8 December 2018 | GENEVA/DAVOS: Today with the generous support of the Davos-based AO Foundation, WHO launches the Global Emergency and Trauma Care Initiative. Around the world, acutely ill and injured people die every day due to a lack of timely emergency care. Among them are children and adults with injuries and infections, heart attacks and strokes, asthma and acute complications of pregnancy. Many countries have no emergency access telephone number to call for an ambulance or no trained ambulance staff. Many hospitals lack dedicated emergency units and have few providers trained in the recognition and management of emergency conditions. These gaps result in millions of avoidable deaths every year.
“No one should die for the lack of access to emergency care, an essential part of universal health coverage,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We have simple, affordable and proven interventions that save lives. This initiative will ensure that millions of people around the world have access to the timely, life-saving care they deserve.”
The goal of the WHO Global Emergency and Trauma Care Initiative is to save millions of lives over the next five years through improvements to emergency care systems. Its aims are two-fold: to rapidly increase capacities to provide quality emergency care in countries around the world, and to foster awareness through a global advocacy campaign about its potential to save lives.
In an initial phase, WHO and partners will support 10 low- and middle-income countries to assess their national emergency care systems, identify any shortcomings and implement proven interventions to address these gaps. Activities at the national level include the development of national plans and key policies, such as laws addressing the role of bystanders and access to care without regard to ability to pay; and implementation of WHO standards addressing the way emergency care systems are organized and resourced.
WHO and partners will also facilitate low-cost improvements in the way that emergency care is delivered. These include implementing triage and WHO checklists that ensure a systematic approach to the care of every patient. In addition, frontline providers will be trained through WHO-ICRC Basic Emergency Care and other courses. The initiative will support systematic data collection on acutely ill and injured people and how their conditions are managed, including via the WHO International Registry for Trauma and Emergency Care.
The launch of this initiative is made possible through a CHF 10 million grant from the AO Foundation, which promotes excellence in patient care through a network of thousands of practitioners in 100 countries. It is one of a number of partners poised to contribute to the WHO Global Emergency and Trauma Care Initiative, including others in the WHO Global Alliance for Care of the Injured. This work executes the mandate established by the World Health Assembly resolution WHA 60.22 on emergency-care systems.
WHO Global Emergency and Trauma Care Initiative https://www.who.int/emergencycare/en/
WHO Trauma Care Checklist https://www.who.int/emergencycare/trauma-care-checklist-launch/en/
WHO-ICRC Basic Emergency Care (BEC): Approach to the acutely ill and injured https://www.who.int/emergencycare/publications/Basic-Emergency-Care/en/
WHO International Registry for Emergency and Trauma Care https://www.who.int/emergencycare/irtec/en/
WHO Global Alliance for Care of the Injured https://www.who.int/emergencycare/gaci/en/
World Health Assembly Resolution WHA 60.22 http://apps.who.int/gb/ebwha/pdf_files/WHASSA_WHA60-Rec1/E/reso-60-en.pdf?ua=1
7 DECEMBER 2018 | Geneva, Switzerland – A new report by the World Health Organization (WHO) indicates road traffic deaths continue to rise, with an annual 1.35 million fatalities. The WHO Global status report on road safety 2018 highlights that road traffic injuries are now the leading killer of children and young people aged 5-29 years.
“These deaths are an unacceptable price to pay for mobility,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “There is no excuse for inaction. This is a problem with proven solutions. This report is a call for governments and partners to take much greater action to implement these measures.”
The WHO Global status report on road safety 2018 documents that despite an increase in the overall number of deaths, the rates of death relative to the size of the world population have stabilized in recent years. This suggests that existing road safety efforts in some middle- and high-income countries have mitigated the situation.
“Road safety is an issue that does not receive anywhere near the attention it deserves – and it really is one of our great opportunities to save lives around the world,” said Michael R Bloomberg, Founder and CEO of Bloomberg Philanthropies and WHO Global Ambassador for Noncommunicable Diseases and Injuries. “We know which interventions work. Strong policies and enforcement, smart road design, and powerful public awareness campaigns can save millions of lives over the coming decades.”
In the settings where progress has been made, it is largely attributed to better legislation around key risks such as speeding, drinking and driving, and failing to use seat-belts, motorcycle helmets and child restraints; safer infrastructure like sidewalks and dedicated lanes for cyclists and motorcyclists; improved vehicle standards such as those that mandate electronic stability control and advanced braking; and enhanced post-crash care.
The report documents that these measures have contributed to reductions in road traffic deaths in 48 middle- and high-income countries. However, not a single low-income country has demonstrated a reduction in overall deaths, in large part because these measures are lacking.
In fact, the risk of a road traffic death remains three times higher in low-income countries than in high-income countries. The rates are highest in Africa (26.6 per 100 000 population) and lowest in Europe (9.3 per 100 000 population). On the other hand, since the previous edition of the report, three regions of the world have reported a decline in road traffic death rates: Americas
, Europe and the Western Pacific.
Variations in road traffic deaths are also reflected by
of road user. Globally, pedestrians and cyclists account for 26% of all road traffic deaths, with that figure as high as 44% in Africa and 36% in the Eastern Mediterranean. Motorcycle riders and passengers account for 28% of all road traffic deaths, but the proportion is higher in some regions, e.g. 43% in South-East Asia and 36% in the Western Pacific.
Global status report on road safety 2018 http://www.who.int/violence_injury_prevention/road_safety_status/2018/en
WHO fact sheet on road traffic injuries http://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries
WHO website on road traffic injuries http://www.who.int/violence_injury_prevention/road_traffic/en/
Experts gather to exchange knowledge to scale up lifesaving violence and injury prevention efforts
5 NOVEMBER 2018 | Bangkok, Thailand – Violence and injuries take the lives of more than 13000 people around the world each day. In an effort to prevent them, experts gather for Safety 2018 to share the latest evidence and experiences from programmes which have demonstrated success in saving lives.
Injuries caused by violence, road traffic crashes, falls, drowning, burns and poisoning, among others, kill nearly 5 million people every year, accounting for 9% of the world’s deaths. These and other injury-related causes are among the many topics addressed by Safety 2018 under the theme “Advancing violence and injury prevention to achieve the Sustainable Development Goals (SDGs)”.
Globally, of injury-related deaths, 29% are due to road traffic crashes; 16% from suicide; 13% from falls; 10% from homicide; and 7% from drowning. Around 4% of injury-related deaths result from war and conflict. Violence and injuries affect people of all ages, but most often impact young people and those in their prime working years. For young adults 15-29 years of age, the top three causes of death are injury-related: road traffic injuries, suicide and homicide. Beyond deaths, tens of millions of people suffer injuries that lead to hospitalization, emergency department visits, and treatment by general practitioners. Many are left with temporary or permanent disabilities.
“Urgent action is needed to avoid this unnecessary suffering of millions of families every year,” notes Dr Etienne Krug, Director of the WHO Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention. “We know what needs to be done. Safety 2018 provides an opportunity for the world’s leading violence and injury prevention researchers, practitioners and advocates to share successful strategies which if scaled up across countries could save lives.”
Preventing violence and injuries will further attainment of the SDGs and WHO’s General Programme of Work (GPW) 2019-2023. A number of SDG targets relate specifically to violence and injuries, including targets 3.6 to cut road traffic deaths by 50% by 2020; target 5.2 to end violence against women and girls; target 11.2 to provide safe and sustainable transport, and target 16.2 to end violence against children. Targets on violence prevention and road safety are also included in WHO’s GPW.
Effective strategies to prevent violence and injuries are reflected in three technical packages produced by WHO and partners in recent years, among them INSPIRE: seven strategies for ending violence against children; SaveLIVES: a road safety technical package and Preventing drowning: an implementation guide. These tools are intended to guide governments and civil society organizations on how to put in place what works.
Among effective strategies to prevent violence and injuries include setting and enforcing laws on a range of issues from speeding and smoke detectors to hot water tap temperatures and window guards; reducing the availability and harmful use of alcohol; limiting access to firearms, knives, pesticides and certain medications to prevent suicide; implementing vehicle and safety equipment standards; installing barriers controlling access to water, including wells and swimming pools; and improving emergency trauma care. These are all strategies where both national and local government officials from across multiple sectors can play a role.
In the context of Safety 2018, WHO is also launching two new tools: the WHO International Registry for Trauma and Emergency Care and the Basic Emergency Care course, which will support countries to better understand the challenges they face in responding to those who have been injured and to train those who care for them.
Safety 2018 http://www.worldsafety2018.org/
WHO violence and injury prevention http://www.who.int/violence_injury_prevention/en/
INSPIRE: seven strategies for ending violence against children http://www.who.int/violence_injury_prevention/violence/inspire-package/en/
SaveLIVES: a road safety technical package http://www.who.int/violence_injury_prevention/publications/road_traffic/save-lives-package/en/
Preventing drowning: an implementation guide http://www.who.int/violence_injury_prevention/drowning/drowning_prevention_guide/en
WHO International Registry for Trauma and Emergency Care http://www.who.int/emergencycare/en/
WHO Basic Emergency Care Course http://www.who.int/emergencycare/en/
PEP consists of the following steps:
- All bite wounds and scratches should be attended to as soon as possible after the exposure; thorough
washing and flushing of the wound for approximately 15 minutes, with soap or detergent and copious
amounts of water, is required. Where available, an iodine-containing, or similarly viricidal, topical
preparation should be applied to the wound.
- RIG should be administered for severe category III exposures. Wounds that require suturing should be
sutured loosely and only after RIG infiltration into the wound.
- A series of rabies vaccine injections should be administered promptly after an exposure.
- Up to 50% of true knee dislocations will spontaneously reduce prior to arrival. Be suspicious of a dislocation in any patient who describes the joint moving out of place or if they have significant swelling, joint effusion or ecchymosis despite normal X-rays
- In all patients with suspected dislocation, perform a neurovascular exam immediately as popliteal artery injury is common. If they’ve got an absent Dorsalis Pedis or Posterior Tibial pulse, reduce immediately and get a CT angiogram as quickly as possible to assess for popliteal injuries
- If distal pulses are intact, you can either do Ankle Brachial Indices (ABIs) and if normal, observe and repeat them or get a CT Angiogram (CTA). If the ABI is abnormal or the patient had an absent or decreased pulse at any point, get the CTA
Every 6 days a woman is killed at the hands of her partner. Victims of intimate partner violence and domestic violence that we see in the ED typically involve an abuse story of repeated escalating violence over time that ends up in a crisis situation.
Universal Screening for Intimate Partner Violence
Start with a normalizing statement
“Because violence is so common in many women’s lives and because there’s help available for women being abused, I now ask every patient about domestic violence.”
The Partner Violence Screen
- Have you been hit, kicked, slapped, punched or otherwise hurt by someone in the past year?
- Do you feel safe in your current relationship?
- Is there a partner from a previous relationship who is making you feel unsafe now?