Article

Best practice guidelines on surgical response in disasters and humanitarian emergencies: report of the 2011 Humanitarian Action Summit Working Group on Surgical Issues within the Humanitarian Space.

Division of General Surgery, University of Western Ontario, London, Ontario, Canada.
Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation 04/2012; 26(6):429-37. DOI: 10.1017/S1049023X12000064
Source: PubMed

ABSTRACT The provision of surgery within humanitarian crises is complex, requiring coordination and cooperation among all stakeholders. During the 2011 Humanitarian Action Summit best practice guidelines were proposed to provide greater accountability and standardization in surgical humanitarian relief efforts. Surgical humanitarian relief planning should occur early and include team selection and preparation, appropriate disaster-specific anticipatory planning, needs assessment, and an awareness of local resources and limitations of cross-cultural project management. Accurate medical record keeping and timely follow-up is important for a transient surgical population. Integration with local health systems is essential and will help facilitate longer term surgical health system strengthening.

0 Followers
 · 
109 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: As a result of the gaps in humanitarian response highlighted by several reports, the international community called for an increased professionalization of humanitarian aid workers. This paper describes a pilot project by an Italian university and a non-profit, non-governmental organization to implement a medical apprenticeship in low-income countries during Anesthesia and Intensive Care Medicine residencies. Before deployment, participants were required to complete a dedicated online training course about safety and security in the field, principles of anesthesia at the district hospital level, emergency and essential surgical care, essentials of medical treatment in resource-constrained environments and psychological support in emergencies. At the end of the program, a qualitative self-evaluation questionnaire administered to participants highlighted how the project allowed the participants to advance their professional skills when working in a low-resource environment, while also mastering their adapting skills and the ability to interact and cooperate with local healthcare personnel. The project also proved to be a means for personal growth, making these experiences a recommendation for all residents as a necessary step for the professionalization of healthcare personnel involved in humanitarian aid.
    07/2014; 6. DOI:10.1371/currents.dis.4b85b2e37f58297619faac3141f0d3e3
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Planning for mass critical care in resource-poor and constrained settings has been largely ignored, despite large, densely crowded populations who are prone to suffer disproportionately from natural disasters. As a result, disaster response has been suboptimal and in many instances hampered by lack of planning, education and training, information, and communication. METHODS: The Resource-Poor Settings panel developed five key question domains; defining the term resource poor and using the traditional phases of the disaster cycle (mitigation/preparedness/response/recovery). Literature searches were conducted to identify evidence to answer the key questions in these areas. Given a lack of data on which to develop evidence-based recommendations, expert-opinion suggestions were developed, and consensus was achieved using a modified Delphi process. RESULTS: The five key questions were as follows: definition, capacity building and mitigation, what resources can we bring to bear to assist/surge, response, and reconstitution and recovery of host nation critical care capabilities. Addressing these led the panel to off er 33 suggestions. Because of the large number of suggestions, the results have been separated into two sections: part I, Infrastructure/Capacity in the accompanying article, and part II, Response/Recovery/Research in this article. CONCLUSIONS: A lack of rudimentary ICU resources and capacity to enhance services plagues resource-poor or constrained settings. Capacity building therefore entails preventative strategies and strengthening of primary health services. Assistance from other countries and organizations is oft en needed to mount a surge response. Moreover, the disengagement of these responding groups and host country recovery require active planning. Future improvements in all phases require active research activities. CHEST 2014; 146 (4_Suppl): e168S-e177S
    Chest 08/2014; 146(4). DOI:10.1378/chest.14-0745 · 7.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Documentation of the patient encounter is a traditional component of health care practice, a requirement of various regulatory agencies and hospital oversight committees, and a necessity for reimbursement. A disaster may create unexpected challenges to documentation. If patient volume and acuity overwhelm health care providers, what is the acceptable appropriate documentation? If alterations in scope of practice and environmental or resource limitations occur, to what degree should this be documented? The conflicts arising from allocation of limited resources create unfamiliar situations in which patient competition becomes a component of the medical decision making; should that be documented, and, if so, how? In addition to these challenges, ever-present liability worries are compounded by controversies over the standards to which health care providers will be held. Little guidance is available on how or what to document. We conducted a search of the literature and found no appropriate references for disaster documentation, and no guidelines from professional organizations. We review here the challenges affecting documentation during disasters and provide a rationale for specific patient care documentation that avoids regulatory and legal pitfalls. (Disaster Med Public Health Preparedness. 2013;0:1-7).
    Disaster Medicine and Public Health Preparedness 08/2013; 7(4):354-360. DOI:10.1017/dmp.2013.76 · 1.14 Impact Factor

Full-text (2 Sources)

Download
55 Downloads
Available from
May 23, 2014

Smita Chackungal