Lower limbs trauma

Lower limbs trauma
BURDEN OF DISEASE IN
SUDDEN ONSET DISASTERS
Depending on the situation the type of casualties expected by EMTs can vary. Understanding
the situation on the ground and the burden of disease it creates is crucial to the planning of any
intervention. Large waves of patients can be created both by disasters(earthquakes) or by conflicts
(short term focused military interventions or terrorist attacks). In contrast some situations such as
enduring conflicts (a long running civil war) or disasters (drought leading to famine) can create a
steady long term flow of patients. A primary goal of the WHO s EMT Initiative isto aid governments
and EMTs in delivering the appropriate type of medical surge capacity that a situation requires.
This can best be understood by thinking about burden of disease in waves.
» WAVE 1
Days 1-3 – This wave encompasses many of the head, neck, chest, and abdominal injuries that
are rapidly fatal without intervention. International EMTs are unlikely to be able to intervene in
this phase. Protecting populations during this wave is primarily achieved by building resilience
into national health systems and through the response of local or possibly regional EMTs.
» WAVE 2
Days 4-20 – This wave consists of those injuries that were not immediately life threatening, the
majority of which will be to the limbs, and constitutes the largest group of victims. These teams
must be prepared to manage not only these cases but other surgical emergencies that arise,
particularly abdominal cases and C-sections.
» WAVE 3
This wave actually starts at day 1 but peaks later. It consists of the infectious disease issues faced
by internally displaced persons (IDPs), as well as the NCDs and mental health issues faced by a
population recovering from a SOD requiring a surge in healthcare capacity. It is unacceptable for
EMTs to come only for surgery and have no plans to address endemic and infectious diseases
and their complications.
» WAVE 4
This wave has variable timing
depending on the phase 1 health
needs of the affected population.
Wave 4 refers to the background
surgical, oncological, and NCD
needs of the population that have
likely gone unaddressed due to
the SOD.