Personal Perspective from Lithuania

I am Lina Jankauskaite, a pediatric emergency physician, transitioning from a background in general pediatrics, currently practicing at the Lithuanian University of Health Science hospital in Kaunas, Lithuania. Recently, I joined the IFEM family as a delegate from EUSEP (European Society for Emergency Medicine, Pediatric Branch).

My expertise lies in general pediatrics and pediatric pulmonology. Since embarking on my journey in the pediatric emergency department (PED) as a fellow, I have harbored no doubts that this would be my guiding pathway, bringing me to the present moment 😊.

Pic Left - Me in PEM. Observation ward.

Pic Right - Our PEM team in EUSEM (European Society of Emergency medicine) conference in 2023. From right down our students Dagna and Urte presenting their scientific works. With Anna from Finland; EUSEP team; with our dear friend Brian, representing Ukraine EM project.

I hold a Ph.D. in human medicine, specializing in basic molecular science, with a focus on investigating influenza-induced acute lung injury. My commitment extends to both fundamental and clinical sciences, where I actively work with my team on innovative antivirals in 3D culture models. Additionally, I contribute to non-invasive diagnostics, prediction modeling, and the exploration of rare diseases—an area of increasing significance in the pediatric emergency department. Moreover, I teach students and fellows and actively participate in societies such as EUSEM and EAP (European Academy of Pediatrics).

You may wonder about my country and its stance on emergency medicine, especially if you've never heard about it in Lithuania. So, allow me to provide some insight. Situated in the northern part of Europe, my town, the second largest in Lithuania with approximately 300,000 inhabitants, stands in the heart of the country. Despite being a relatively young field, emergency medicine in Lithuania has made significant strides, with the first emergency medicine physicians completing their training just a few years before the COVID-19 pandemic. Regrettably, we still lack a formal training program for PEM.

 

Left - Trauma and emergency medicine center (including PEM).

Right - Trauma and emergency care center of Lithuanian University of Health Sciences Hospital Kauno Klinikos.

Fortunately, our pediatric emergency team, particularly at my hospital, is diverse, encompassing pediatricians, emergency physicians (with a year of training in pediatrics), and/or intensive care pediatricians. The new Emergency Department (ED), inaugurated in 2016, has a dedicated separate space for pediatric patients within our university hospital. This facilitates a concentrated effort from all staff members, including physicians, fellows (pediatric, EM, or GPs), and nurses, all dedicated to addressing children's medical needs.

Being the largest trauma center and one of the prominent centers in the Baltic countries, our hospital witnesses a substantial patient visit count, ranging from 30,000 to 40,000 only pediatric patients annually. We handle a spectrum of pediatric complaints and diseases, from minor skin problems to major traumas. Operating round the clock, our PED is staffed by two physicians, 2 registrants, 6 nurses, one social worker (on workdays), and a varying number of fellows.

Left - A small part of our PEM team. From left PICU fellow, PEM doctor Kristina, PEM nurse Skaiste, me, chief of PEM Algirdas.

Right - PEM shock room.

We admit all transferred patients, with priority given to severe cases in the PED before subsequent transfer to the PICU or operation theater. Trauma management, conducted by our team alongside a pediatric surgeon and pediatric trauma surgeon, involves trauma teams tailored to the severity of the situation. For observation needs, we offer 6 beds for noninfectious patients and 9 beds for infectious patients for 24-hour observation periods.

Together with ana dult ED, we have 2 isolation rooms for specific highly infectious conditions when those children need specific urgent consultations from our hospital (surgery, trauma care, specific investigation in general pediatrics or subspecialty, CT, MRI etc.).

Many thanks to our Communication center of our hospital for permission to share the photos.