A New Era in Pediatric Anesthesiology and Critical Care: Ultrasound Navigation in Critical Conditions

Kazakhstani pediatric intensive care units are launching a large-scale program to introduce ultrasound navigation for the diagnosis and treatment of patients in critical condition. This involves a comprehensive system of bedside ultrasound use following international protocols — FAST, BLUE, RUSH, and others — specially adapted for pediatrics.

On August 16–17, an international master class titled "Practical Ultrasonography in Anesthesiology and Critical Care. Vascular Access Under Ultrasound Navigation. EFAST, BLUE, RUSH Protocols" was held in Atyrau, supported by the Ministry of Healthcare of the Republic of Kazakhstan, PHILIPS, and KhimFarmService.

More than 150 specialists took part in the professional development course: anesthesiologists-resuscitators, ultrasound specialists, as well as nursing staff from Western Kazakhstan.

Participants gained valuable knowledge and practical skills that they can already apply in their clinical practice to improve the quality of patient diagnosis and treatment.

The course focused on the application of practical ultrasonography, emergency diagnostic protocols, and vascular access under ultrasound navigation.

What is this system?

The program includes:

• Portable ultrasound devices in every intensive care unit and mobile response team.
• Standardized algorithms: FAST (rapid trauma assessment), BLUE (diagnosis of respiratory failure), and RUSH (assessment of shock causes).
• Ultrasound navigation for invasive procedures — catheter and drain placement, image-guided punctures.

"This isn't just training on how to use the device — it's about building a unified protocol-based approach so that doctors 'speak the same language' and follow clear steps. Why is this needed? First, it reduces diagnosis time in cases of trauma, massive bleeding, and respiratory failure — from hours to minutes. Second, it minimizes the risk of errors through visual confirmation of findings. Third, it reduces complications during punctures and catheterizations of central and peripheral vessels. This entire system increases survival rates in children, especially in shock conditions," noted Gulshat Alimkhanova, Candidate of Medical Sciences and Chief Freelance Pediatric Anesthesiologist-Resuscitator of the Ministry of Healthcare of the Republic of Kazakhstan.

According to international research, the use of bedside ultrasound in pediatric intensive care reduces mortality in critical cases by 20–30%.

How will implementation proceed?

Equipping departments — procurement of portable ultrasound devices with pediatric probes.
Training doctors — theory, simulators, bedside mentoring, certification.
Implementing protocols — FAST/BLUE/RUSH in emergency cases.
Monitoring and audit — regular analysis of effectiveness and review of clinical cases.

What results are expected?

• Every resuscitation team will be able to provide a detailed picture of a patient's condition within 2–5 minutes.
• The number of complications from invasive procedures will decrease by 40–50%.
• Treatment decisions will be made faster and more accurately, which is especially critical in pediatrics, where every minute can save a life.
• Kazakhstan will join the ranks of countries where bedside ultrasound is the gold standard in pediatric critical care medicine.

As part of the master class, Gulshat Alimkhanova, Chief Freelance Pediatric Anesthesiologist-Resuscitator of the Ministry of Healthcare of the Republic of Kazakhstan, made rounds at the Atyrau Regional Children's Hospital, consulted with children in the anesthesiology and intensive care unit, and provided recommendations. Current issues and solutions were also discussed with regional pediatric anesthesiologists-resuscitators.

Organizers:
Republican Public Association "Federation of Anesthesiologists-Resuscitators"
National Scientific Center of Pediatrics and Pediatric Surgery
Public Association "Society of Regional Anesthesia and Interventional Pain Treatment"
POCUS KAZAKHSTAN & POCUS MOSCOW