Anthony D Redmond

• The University of Manchester

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-s...

Introduction 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 Had...

Introduction: Frail, older patients with COVID-19 have an increased risk of hospital admission and death. Methods: We studied a regional model of care used for older patients with COVID-19 in spring 2020 across three settings: an acute teaching hospital, a district general hospital and a temporary emergency hospital. We also studied demographic...

Objectives COVID-19 temporary emergency ‘field’ hospitals have been established in the UK to support the surge capacity of the National Health Service while protecting the community from onward infection. We described the population of one such hospital and investigated the impact of frailty on clinical outcomes. Design Cohort study. Setting NHS...

We review a twenty year old paper on sex differences in human neonatal social perception, and identify a serious issue: a failure to assess whether the results were distorted by an exceptionally high Caesarean Section rate. This is in addition to a number of other methodological weaknesses, which together mean that there is too much ‘noise’ in the...

Objective The effectiveness of Emergency Medical Teams (EMTs) is strongly related to their time of arrival, and usually only few teams arrive within 24-48 h postdisaster. The decision to deploy and the scale of deployment rely heavily on context and nature of the event and consequently a rapid assessment of needs/gaps is critical to an appropriate...

Background Awareness of residual disabilities amongst people living in countries recovering from prolonged armed conflicts and their socio-economic consequences is increasing. Robust data on the prevalence of such disabilities are important for planning cost effective health services. This study outlines the first community-based prevalence study o...

When a disaster exceeds the capacity of the affected country to cope with its own resources, the provision of external rescue and health services is required, and the deployment of relief units requested. Recently, the cost of international relief and the belief that such deployment is cost-effective has been questioned by the international communi...

Introduction Improving medical record keeping is a key part of the World Health Organization’s (WHO’s; Geneva, Switzerland) drive to standardize and evaluate emergency medical team (EMT) response to sudden onset disasters (SODs). Problem In response to the WHO initiative, the UK EMT is redeveloping its medical record template in line with the WHO...

RedmondAD . Characteristics of medical teams in disaster .

Healthcare professionals worldwide must condemn attacks on hospital and healthcare workers in Syria and other nations in conflict. Must recognize the neutrality of healthcare workers and their rights to care for any sick and injured patient, regardless of nationality, race, religion, or political point of view

Study/Objective The WHO has, for some time, been working to standardize and professionals in the humanitarian field. One branch of this work has been to develop a minimum data set for daily reporting of Emergency Medical Team (EMT) activity during Sudden Onset Disasters (SODs). This minimum data set is under final development following expert stake...

Study/Objective To establish a “core curriculum” for the Emergency Medical Teams (EMTs) internationally, by conducting a systematic mapping study of all training programs currently targeting EMTs internationally. Background Standardized education and training are essential components to improve global emergency response, by providing mechanisms to...

Study/Objective Analyzing and optimizing the response to a disaster is made very difficult by the use of unstructured data captured on paper. Such data is difficult to aggregate and analyze in a consistent and meaningful manner – both in real-time for management and clinical quality assurance, and afterwards for comparative analysis and ‘whole syst...

Study/Objective Electronic patient records are in widespread use in high-income countries. The factors that make electronic records useful in everyday practice are magnified in a disaster response, particularly the ability to: ∙ minimize poor/absent data due to paper management and handwriting; ∙ identify patients consistently eg, using barcodes; ∙...

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Background and objectives: Deaths from trauma occurring in the prehospital phase of care are typically excluded from analysis in trauma registries. A direct historical comparison with Hussain and Redmond's study on preventable prehospital trauma deaths has shown that, two decades on, the number of potentially preventable deaths remains high. Using...

Background & objectives: In 1994, Hussain and Redmond revealed that up to 39% of prehospital deaths from accidental injury might have been preventable had basic first aid care been given. Since then there have been significant advances in trauma systems and care. The exclusion of prehospital deaths from the analysis of trauma registries, giv en th...

The wars in the Middle East have led to unprecedented threats and attacks on patients, healthcare workers, and purposeful targeting of hospitals and medical facilities. It is crucial that every healthcare provider, both civilian and military, on either side of the conflict become aware of the unique and inherent protections afforded to them under I...

An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, a...

Sudden-onset disasters continue to cause extremely high numbers of casualties in the new millennium (Table 8.1). Having overwhelmed the local and national medical facilities, many countries have called upon international medical teams to provide surgical support as many of those rescued had suffered life-threatening injuries that required emergency...

