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Kernan Anesthesiologist Provides Care in Haiti

Dr. Eric Shepard is part of University of Maryland Medical Haiti Relief Team

Dr. Eric Shepard of Kernan  supervises Emilene Drager, CRNA, of Shock Trauma, as she places a brachial plexus block in a Haitian patient who is about to have upper extremity surgery.
Dr. Eric Shepard of Kernan (left) supervises Emilene Drager, CRNA, of Shock Trauma, as she places a brachial plexus block in a Haitian patient who is about to have upper extremity surgery.

Baltimore, MD (March 1, 2010) - Eric Shepard, MD, Director of Respiratory Therapy at Kernan Orthopaedics and Rehabilitation and Assistant Professor of Anesthesiology and Critical Care Medicine at the University of Maryland School of Medicine, was part of the health professional relief team from the University of Maryland Medical Center and School of Medicine who assisted with lifesaving medical care of survivors from the January 12 earthquake in Haiti.

In support of this mission, Dr. Shepard, a member of the regional anesthesia team at Kernan, deployed to Haiti on February 4, with an ultrasound machine loaned by Kernan. Additional regional anesthesia experts from Kernan will be deploying in the future in support of the University of Maryland's long term commitment to rebuild the hospital and provide medical care to the people of Haiti. Kernan is the home of the Regional Anesthesia division of the University of Maryland Department of Anesthesiology.

The team from the University of Maryland Shock Trauma Center was based at Hospital Saint Francois De Salle in Port-Au-Prince. The earthquake destroyed more than half of the hospital, including the entire patient wing. Approximately 120 patients, families, and staff were killed in the quake. The operating rooms and supporting areas were also destroyed.

The hospital reopened several days after the earthquake, with most of the medical staff coming from relief agencies. Makeshift operating rooms and postoperative care provided mostly by families in outdoor tent wards, made perioperative management especially challenging. Using regional anesthesia has proven to provide safe, effective operative anesthesia and postoperative pain control. Regional anesthesia generally involves the introduction of local anesthetics to block the nerve supply to a specific part of the body, such as a limb, so patients cannot feel pain.

"In the first five days from February 5 – 10, the UMMS team performed 41 surgeries on 39 patients," Dr. Shepard said. "The majority of procedures were orthopaedic and soft tissue/wound related. Many procedures were revisions of surgeries performed by previous teams," he continued. "The operating room was a large multipurpose room converted to hold two OR tables and anesthesia machines.  There were no ventilators or recovery room."

The room was relatively open to the environment, with other non-OR functions being performed in the back of the room. Postoperative pain control was usually limited to NSAIDs (Nonsteroidal Antiinflammaory Drugs) and acetaminophen, because oral narcotics are not used in Haiti. Intravenous drugs were not used because the hospital did not have an overnight nursing staff available to monitor patients.

"Regional anesthesia accompanied by light or no sedation was utilized by our team in order to both eliminate the need for the typical postoperative recovery, and to provide postoperative pain relief," Dr. Shepard said. Of the first 41 cases performed by our team, all but two were performed with either regional anesthesia or sedation. We were proud to be able to contribute to this worthy cause."

About James Lawrence Kernan Hospital:

A 138-bed rehabilitation and orthopaedic hospital, Kernan offers inpatient and outpatient surgery in a variety of specialties, including total joint replacement, sports injuries, scoliosis, neck, back, upper and lower extremity injuries, as well as plastic surgery, dental surgery, and trauma reconstruction, for children and adults. Kernan’s William Donald Schaefer Rehabilitation Center offers the most technologically advanced therapy for orthopaedic injuries, brain and spinal cord injuries, stroke, multiple sclerosis, and other neurologic disorders. Kernan houses the University of Maryland Complementary Medicine Program. Kernan also operates an outpatient center in Timonium that offers comprehensive orthopaedic services, physical therapy, and sports medicine for professional and college athletes as well as "weekend warriors."