosis
Portable ultrasound machines are invaluable diagnostic tools for surgeons working in the Pacific Islands and other areas
where medical resources are poor.
Surgeon Semisi Aiona says that despite their cost and problems in training and maintaining skill levels the machines are
a boon to people in Pacific Island, third world and even rural New Zealand with little access to specialist radiology
services.
Mr Aiona is presenting a paper entitled “Utility of Surgeon-Performed Ultrasound in Samoan at the Royal Australasian
College of Surgeons’ Scientific Meeting in Hamilton this week.
Developed by the military, as diagnostic tools in battlefield trauma medicine, portable ultrasound machines are
particularly useful in situations where speed of diagnosis is important. Worth around $30,000 each some machines are
small enough to fit in one hand.
Mr Aiona studied the use of the machines while working in Apia’s Tupua Tamasese Meaole Public Hospital between September
2003 and April 2004.
Although common in New Zealand hospitals there are only two portable ultrasound machines at Tupua Tamasese Meaole Public
Hospital and one stationary machine.
Mr Aiona reviewed 190 scans of patients ranging in age from seven months to 92 years, 79 of which were emergency
admissions. He compared the scanner results and initial assessments with subsequent treatment to determine the
effectiveness of each diagnosis.
His study showed that a surgeon using the portable ultrasound machine could make rapid, accurate diagnoses aiding prompt
treatment and efficient use of scarce resources. It can also be used to guide lifesaving procedures such as inserting
drains for a blocked kidney.
Mr Aiono grew up in Samoa, before training in Medicine and Surgery at Otago University. He became interested in the
potential for surgeons using the machines in emergencies while training in Britain. In the English-speaking world
(United States, Britain and Canada) ultrasounds are traditionally performed by radiologists who, once trained become
experts by experience. Finding time to maintain skills and build the necessary experience can be major obstacles for
busy surgeons.
American College of Emergency Physicians guidelines recommend 150 supervised examinations if practitioners are to
develop and maintain adequate interpretive skills.
“Despite these problems using portable ultrasounds to obtain quick, accurate diagnosis in poor or remote areas of the
world can definitely improve the quality of care surgeons give patients,” Mr Aiona says.
He says he has received generous help from radiologist colleagues from the United Kingdom, Australia and Samoa.
The Royal Australasian College of Surgeons is an internationally recognized organization representing more than 6,300
members, including 1,700 trainees in nine different specialties in New Zealand and Australia – 90 per cent of surgeons
in both countries have been trained and examined by the College. Seven hundred New Zealand surgeons are members of RACS.
The key roles of the college are in advocacy, education, professional development and membership support. The nine
specialist areas represented by RACS are: general surgery, neurology, urology, otolaryngology, paediatrics, plastic and
reconstructive surgery, vascular surgery and, cardio-thoracic surgery.
The conference – to be held at the Novatel Tainui, in Hamilton, will run from Tuesday September 13 to Friday September
16.
ENDS