The first act of preparation for responding to a conflict or disaster is to ask yourself three fundamental questions (and give yourself three honest answers): Do I have the necessary skills and experience? Have I been asked to respond? Am I authorised to practice medicine in that country? This chapter will provide an overview of the skills, knowled...

Risks to the mental health of children and families exposed to conflict in Syria are of such magnitude that research identifying how best to deliver psychological first aid is urgently required. This study tested the feasibility of a novel approach to large-scale distribution of information and data collection. Methods. Routine humanitarian delive...

Medical records are a tenet of good medical practice and provide one method of communicating individual follow-up arrangements, informing research data, and documenting medical intervention. The objective of this review was to look at one source (the published literature) of medical records used by foreign medical teams (FMTs) in sudden onset disas...

There have been numerous attempts to provide a universally accepted definition of a disaster. Any new definition is almost always accompanied by a challenge to its accuracy and widespread applicability. However, whatever definition is chosen it always reveals a small number of key elements. Something happens, usually quite suddenly, but sometimes o...

Sarajevo has two main hospitals, the Koševo Hospital (a tertiary teaching hospital with 3,000 beds) and the State Hospital (420 beds), which had been a military hospital until the war. Hospital practice had developed as a mixture of local, Russian and European techniques. Emergency medicine as such did not exist. Before the war, at the Koševo Hospi...

There is little doubt that the hospital was damaged when the Serbs departed, but this was but a last parting shot at an institution that had been run down for years and particularly since 1990. It was about then that Milosevic redeployed Serb staff from Belgrade to replace local ethnic Albanian staff and the slide to the present situation really be...

Cross-cutting Principle Use knowledge, innovation, and education to build a culture of safety and resilience at all levels

Earthquakes are the leading cause of natural disaster-related mortality and morbidity. Soft tissue and musculoskeletal injuries are the predominant type of injury seen after these events and a major reason for admission to hospital. Open fractures are relatively common; however, they are resource-intense to manage. Appropriate management is importa...

Paul Sutton and Anthony Redmond explain the role of the United Kingdom International Emergency Trauma Register in preparing UK clinicians for volunteering in resource poor environments.

Following large-scale disasters and major complex emergencies, especially in resource-poor settings, emergency surgery is practiced by Foreign Medical Teams (FMTs) sent by governmental and non-governmental organizations (NGOs). These surgical experiences have not yielded an appropriate standardized collection of data and reporting to meet standards...

Dear Sir, I was pleased to read of the work of orthopaedic surgeons from the high-income countries supporting the day-to-day work of those in low- and middle-income countries.1,2 There is also another way that the skills of the orthopaedic surgeon can be brought to benefit the most vulnerable and this is in the response to sudden onset disasters o...

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 o...

The disaster response environment in Haiti following the 2010 earthquake represented a complex healthcare challenge. This study was designed to identify challenges during the Haiti disaster response. Qualitative and quantitative study of injured patients carried out six months after the January 2010 earthquake in Haiti to review the surgical inputs...

Limb amputations are frequently performed as a result of trauma inflicted during conflict or disasters. As demonstrated during the 2010 earthquake in Haiti, coordinating care of these patients in austere settings is complex. During the 2011 Humanitarian Action Summit, consensus statements were developed for international organizations providing car...

There has been a continuing rise in recent years of the number of medical schools in the developed world offering 'global health' teaching to its students. Yet, the term itself is used in a number of contexts and as yet no clear consensus on what constitutes an appropriate or successful global health education programme has been reached. Approaches...

At 14:48 on 12 May 2008 an earthquake of magnitude 8.0 struck the Wenchuan area of Sichuan province, China. A decision to offer/receive UK medical assistance was agreed at a Sino/British political level and a medical team was despatched to the earthquake area. This study describes the team's experience during the immediate aftermath of the earthqua...

Disasters are commonly divided into “natural” and “man made,” but such distinctions are generally artificial. All disasters are fundamentally human made, a function of where and how people choose or are forced to live. The trigger may be a natural phenomenon such as an earthquake, but its impact is governed by the prior vulnerability of the affecte...

*Longer versions of three of these letters appear on the BMJ's website (www.bmj.com) EDITOR—Nicholl and Turner's attempt to perform a definitive before and after study on regionalised trauma care was beset by logistical problems.1 Firstly, ambulance workers were not empowered to bypass the surrounding hospitals, who in turn were reluctant to be byp...

To analyse the effect on outcome of referral to specialist facilities after cardiopulmonary arrest in a general ward. A retrospective analysis of resuscitation records of 743 patients in whom cardiopulmonary resuscitation was performed in a general ward between 1988 and 1992. After successful initial cardiopulmonary resuscitation, patients were ide...

