I think you are absolutely right that "amputations" should be included in the Table 1 list of Priority 1 procedures under the Trauma section. Clearly the Haiti earthquake experience highlights thousands of times over the importance of the procedure as a life saving measure in the care of trauma patients. It's very telling, this article was largely written, edited, and revised prior to the Earthquake, and we missed this obvious lesson in the final revisions.
A couple articles have recently been published that act as nice companions to this article. Both are, like our piece, advocacy articles that argue the importance and need of essential and emergency surgical (EES) services in discussion of global health service provision. The first, by Hedges (Tenwek Hospital, Kenya), Mock (WHO), and Cheerian (WHO) advances a political economic approach to EES advocacy. The second by McIntyre and Zenilman (SUNY Downstate / PIH) is a call to action to North American surgeons and our leadership to communicate a unified vision and to formulate a clear plan to provide improve surgical services to the world's poorest. All three are advocacy pieces targeting different, and hopefully slightly overlapping, audiences. All ...
I think you are absolutely right that "amputations" should be included in the Table 1 list of Priority 1 procedures under the Trauma section. Clearly the Haiti earthquake experience highlights thousands of times over the importance of the procedure as a life saving measure in the care of trauma patients. It's very telling, this article was largely written, edited, and revised prior to the Earthquake, and we missed this obvious lesson in the final revisions.
A couple articles have recently been published that act as nice companions to this article. Both are, like our piece, advocacy articles that argue the importance and need of essential and emergency surgical (EES) services in discussion of global health service provision. The first, by Hedges (Tenwek Hospital, Kenya), Mock (WHO), and Cheerian (WHO) advances a political economic approach to EES advocacy. The second by McIntyre and Zenilman (SUNY Downstate / PIH) is a call to action to North American surgeons and our leadership to communicate a unified vision and to formulate a clear plan to provide improve surgical services to the world's poorest. All three are advocacy pieces targeting different, and hopefully slightly overlapping, audiences. All are useful in our thought processes and our discussions going forward.
An arena where this discussion will be carried forward is an upcoming symposium, sponsored by the Harvard Institute of Global Health.
The Role of Surgery in Global Health:
Addressing the Crisis - Anesthesia, Surgical Need and Global Health Dialogue
I encourage you to look over the initial website http://events.globalhealth.harvard.edu/icb/icb.do I am sad that I personally will not be able to attend, but I am hopeful for the discussion and action that it will engender.
The article highlights an area of personal interest to me -- trauma resuscitation and training in underserved countries. I was wondering if anyone could share their experiences with trauma in other countries - what protocols, if any, are utilized in managing traumas? What barriers are there in delivering effective care and educating healthcare workers in emergency situations?
Trauma care is a huge global need and as road traffic injuries are projected to be a growing problem in low/middle income countries, it is an important topic for all who are interested in global health and surgical services. I have had the opportunity and privilege to work with a group that provides emergency trauma training to workers (usually lay people who want to help their community) living in Eastern Burma. In this area, landmine injuries are an ongoing problem. This program has trained a number of “medics” and their skill level is quite exceptional.
The primary survey protocol, the DR. ABCs are attached. It is essentially the typical ABCs with the addition of checking to be sure the accident scene is safe prior to providing care. This is a significant concern when dealing with landmines or in areas of conflict- as the people with medical skills are often in very short supply, and must therefore keep themselves safe while helping others.
Thanks, Nadine, for those resources. Seems like Burma's emergency response protocol would be a useful model in other conflict areas. I also am impressed by the community effort -- how most of the workers who receive training are jusually lay people.
Robert Riviello
Nadine,
expand commentThank you for posting the article.
I think you are absolutely right that "amputations" should be included in the Table 1 list of Priority 1 procedures under the Trauma section. Clearly the Haiti earthquake experience highlights thousands of times over the importance of the procedure as a life saving measure in the care of trauma patients. It's very telling, this article was largely written, edited, and revised prior to the Earthquake, and we missed this obvious lesson in the final revisions.
A couple articles have recently been published that act as nice companions to this article. Both are, like our piece, advocacy articles that argue the importance and need of essential and emergency surgical (EES) services in discussion of global health service provision. The first, by Hedges (Tenwek Hospital, Kenya), Mock (WHO), and Cheerian (WHO) advances a political economic approach to EES advocacy. The second by McIntyre and Zenilman (SUNY Downstate / PIH) is a call to action to North American surgeons and our leadership to communicate a unified vision and to formulate a clear plan to provide improve surgical services to the world's poorest. All three are advocacy pieces targeting different, and hopefully slightly overlapping, audiences. All ...
Attached resource:
Source: Center for Surgery and Public Health - BWH
4:55 PM, 18 Aug 2010 | Permalink
Robert Riviello
The Globalization of Surgery Article in Archives of Surgery
Attached resource:
Source: Center for Surgery and Public Health - BWH
4:56 PM, 18 Aug 2010 | Permalink
Ann Hau
The article highlights an area of personal interest to me -- trauma resuscitation and training in underserved countries. I was wondering if anyone could share their experiences with trauma in other countries - what protocols, if any, are utilized in managing traumas? What barriers are there in delivering effective care and educating healthcare workers in emergency situations?
6:31 PM, 1 Oct 2010 | Permalink
Nadine Semer
Trauma care is a huge global need and as road traffic injuries are projected to be a growing problem in low/middle income countries, it is an important topic for all who are interested in global health and surgical services. I have had the opportunity and privilege to work with a group that provides emergency trauma training to workers (usually lay people who want to help their community) living in Eastern Burma. In this area, landmine injuries are an ongoing problem. This program has trained a number of “medics” and their skill level is quite exceptional.
The primary survey protocol, the DR. ABCs are attached. It is essentially the typical ABCs with the addition of checking to be sure the accident scene is safe prior to providing care. This is a significant concern when dealing with landmines or in areas of conflict- as the people with medical skills are often in very short supply, and must therefore keep themselves safe while helping others.
Check out their website- they are doing really innovative work to help the people of Eastern Burma. http://www.ghap.org/programs/landmine/
Attached resource:
Link leads to: http://www.ghap.org/programs/landmine/
Source: Global Health Access Program - GHAP
12:03 AM, 7 Oct 2010 | Permalink
Ann Hau
Thanks, Nadine, for those resources. Seems like Burma's emergency response protocol would be a useful model in other conflict areas. I also am impressed by the community effort -- how most of the workers who receive training are jusually lay people.
12:03 PM, 13 Oct 2010 | Permalink