Management of Limb Injuries During Disasters and Conflicts

In 2013, the WHO EMT Initiative published the Classification and Minimum Standards for Foreign Medical Teams in Sudden Onset Disasters in response to concerns from the humanitarian community that the world had largely failed in its efforts to provide life- and limb-saving care following the Haiti earthquake and Pakistan floods.

Many of the teams arriving on the ground were unable to provide care that truly met the needs of the population they hoped to serve. They were unfamiliar not only with the emergency-response system and standards, but also with the particular challenges of providing care in extremely austere environments.

Nowhere was this more pronounced than in the care of patients with limb injuries. Although data and hard evidence were difficult to obtain, stories abounded of patients who underwent surgical procedures without any follow-up, and most disturbing, patients whose amputations were inappropriate or unnecessary.

Lately, the EMT Initiative has been helping countries and NGOs set up emergency medical teams that will be able to maintain agreed standards of quality and self-sufficiency, resulting in better patient care. As more teams strive to reach these standards, they need clear guidance on best practice, particularly in managing patients with limb injuries, which make up the majority of cases.

This consensus-based field guide is aimed at providing that guidance. It draws on the expertise of the International Committee of the Red Cross, which has a long history of delivering care to patients and protecting them in conflict. It also captures the knowledge of other experts whose experience was forged in disasters and conflicts past.

Ultimately, this guide will help national and international emergency teams improve the care they provide to those we all seek to serve: our patients – the victims of armed conflicts and natural disasters.