Background: Humanitarian mine action (HMA) stakeholders have an organized presence with well-resourced medical capability in many conflict and post-conflict settings. Humanitarian mine action has the potential to positively augment local trauma care capacity for civilian casualties of explosive ordnance (EO) and explosive weapons (EWs). Yet at present, few strategies exist for coordinated engagement between HMA and the health sector to support emergency care system strengthening to improve outcomes among EO/EW casualties.
View Article and Find Full Text PDFBackground: The evolving nature of irregular warfare and the increasingly frequent violations of human rights law and international humanitarian law pose unique challenges for humanitarian actors delivering trauma care in conflict settings.
Methods: A scoping review was conducted on PubMed, Scopus, and Web of Science and a web search (on Google, Google scholar and Bing) to analyze and review past humanitarian interventions offering trauma care in conflict settings. Relevant records were identified from scientific and grey literature.
: Failure mode and effect analysis (FMEA) is a valuable risk analysis tool aimed at predicting the potential failures of a system and preventing them from occurring. Since its initial use, it has also recently been applied to the healthcare setting, which has been made progressively more complex by technological developments and new challenges. Infection prevention and control (IPC) is an area that requires effective strategies.
View Article and Find Full Text PDFInt J Environ Res Public Health
December 2024
Background: On 16 January 2021 (EB148/18 Session), the World Health Organization (WHO) and Member States emphasized the importance of expanding the WHO Emergency Medical Teams (EMT) Initiative, investing in a global health workforce and multidisciplinary teams capable of being rapidly deployed, equipped, and fully trained to respond to all-hazard emergencies effectively. This resulted in the need to define a comprehensive framework. To achieve this, the EMT Initiative proposes the application of the four components of Surge Capacity, known as the 4"S" (Staff, Systems, Supplies, and Structure/Space), to build global capacities and capabilities, ensuring rapid mobilization and efficient coordination of national and international medical teams for readiness and response, complying with crisis standards of care defined in an ethical and evidence-based manner.
View Article and Find Full Text PDFBackground: Resource limitations in settings such as burn mass casualty incidents (MCIs) present challenges to the judicious fluid resuscitation required for major burns. Previous recommendations for burns care in MCIs have suggested certain adaptations from routine care, such as delaying intravenous (IV) fluid resuscitation until arrival at facility; using a fluid calculation formula that is independent of percentage of total body surface area (%TBSA) burned; or using fluid calculation formula based on time of arrival to first receiving facility rather than from time of injury, thus omitting 'catch-up' fluid.
Objectives: To synthesize and assess certainty of evidence from resource-limited settings on the three adaptations to fluid resuscitation for patients with major burns in MCIs.
Background: Timely and safe intravenous (IV) fluid resuscitation for major burns may be difficult or impossible during mass casualty burn incidents. Oral/enteral fluid resuscitation may be an alternative.
Objectives: To synthesize and assess certainty of evidence on oral/enteral fluid resuscitation as compared to IV or no fluid resuscitation for major burns.
Int J Environ Res Public Health
May 2024
Background: Standardized health-data collection enables effective disaster responses and patient care. Emergency medical teams use the Japan Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED) reporting template to collect patient data. EMTs submit data on treated patients to an EMT coordination cell.
View Article and Find Full Text PDFDisaster Med Public Health Prep
May 2024
The purpose of World Health Organization (WHO) Emergency Medical Teams (EMT) is to provide timely, high-quality health services in the immediate aftermath of disasters and during disease outbreaks and other emergencies, including conflict and insecurity.The war in Ukraine has presented all health-care providers with many unique challenges. This assessment addresses the importance and the complexities of the global spread of the Emergency Medical Team system challenges to meet a wide variety of crises including war, those that are unique to this very complex crisis in Ukraine, and the essential role of educational initiatives, not only in professional development but also in teamwork and cultural integration.