The symptoms reported by patients who have experienced minor head or minor neck injury are compared. Symptoms were identified using a questionnaire-based out-patients interview. Rank order correlation analyses were carried out on data obtained at 2 and 6-12 weeks post-injury. Data on 24 head-injured and 29 neck-injured patients are presented. There...

Non-specific abdominal pain (NSAP) is a benign condition with low morbidity. This follow-up study of 82 patients discharged from an emergency department after presenting with abdominal pain, during 1 calendar month, has shown that only 9.6% were diagnosed as having NSAP. It has been shown previously that 34.9% to 45.6% of patients presenting to an...

Objective: A statistical model is a powerful tool for evaluating trauma care. With accident and emergency clinicians becoming more aware of the importance of monitoring their department's performance, there is a danger that such models may be inappropriately applied to new sets of trauma cases, resulting in misleading evaluations. The primary obje...

To determine what proportion of pre-hospital deaths from accidental injury--deaths at the scene of the accident and those that occur before the person has reached hospital--are preventable. Retrospective study of all deaths from accidental injury that occurred between 1 January 1987 and 31 December 1990 and were reported to the coroner. North Staff...

The observations of pallor, sweating, agitation and restlessness, at the time of an injured patient's admission to the resuscitation room, were compared with other more complex indices of injury severity and the ability of each observation to predict mortality was observed. The number of positive observations was significantly related to the Revise...

EDITOR,- The impression gained by Jon Nicholl and colleagues - “that the trauma centre is showing promising results is founded on the results put out by the trauma centre itself” - is correct.1 We work in the north west midlands trauma system and believe that we have a duty to audit our work and that the results of our internal audit should not …

Six years after the Royal College of Physicians published its report, most hospitals in the UK with acute coronary beds fail to train or test their doctors adequately in the skills of cardiopulmonary resuscitation. Doctors want more training, and consultants try to give it, but there is a lack of funds for this basic yet critical task.

In July 1991, a pilot trauma center was established in the United Kingdom as part of a government-funded evaluation of trauma services. The North Staffordshire Hospital is at the center of a trauma system that serves 2 million people. This system involves the five surrounding hospitals and the ambulance service. Key developments have been the provi...

The first trauma centre in the UK has been established at the North Staffordshire Hospital in Stoke-on-Trent. The early development of this centre and the wider system within which it functions is described. The Trauma Centre and corresponding evaluation project by the University of Sheffield have been funded by the Department of Health. The outcom...

Fifteen consecutive patients who had been resuscitated from cardiac arrest and transferred immediately to an Intensive Care Unit were studied. Measurements of intraarterial pressure, cardiac output and systemic vascular resistance demonstrate that 'cuff' blood pressure may not always be related to intraarterial pressure or cardiac output and cannot...

Many patients presenting to the Emergency Medical Services have recently consumed alcohol. This may profoundly affect their behaviour, conscious level and response to illness and treatment. The blood alcohol level (BAL) is of little use in the evaluation of these responses. Abnormal conscious level should never be ascribed to alcohol intoxication a...

Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment....

2nd Ed Bibliogr. na konci kapitol

The delay in receiving authorisation for the despatch of SMART significantly reduced our overall effectiveness. The majority of injured survivors were extracted during this time and our special expertise could have saved a significant number of lives. The episode has provided SMART with unique experience for a British medical team and this knowledg...

Comment In this study the patients were between 17 and 69 yr of age. Most sustained their injuries in motor vehicle accidents and had severe blunt trauma. No patient was anesthetized, but some received small intravenous doses of papav-eretum. Four of the 16 patients died. The mean time from injury to measurements being made was 1.6 hr. Following th...

Cardiac arrest is basically failure of brain perfusion due to sudden hemodynamic failure. However, hemodynamics are never measured during resuscitation and almost never during the post-resuscitation period.

The TRISS methodology for evaluating trauma care has been applied in two UK hospitals over a 12 month period. Unexpected deaths occurred in both hospitals and were related to delays in transport between hospitals. The delays were instigated by the receiving hospitals and never the despatching hospital. Unexpected survival occurred in one of the hos...

Oxygen consumption (VO2) immediately following major injury in man has been said to be reduced. The evidence for this is poor. We have therefore measured VO2 soon after major injury in 16 patients. VO2 was reduced in only two patients, within the normal range in four and increased in ten. VO2 was maintained by increased oxygen extraction in six pat...