AIHA Success StoriesEMSTC Opens Professional Doors toAmbulance PediatricianAs a child, Oleg Zinevich dreamed ofbecoming a doctor and he workedsteadily toward that goal. But, aftergraduating from the ChernovtsyMedical Institute and completing a pediatricinternship at the KievMedical Academy of PostgraduateEducation, Oleg says he “began towork for the 15th KievAmbulance Substation and foundthat I lacked sufficient practicalskills in emergency care and wasvery concerned with that discovery.Luckily, some physicians withwhom I work told me about theKiev EMSTC, which they said hadall the necessary resources to polishone’s skills.”Unable to obtain the necessaryclass admittance voucher from theCentral Ambulance Station, buteager to attend a course at theCenter, Oleg visited the EMSTC tomeet its Director, MikhailNatsyuk, who eventually permittedhim to join an already formed group. “Iwas very surprised at what I found therebecause it was different from my previouseducational experiences,” recalls Oleg. “Firstof all, the teaching methodology was veryclear and the trainers were very skilled. Then,during the training, I was expected to practicethe knowledge I learned on mannequinsdesigned to copy the human body to themaximum extent possible. I was alsoimpressed with the audiovisual equipmentused to show films describing how to providecare in emergency situations.” Inspiredby the classes and the greater potential forproviding care to those in need, an enthusiasticOleg says he “remained in the classroomlong after the classes ended to practice andpolish all the algorithms.”“The algorithmsare very important,” he explains, “becausethey helped me know exactly how muchtime I should spend on any given manipulation,and, as an ambulance physician, time isoften my most precious resource.”Oleg’s dedication did not go unnoticed byhis trainers. After completing the trainingprogram, he was offered the opportunity tobecome a trainer at the Center, an offer heimmediately accepted. Since this is not a fulltimeposition, Oleg continues to work at the15th Ambulance Substation as a member ofthe pediatric team, which allows him topractice the skills he teaches every day.In addition to his jobs as an ambulance physician and instructorat the Kiev EMSTC, ambulance physician Oleg Zinevich also volunteersat a local shelter for homeless children.“When we get a call to visit a small child,we usually go without knowing what toexpect, so we must be prepared for anything,”explains Oleg. Soon after he completedhis training course, Oleg’s team wascalled to visit a two-month-old infant. Herecalls the incident: “When we went in theapartment, the infant was in her mother’sarms and I instantly knew something wasvery wrong. The infant was not breathing,nor was there a heart beat. I put an oxygenmask on her for 20-30 seconds, but that didn’thelp, so I immediately started closedchest massage and my assistant beganmouth-to-mouth resuscitation—to noeffect. We knew we had to switch to drugtherapy as soon as possible so I quicklyexplained to the father how to do mouth-tomouthwhile my assistant prepared the necessarymedicine. We gave the infant a subclavianinjection of adrenalin with a physiosolutionand thankfully her heart startedbeating. Once she was stabilized, we tookher to the local ICU.” Oleg says he facesmany such cases daily. “I now feel satisfactionwhen I leave my patients. I began to getthat feeling after taking the EMS coursePHOTOS: VIRA ILLIASH.The Kiev EMS Training Center(EMSTC), which was opened as partof AIHA’s Kiev/Coney Island partnership,has been operating since 1995.According to research carried out bythe Center’s staff, the mortality rate ofpatients admitted to Kiev AmbulanceHospital with trauma or acute poisoningcontinues to gradually decline asthe number of emergency servicesspecialists who receive training at theCenter increases. Additionally, by theorder of the Minister of Health ofUkraine, all ambulance teams inUkraine are now equipped with theimmobilization kits first demonstratedat the Kiev EMSTC. This is the story ofa trainee whose professional life waschanged by attending a course at theCenter. The history of Kiev EMSCenter is on the other side.because my training allowed me to act automatically,without losing a single second.”One month after completing his initialtraining at the Kiev EMSTC, Oleg attendeda workshop in Tashkent, Uzbekistan, organizedby AIHA for new EMSTC trainerswhere, in addition to other things, he practicedhis teaching skills by instructing childrenin emergency medicine techniques.Since that time, Oleg has also accepted aposition as pediatrician for the AspernChildren’s Charitable Foundation, whichtakes care of street children. At theFoundation, Oleg provides medical care tothe homeless children and teaches thememergency medicine. “These kids often findthemselves in difficult situations, includingthose where emergency care is needed.There is a good chance that the knowledge Iimpart can help them save a human life,making all the time I spend doing thisworthwhile,” he says.Talking about his life now, Oleg says: “Eventhough I have virtually no personal time, I’mhappy that my life is what it is. Thanks to theKiev EMSTC, I have achieved maximum successin professional terms and am deeply satisfiedwith my work in moral terms.For more informationon AIHA, visitwww.aiha.com.7/02/No.10Text and interviews by Vira Illiash.
