Highlights of President Franco Servadei's ICRAN Presentation

22 December 2020

Highlights of President Franco Servadei’s ICRAN Presentation:
Neurotrauma Education in the COVID Era

Among the profound effects of the COVID pandemic has been its effects on neurotrauma education worldwide. This report presents highlights of WFNS President Franco Servadei’s presentation during the ICRAN virtual conference December 5-6.

Although accuracy of reporting is always an issue when comparing data from countries around the world, the figure below demonstrates the devastating effect of COVID-19 in terms of deaths per one million population (as of November 26, 2020) – and illustrates the lethal nature of COVID-19 in high-income countries (HICs) as well as low- and middle-income countries (LMICs):

The effect of the COVID pandemic on neurosurgical scientific/education and research activities can be seen in the following figure (El-Ghandour et al Neurosurgery August 2020):

One technology that has been adopted much more rapidly due to the COVID pandemic is telemedicine. In addition to the benefit of telemedicine for avoiding unnecessary travel for consultation and follow-up, the article noted below is one example of the cost savings that can be achieved by using telemedicine to reduce the number of neurotrauma patients who are transferred to a neurosurgical center unnecessarily:

Journal of Clinical Neuroscience 81 (2020) 246–251

Clinical study

Inter-facility transfer of patients with traumatic intracranial hemorrhage and GCS 14–15: The pilot study of a screening protocol by neurosurgeon to avoid unnecessary transfers

Nima Alan ^a,* , Song Kim ^b , Nitin Agarwal ^a , Jamie Clarke ^a , Donald M. Yealy ^c , Aaron A. Cohen-Gadol ^d , Raymond F. Sekula ^a

^aUniversity of Pittsburgh Medical Center, Department of Neurological Surgery, Pittsburgh, PA, United States
^bUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, United States
^cUniversity of Pittsburgh Medical Center, Department of Emergency Medicine, Pittsburgh, PA, United States
^dIndiana University, Department of Neurological Surgery, Indianapolis, IN, United States

Cost of care for patients screened by telemedicine was less than ½ the cost for patients who were transferred without screening.

During the COVID pandemic, neurosurgeons can be called upon to provide critical care for COVID patients. An excellent guide for transitioning from neurosurgeon to critical care physician is the following (available for PDF download at www.neurotraumasection.org):

The adoption of online neurosurgical education has increased dramatically in the COVID era – in all regions of the world. Reports are cited from North America, Europe (Italy), Africa, Middle East (Saudi Arabia), India, Southeast Asia (Indonesia, Malaysia, Singapore, Thailand). In addition, worldwide efforts to improve neurosurgical education in general – and neurotrauma education in particular – have been ongoing both before and during the COVID pandemic:

The WFNS has been instrumental in the shift to educational webinars – begun before the COVID pandemic but clearly accelerated by the pandemic:

Hundreds of Webinars organized in the COVID
era in collaboration with the WFNS

Lessons in Latin that we have learned from the COVID pandemic:

First Latin Sentence: Mater artium necessitas
Necessity is the mother of invention - the future will never be like the past!

Second Latin Sentence: Ex malo bonum

From the worst experience of our life we have taken positive messages:

1) Web based education is mostly free and can reach any Neurosurgeon in the World AND IT IS HERE TO STAY
2) Telemedicine can be of help in the future
3) Our residents learned how to prioritize our surgeries and how to keep emergency surgery alive in very difficult situations
4) They also learned to work together at a distance with other Universities

Neurosurgical Focus (December 2020) is excellent source of articles on neurosurgery and the pandemic: