Challenges in Delivering Rehabilitation in Disasters and Conflicts: Difference between revisions
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== Introduction == | == Introduction == | ||
Rehabilitation professionals face unique challenges associated with complex trauma, injury surge and resource scarcity that many have never encountered before. Understanding and recognising these challenges is vital for rehabilitation professionals to be able to navigate the de | |||
[[Category:Rehabilitation in Disaster and Conflict Situations Content Development Project]] | |||
[[Category:Rehabilitation]] | |||
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mands of emergency medical response. | |||
== Overwhelming Patient Numbers == | |||
Disaster is a serious disruption of the functioning of a community or society, which involve widespread human, material, economic or environmental impacts that exceed the ability of the affected community or society to cope using its own resources.<ref>United Nations Office for Disaster Risk Reduction. Terminology. Available fromh [./Ttp://www.unisdr.org/we/inform/terminology#letter-p ttp://www.unisdr.org/we/inform/terminology#letter-p] [Accessed 29 Nov 2016]</ref>In the wake of a disaster or conflict health infrastructure and workforce can often become overwhelmed, particularly within the early days of the emergency response following a sudden onset disaster, with mass casualties and an overwhelming surge of patients presenting to health services with injury, or in in conflicts and protracted crises with ongoing patients presenting , resulting in a persistent challenge of balancing the needs of new patients requiring early rehabilitation and those with ongoing needs. | |||
Both of these situations brings significant challenges for the medical team and rehabilitation professional as it is not always possible to treat everyone optimally, and ability to prioritise become vital. Rehabilitation professionals need to both prioritise who they treat and consider their interventions in order to maximise the limited time they have with patients, and ensure the best possible carry over within the constraints of the environment. The field handbook, Early Rehabilitation in Conflicts and Disasters suggests the following priorities for provision of early rehabilitation to enable best possible outcomes and minmise complications; | |||
# Patients whose '''life may be at risk''' without rehabilitation input, e.g. new suspected spinal injuries, brain injury or patients in need of urgent respiratory input. | |||
# Patients who are likely to '''quickly develop complications''' without rehabilitation input, e.g. patients with spinal injuries, or burns | |||
# Patients who may be facing '''early discharge''' or who can potentially be safely discharged from acute care with rehabilitation input, such as patients requiring assistive devices, education and a follow-up appointment (e.g. patients with an upper limb or lower limb fractures following surgical management) | |||
# Patients whose conditions will be '''quickly improved''' through rehabilitation input or who might be at risk of '''slowly developing complications''', such as patients with new amputations, patients on traction and patients with brain injuries.<ref>Lathia C, Skelton P, Clift Z. Early rehabilitation in conflicts and disasters. Handicap International: London, UK. 2020.</ref> | |||
Interventions that have the most value during include patient and caregiver education around management of the condition and recognition of complications and what to do if they occur. Positioning, exercises and functional activities are the key active treatments to utilise with a focus on being able to do activities of daily living. | |||
== Prioritisation == | == Prioritisation == | ||
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== References == | == References == | ||
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Revision as of 20:56, 22 March 2022
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Top Contributors - Naomi O'Reilly, Kim Jackson, Jess Bell, Uchechukwu Chukwuemeka and Olajumoke Ogunleye
Introduction[edit | edit source]
Rehabilitation professionals face unique challenges associated with complex trauma, injury surge and resource scarcity that many have never encountered before. Understanding and recognising these challenges is vital for rehabilitation professionals to be able to navigate the de mands of emergency medical response.
Overwhelming Patient Numbers[edit | edit source]
Disaster is a serious disruption of the functioning of a community or society, which involve widespread human, material, economic or environmental impacts that exceed the ability of the affected community or society to cope using its own resources.[1]In the wake of a disaster or conflict health infrastructure and workforce can often become overwhelmed, particularly within the early days of the emergency response following a sudden onset disaster, with mass casualties and an overwhelming surge of patients presenting to health services with injury, or in in conflicts and protracted crises with ongoing patients presenting , resulting in a persistent challenge of balancing the needs of new patients requiring early rehabilitation and those with ongoing needs.
Both of these situations brings significant challenges for the medical team and rehabilitation professional as it is not always possible to treat everyone optimally, and ability to prioritise become vital. Rehabilitation professionals need to both prioritise who they treat and consider their interventions in order to maximise the limited time they have with patients, and ensure the best possible carry over within the constraints of the environment. The field handbook, Early Rehabilitation in Conflicts and Disasters suggests the following priorities for provision of early rehabilitation to enable best possible outcomes and minmise complications;
- Patients whose life may be at risk without rehabilitation input, e.g. new suspected spinal injuries, brain injury or patients in need of urgent respiratory input.
- Patients who are likely to quickly develop complications without rehabilitation input, e.g. patients with spinal injuries, or burns
- Patients who may be facing early discharge or who can potentially be safely discharged from acute care with rehabilitation input, such as patients requiring assistive devices, education and a follow-up appointment (e.g. patients with an upper limb or lower limb fractures following surgical management)
- Patients whose conditions will be quickly improved through rehabilitation input or who might be at risk of slowly developing complications, such as patients with new amputations, patients on traction and patients with brain injuries.[2]
Interventions that have the most value during include patient and caregiver education around management of the condition and recognition of complications and what to do if they occur. Positioning, exercises and functional activities are the key active treatments to utilise with a focus on being able to do activities of daily living.
Prioritisation[edit | edit source]
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Injury Complexity[edit | edit source]
Expertise[edit | edit source]
Environment[edit | edit source]
Access to Equipment[edit | edit source]
Medical Records[edit | edit source]
Discharge Planning[edit | edit source]
Resources[edit | edit source]
References [edit | edit source]
- ↑ United Nations Office for Disaster Risk Reduction. Terminology. Available fromh [./Ttp://www.unisdr.org/we/inform/terminology#letter-p ttp://www.unisdr.org/we/inform/terminology#letter-p] [Accessed 29 Nov 2016]
- ↑ Lathia C, Skelton P, Clift Z. Early rehabilitation in conflicts and disasters. Handicap International: London, UK. 2020.