AIHA Success Stories“EMS Training Center DreamBecomes a RealityThe idea to establish anEmergency MedicalService Training Center(EMSTC) came to me inthe early 1990s when Ibecame the head of theDepartment for DisasterMedicine—which providescomprehensive training to theemergency medicine specialists—atthe Kiev MedicalAcademy of PostgraduateEducation,” says MikhailNatsyuk, director of the KievEMSTC. “At that time, I wasalways thinking about how wecould teach people to useemergency medicine methodologiesbecause I saw the need for this andknew that ambulance teams often encounteredproblems related to cardiopulmonaryresuscitation and transport immobilization,for example, at the pre-hospital stage,” heexplains, adding, “I knew that EMS techniquescould help these physicians and theirpatients, but we had no way to teach themappropriate skills at that time as we lackedthe necessary equipment and materials.”Thus, when AIHA proposed that theDepartment of Disaster Medicine andConey Island Hospital in Brooklyn, NewYork—as part of AIHA’s now-graduatedKiev/Coney Island partnership—worktogether to establish a joint EMSTC,Mikhail Natsyuk was eager to accept theoffer. Looking back on the program,Natsyuk says, “Our partnership broadenedour opportunities. We got access to theInternet, new information, mannequins,training tools, and state-of-the-art equipment,not to mention the opportunity tomeet colleagues from other countries,which opened our minds to new ways oflooking at the world. In addition, six of ourtrainers spent time in the United States,where they gained both theoretical andpractical knowledge. So, thanks to AIHA, Iwas able to make my dream come true.”Over the years, Natsyuk and his trainershave implemented various courses torespond to the specific needs of diversegroups of trainees. As he explains, “ForPHOTO: VIRA ILLIASH.Dr. Mikhail Natsyuk, director of the Kiev EMSTC, explains anintubation procedure to a group of ambulance physicians from Kievand Vinnytsia.ambulance teams, we have introduced atwo-week training program that covers allthe fundamentals of emergency medicine—from the primary examination to cardiopulmonaryresuscitation, intubation,and immobilization in cases of an acutetrauma. We also offer a shorter course fornon-medical professionals that covers issuesof providing emergency treatment inextreme conditions. It is worth noting thatwe teach all of the topics to each category oftrainees in different volumes and skill levels—tailoredto meet their needs. We alsooffer two-day courses on selected topics. Forexample, not all ambulances are equippedwith laryngoscopes, so we teach ambulanceteams how to intubate manually.”The success of the Kiev EMSTC providedthe impetus for opening a network ofsimilar centers across Ukraine. The Centerhas trained the instructors at the L’viv andDonetsk EMSTCs, which were also establishedin cooperation with AIHA. And, inthe near future, the Ukrainian Ministry ofHealth plans to set up similar centers inSimferopol and Uzhgorod, and eventuallyin other Ukrainian regions, as well.“Since the very first months of its existence,our Center has been extremely popularamong all categories of trainees—fromambulance doctors to non-medical firstresponders.The teaching methodology thatwe use is very accessible and thus there aremany people who want to take our courses.The Kiev EMS Training Center wasestablished in November 1995 at theKiev Medical Academy of PostgraduateEducation, a member of AIHA’sKiev/Coney Island partnership.Designed to train EMS specialists toprovide pre-hospital care to those inneed, the Center has trained morethan 4,350 individuals to date. Apartfrom medical specialists, the Centeralso trains policemen, traffic officers,firefighters, rescuers, and other nonmedicalfirst-responders. The story ofhow this Center came into existenceand what it offers is on this page; thestory of a trainee whose professionallife was changed by attending acourse at the Center is found on theother side.Trainee groups are usually formed severalmonths in advance, so it is often difficult toget in,” Natsyuk laughs, adding, “Such wasthe case with Oleg Zinevich. Usually, wesend trainee admittance vouchers to theCentral Ambulance Station, which distributesthem among substations. One day, afterour trainee pool was already formed, I wasapproached by a young physician who wasdenied a voucher, but desperately wanted toattend the training. I appreciated his persistenceand decided to admit him. Not onlydid he master the EMS methodology, butOleg also immediately understood theimportance teaching others how easily ahuman life can be saved. I saw that the EMStopic was extremely interesting to him anddecided to offer him a job. Oleg is currentlya successful trainer at the Center.”“I always tell my trainees that theirknowledge of EMS techniques should be sowell developed, so automatic, that they areable to save a human life without thinking.That’s why we do what we do,” emphasizesMikhail Natsyuk.For more informationon AIHA, visitwww.aiha.com.7/02/No.10Text and interviews by Vira Illiash.