Tele-Pediatric Intensive Care for Critically Ill Children in Syria

Ghbeis, Muhammad B.; Steffen, Katherine; Braunlin, Elizabeth; Beilman, Gregory J.; Dahman, Jay; Ostwani, Waseem; Steiner, Marie

doi:10.1089/tmj.2017.0216

Cited by 12 publications

(36 citation statements)

References 6 publications

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“…The included studies predominantly described telemedicine interventions for conflict-affected populations from Afghanistan [ 32 , 34 – 36 , 40 , 45 , 46 , 49 ], Iraq [ 28 , 30 , 35 , 41 , 47 , 48 , 50 ] and Syria [ 27 , 29 , 31 , 33 , 38 , 39 , 43 , 44 ]. There was one study from Yemen [ 37 ] and Gaza [ 42 ] each, and none from Libya.…”

Section: Resultsmentioning

confidence: 99%

Telemedicine interventions in six conflict-affected countries in the WHO Eastern Mediterranean region: a systematic review

et al. 2022

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Background The COVID-19 pandemic has escalated the use of telemedicine in both high and low resource settings however its use has preceded this, particularly in conflict-affected settings. Several countries in the WHO Eastern Mediterranean (EMR) region are affected by complex, protracted crises. Though telemedicine has been used in such settings, there has been no comprehensive assessment of what interventions are used, their efficacy, barriers, or current research gaps. Main body A systematic search of ten academic databases and 3 grey literature sources from January 1st 2000 to December 31st 2020 was completed, identifying telemedicine interventions in select EMR conflict-affected settings and relevant enablers and barriers to their implementation. Included articles reported on telemedicine use in six conflict-affected EMR countries (or territories) graded as WHO Health Emergencies: Afghanistan, Gaza, Iraq, Libya, Syria and Yemen. Data were extracted and narratively synthesised due to heterogeneity in study design and outcomes. Of 3419 articles identified, twenty-one peer-reviewed and three grey literature sources met the inclusion criteria. We analysed these by context, intervention, and evaluation. Context: eight related to Afghanistan, eight to Syria and seven to Iraq with one each in Yemen and Gaza. Most were implemented by humanitarian or academic organisations with projects mostly initiated in the United States or Europe and mostly by physicians. The in-country links were mostly health professionals rather than patients seeking specialist inputs for specialities not locally available. Interventions: these included both SAF (store and forward) and RT (real-time) with a range of specialities represented including radiology, histopathology, dermatology, mental health, and intensive care. Evaluation: most papers were observational or descriptive with few describing quality measures of interventions. Conclusions Telemedicine interventions are feasible in conflict-affected settings in EMR using low-cost, accessible technologies. However, few implemented interventions reported on evaluation strategies or had these built in. The ad hoc nature of some of the interventions, which relied on volunteers without sustained financial or academic investment, could pose challenges to quality and sustainability. There was little exploration of confidentiality, ethical standards, data storage or local healthcare worker and patient acceptability.

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Section: Resultsmentioning

confidence: 99%

Telemedicine interventions in six conflict-affected countries in the WHO Eastern Mediterranean region: a systematic review

et al. 2022

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“…Lastly, another recommendation could be to utilise telemedicine powered camps to provide paediatric care. Ghbeis et al [ 41 ] describe a preliminary trial of a tele-paediatric intensive care unit to expand the war-torn affected children's access to care. Under the guidance of a telemedicine physician, other personnel may be trained to carry out the actions recommended by the physician.…”

Section: Possible Long-term Implications Of the War On Children Carementioning

confidence: 99%

Vulnerable in silence: Paediatric health in the Ukrainian crisis

Awuah

Ng²,

Mehta³

et al. 2022

Annals of Medicine &Amp; Surgery

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“…An example of the successful use of Tele-Pediatric Intensive care came from its' use in war torn Syria where a volunteer core of physicians provided consultation to medical directors in field hospitals regarding multiple management decisions such as mechanical ventilation settings, vasoactive medications, resuscitation, and intravenous fluid management ( 62 ). When high-definition video failed due to limited internet connectivity they quickly resorted to text, voice, and photo-based interactions such Facebook TM messenger and Skype TM to facilitate communication ( 63 ).…”

Section: Virtual Technology Collaboration and Resource Sharingmentioning

confidence: 99%

Pediatric Critical Care in Resource Limited Settings—Lessening the Gap Through Ongoing Collaboration, Advancement in Research and Technological Innovations

et al. 2022

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Pediatric critical care has continued to advance since our last article, “Pediatric Critical Care in Resource-Limited Settings—Overview and Lessons Learned” was written just 3 years ago. In that article, we reviewed the history, current state, and gaps in level of care between low- and middle-income countries (LMICs) and high-income countries (HICs). In this article, we have highlighted recent advancements in pediatric critical care in LMICs in the areas of research, training and education, and technology. We acknowledge how the COVID-19 pandemic has contributed to increasing the speed of some developments. We discuss the advancements, some lessons learned, as well as the ongoing gaps that need to be addressed in the coming decade. Continued understanding of the importance of equitable sustainable partnerships in the bidirectional exchange of knowledge and collaboration in all advancement efforts (research, technology, etc.) remains essential to guide all of us to new frontiers in pediatric critical care.

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Tele-Pediatric Intensive Care for Critically Ill Children in Syria

Abstract: Even limited Tele-PICU can provide timely and potentially lifesaving assistance to pediatric care providers. Future efforts are encouraged.

Cited by 12 publications

References 6 publications

Telemedicine interventions in six conflict-affected countries in the WHO Eastern Mediterranean region: a systematic review

Telemedicine interventions in six conflict-affected countries in the WHO Eastern Mediterranean region: a systematic review

Vulnerable in silence: Paediatric health in the Ukrainian crisis

Pediatric Critical Care in Resource Limited Settings—Lessening the Gap Through Ongoing Collaboration, Advancement in Research and Technological Innovations

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