The war in Gaza has resulted in many hundreds of spinal cord injuries (SCI), which will have a devastating impact on those injured and their families for the rest of their lives.
The optimal management of SCI requires effective pre-hospital care,
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early specialized imaging (using CT or MRI) and in many cases early surgical interventions by a highly specialised neurosurgical team. Surgery requires many hours of use of a sterile operating room environment and supportive critical care capacity, as well as intensive post-operative care – none of which is currently possible due to the ongoing war, destruction, and disruption of health services in Gaza.
An alternative to surgery is conservative management – this requires intensive nursing care under full spinal precautions for many weeks in order to allow for bone and soft tissue healing and prevent further injury to the spinal cord. The patient is unable to move independently in bed during this period. Those caring for the patient need to be able to safely reposition them every 2 hours, and manage all their bowel and bladder care needs. The patient needs good nutrition and hydration at all times, as well as access to medication to support bowel care, manage pain (including neuropathic pain). A caregiver must remain with the patient to be trained to provide ongoing care and assist with daily care.
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The clinical guidelines and protocols for the practice of emergency medicine presented in this document are designed to be a useful resource not only for those wishing to become emergency medicine specialists, but also for general practitioners and other healthcare providers tasked with caring for p
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atients in hospital emergency departments. Healthcare providers using this Emergency Medicine Clinical Guideline (EMCG) are provided with fundamental concepts and principles essential to emergency medicine and the management of patients with undifferentiated emergency conditions.
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A Manual for mid-level rehabilitation workers.
This manual is to support the work of mid-level rehabilitation workers on their work with children or adults with spinal cord injury and their familie
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s. It refers to the physical effects of this type of injury, the different levels of injury and the basic care of a person following a spinal cord injury. Available in Chinese and Mongolian, too
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Working with limited resources in armed conflict and other situations of violence. Vol.2
This is an open-access training course for frontline healthcare providers who manage acute illness and injury with limited resources. Produced in response to requests from multiple countries and international partners, the BEC package includes a Par
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ticipant Workbook and electronic slide decks for each module. Integrating the guidance from WHO Emergency Triage, Assessment and Treatment (ETAT) for children and the Integrated Management of Adult/Adolescent Illness (IMAI), BEC teaches a systematic approach to the initial assessment and management of time-sensitive conditions where early intervention saves lives
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The Guidelines for essential trauma care seek to set achievable standards for trauma treatment services which could realistically be made available to almost every injured person in the world. They then seek to define the resources that would be necessary to assure such care. These include human res
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ources (staffing and training) and physical resources (infrastructure, equipment and supplies).
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This quality standard covers prevention of falls and assessment after a fall in older people (aged 65 and over) who are living in the community or staying in hospital. It describes high-quality care in priority areas for improvement.
his document, a first of its kind, clearly sets out the standards for rehabilitation and provides guidance on building or strengthening the capacity of EMTs in this area.The importance of early rehabilitation for functional outcomes is well documented. Rehabilitation needs can pe
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rsist far beyond the departure of EMTs; therefore, close, supportive collaboration must be established with local services. Emergency response presents an opportunity to rebuild devastated health systems and build local rehabilitation capacity. This document emphasizes the importance of aligning practices to the local context and maximizing opportunities for training and mentorship. The minimum standards and recommendations described will result in faster access of patients to rehabilitation services and equipment and a better transition between EMTs and local health facilities.
Available in English, German, Arabic, Chinese
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Guidelines for essential trauma care. Russian Version
This manual provides guidance for policymakers on the issue of prehospital trauma care systems. The main areas covered include the organisation of the prehospital trauma care system, capacity development, data collection, transportation and communication, as well as ethical and legal considerations
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"Explosions can produce unique patterns of injury seldom seen outside combat.
When they do occur, they have the potential to inflict multi-system life-threatening injuries
on many persons simultaneously. The
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injury patterns following such events are a product of
the composition and amount of the materials involved, the surrounding environment,
delivery method (if a bomb), the distance between the victim and the blast, and any
intervening protective barriers or environmental hazards. Because explosions are relatively
infrequent, blast-related injuries can present unique triage, diagnostic, and management
challenges to providers of emergency care. "
accessed 2018/03/29
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