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Wild H, LeBoa C, Markou-Pappas N, Trautwein M, Persi L, Loupforest C, Hottentot E, Calvello Hynes E, Denny J, Alizada F, Muminova R, Jewell T, Kasack S, Pizzino S, Hynes G, Echeverri L, Salio F, Wren SM, Mock C, Kushner AL, Stewart BT. Synthesizing the Evidence Base to Enhance Coordination between Humanitarian Mine Action and Emergency Care for Casualties of Explosive Ordnance and Explosive Weapons: A Scoping Review. Prehosp Disaster Med 2024; 39:421-435. [PMID: 39851170 PMCID: PMC11821299 DOI: 10.1017/s1049023x24000669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 08/03/2024] [Accepted: 09/10/2024] [Indexed: 01/26/2025]
Abstract
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. METHODS A scoping literature review was conducted to identify records that described trauma care interventions pertinent to civilian casualties of EO/EW in resource-constrained settings using structured searches of indexed databases and grey literature. A 2017 World Health Organization (WHO) review on trauma systems components in low- and middle-income countries (LMICs) was updated with additional eligible reports describing trauma care interventions in LMICs or among civilian casualties of EO/EWs after 2001. RESULTS A total of 14,195 non-duplicative records were retrieved, of which 48 reports met eligibility criteria. Seventy-four reports from the 2017 WHO review and 16 reports identified from reference lists yielded 138 reports describing interventions in 47 countries. Intervention efficacy was assessed using heterogenous measures ranging from trainee satisfaction to patient outcomes; only 39 reported mortality differences. Interventions that could feasibly be supported by HMA stakeholders were synthesized into a bundle of opportunities for HMA engagement designated links in a Civilian Casualty Care Chain (C-CCC). CONCLUSIONS This review identified trauma care interventions with the potential to reduce mortality and disability among civilian EO/EW casualties that could be feasibly supported by HMA stakeholders. In partnership with local and multi-lateral health authorities, HMA can leverage their medical capabilities and expertise to strengthen emergency care capacity to improve trauma outcomes in settings affected by EO/EWs.
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Affiliation(s)
- Hannah Wild
- Department of Surgery, University of Washington, Seattle, WashingtonUSA
- Explosive Weapons Trauma Care Collective, International Blast Injury Research Network, University of Southampton, Southampton, United Kingdom
| | - Christopher LeBoa
- Department of Environmental Health Sciences, University of California Berkeley, Berkeley, CaliforniaUSA
| | - Nikolaos Markou-Pappas
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health (CRIMEDIM), Novara, Italy
| | - Micah Trautwein
- Dartmouth Geisel School of Medicine, Hanover, New HampshireUSA
| | - Loren Persi
- Victim Assistance Specialist, Belgrade, Serbia
| | | | | | | | - Jack Denny
- International Blast Injury Research Network (IBRN), University of Southampton, Southampton, United Kingdom
| | - Firoz Alizada
- Antipersonnel Mine Ban Convention Implementation Support Unit, Geneva, Switzerland
| | | | - Teresa Jewell
- Health Science Library, University of Washington, Seattle, WashingtonUSA
| | | | - Stacey Pizzino
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Gregory Hynes
- International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | - Lina Echeverri
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health (CRIMEDIM), Novara, Italy
| | | | - Sherry M. Wren
- Stanford University School of Medicine, Stanford, CaliforniaUSA
| | - Charles Mock
- Department of Surgery, University of Washington, Seattle, WashingtonUSA
| | | | - Barclay T. Stewart
- Department of Surgery, University of Washington, Seattle, WashingtonUSA
- Global Injury Control Section, Harborview Injury Prevention Washington and Research Center, Seattle, WashingtonUSA
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Ullrich PJ, Ramsey MD. Global Plastic Surgery: A Review of the Field and a Call for Virtual Training in Low- and Middle-Income Countries. Plast Surg (Oakv) 2023; 31:118-125. [PMID: 37188140 PMCID: PMC10170637 DOI: 10.1177/22925503211034833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
Lack of surgical access severely harms countless populations in many low- and middle-income countries (LMICs). Many types of surgery could be fulfilled by the plastic surgeon, as populations in these areas often experience trauma, burns, cleft lip and palate, and other relevant medical issues. Plastic surgeons continue to contribute significant time and energy to global health, primarily by participating in short mission trips intended to provide many surgeries in a short time frame. These trips, while cost-effective for lack of long-term commitments, are not sustainable as they require high initial costs, often neglect to educate local physicians, and can interfere with regional systems. Education of local plastic surgeons is a key step toward creating sustainable plastic surgery interventions worldwide. Virtual platforms have grown popular and effective-particularly due to the coronavirus disease 2019 pandemic-and have shown to be beneficial in the field of plastic surgery for both diagnosis and teaching. However, there remains a large potential to create more extensive and effective virtual platforms in high-income nations geared to educate plastic surgeons in LMICs to lower costs and more sustainably provide capacity to physicians in low access areas of the world.
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Affiliation(s)
- Peter J. Ullrich
- Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew D. Ramsey
- Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Unal E, Ozdemir A. The effect of hybrid simulated burn care training on nursing students' knowledge, skills, and empathy: A randomised controlled trial. NURSE EDUCATION TODAY 2023; 126:105828. [PMID: 37086499 DOI: 10.1016/j.nedt.2023.105828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/16/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Although improvements in burn care have increased the probability of survival in recent years, major complications are still common in burn patients. Nursing students should be competent to evaluate and intervene in the burn. OBJECTIVE To examine the effects of hybrid simulated burn care training on nursing students' knowledge, skills, and empathy. DESIGN In this study, a randomised experimental design was used. PARTICIPANTS This study was conducted on third-year undergraduate nursing students. METHODS Students in this study were randomly assigned to one of two groups: the Hybrid Simulated Group (N = 26) and the Control Group (N = 30). Standard Education training was completed by all participants. Only the hybrid simulation group students received training on the standardised patient with wearable burn plasters. Students' knowledge of burn care was assessed using an information questionnaire immediately following the theoretical training and after training for three weeks. An Objective Structured Clinical Exam was used to assess students' abilities. The Objective Structured Clinical Exam was convened three weeks after the theoretical training. The Multidimensional Emotional Empathy Scale was used to assess the students' empathy ability level immediately following the theoretical training and three weeks later. RESULTS After the intervention, nursing students in the Hybrid Simulated group had improved empathy, knowledge, skills of physical assessment, and implementation of interventions and referral criteria on burn care (p < 0.05). CONCLUSION Simulated burn training could be utilised to improve nursing students' empathy, knowledge, and skills of physical assessment evaluation of interventions and referral criteria on burn care.
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Affiliation(s)
- Eda Unal
- Bursa Uludag University, Faculty of Health Sciences, Department of Public Health Nursing, Bursa, Turkey.
| | - Aysel Ozdemir
- Bursa Uludag University, Faculty of Health Sciences, Department of Public Health Nursing, Bursa, Turkey.
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