View Article and Find Full Text PDFNat Rev Dis Primers
October 2023
Disaster Med Public Health Prep
September 2023
Objective: This study describes the progress that the World Health Organization (WHO) African (AFRO) region has made in establishing National Emergency Medical Teams (N-EMTs), the coordination mechanisms of the EMTs, and the regional training centers.
Methods: It used a retrospective descriptive analysis of the formulation and implementation of the EMTs Initiative from an insider perspective. The analysis is based on the review of available documents such as EMTs mission reports, assessments, surveys, EMT monthly bulletins, and meeting minutes in addition to key informant interviews ( = 5) with the EMT teams' members to validate the findings and share field experiences.
Since its inception, the World Health Organization's Emergency Medical Teams (EMT) Initiative has strived to save lives, preserve health, and alleviate suffering through inclusiveness, transparency, global cohesion, and regional adaptation of quality standards and methodology. The mission of the Global EMT Initiative is to enhance the surge capacity of countries through the promotion of rapid mobilization and efficient coordination of both national and international medical teams and health care workforce to reduce loss of life and prevent long-term disability because of disasters, outbreaks, and other emergencies.Over the past decade, four EMT Global Meetings have been held and serve as a platform to foster collaboration and support among the global EMT community, which consists of clinicians and non-clinical providers, Member States, and partners.
View Article and Find Full Text PDFBull World Health Organ
November 2022
Introduction: The emerging trends of asymmetric and urban warfare call for a revision of the needs and the way in which frontline trauma care is provided to affected population. However, there is no consensus on the process to decide when and how to provide such lifesaving interventions in form of Trauma Stabilization Point (TSP).
Methods: A three-step Delphi method was used to establish consensus.
The paper documents experiences and lesson learned in responding to COVID-19 pandemic in Eswatini with the support of the Emergency Medical Teams. WHO databases, operation reports and hospitalization records were reviewed. The WHO Emergency Medical Teams built the capacity of the local response teams in Eswatini.
View Article and Find Full Text PDFIntroduction: Asymmetric warfare and the reaction to its threats have implications in the way far-forward medical assistance is provided in such settings. Investments in far-forward emergency resuscitation and stabilization can contribute to saving lives and increase the resilience of health systems. Thus, it is proposed to extend the use of the Haddon Matrix to determine a set of strategies to better understand and prioritize activities to prepare for and set-up frontline care in the form of Trauma Stabilization Points (TSPs).
View Article and Find Full Text PDFIntroduction: On August 4, 2020, a massive explosion struck the Beirut Harbor in Lebanon. Approximately 220 people were killed and around 7,000 were injured, of which 12% were hospitalized. Despite being weakened by economic crisis and increasing numbers of coronavirus disease 2019 (COVID-19) cases, the national health care system responded promptly.
View Article and Find Full Text PDFOn March 15, 2019, Cyclone Idai made landfall near the port city of Beira in central Mozambique causing significant casualties and serious damage to infrastructure. The Emergency Medical Team Type 2 - Italy Regione Piemonte (EMT2-ITA) was deployed approximately two weeks after the disaster to support the country in need, providing essential medical and surgical care.The EMT2-ITA staff was composed of 77 team members including two rotations and integrating local staff.
View Article and Find Full Text PDFDisaster Med Public Health Prep
October 2022
A massive explosion have ripped Beirut on August 4, 2020, leaving behind more than 6000 casualties, 800 regular floor admissions, 130 intensive care unit admissions, and over 200 deaths. Buildings were destroyed, hospitals in Beirut were also destroyed, others became nonfunctional. A disaster code was initiated in all the hospitals.
View Article and Find Full Text PDFObjectives: Mid-upper arm circumference (MUAC) and weight-for-height Z-score (WHZ) identify different populations of children with severe acute malnutrition (SAM) with only some degree of overlap. In an urban slum in Bangladesh, we conducted a prospective cohort study on children assessed as being severely malnourished by WHZ (<-3) but not by MUAC (>115 mm), to: 1. Assess their nutritional outcomes, and 2.
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