72nd World Health Assembly adopts resolution on emergency and trauma care

Delegates to the 72nd World Health Assembly have adopted a resolution on emergency and trauma care aimed at helping countries to ensure timely care for the acutely ill and injured. It is estimated that more than half of deaths in low- and middle-income countries result from conditions that could be treated with prehospital and emergency care, including injuries; infections; acute exacerbations of cancer, diabetes and other noncommunicable diseases; and complications of pregnancy. Effective emergency care systems save lives.

During the discussions, 22 Member States spoke in support of the resolution, which was tabled by the Governments of Ethiopia and Eswatini and co-sponsored by over 30 countries. In their remarks, they praised the sponsoring countries for bringing attention to this area, committed to the recommended actions and requested near-term WHO support for specific activities, including: training for all cadres of health workers, system- and facility-level assessments, implementing standards for essential equipment and processes at each level of the health system, and data collection and quality improvement. They also emphasized the importance of fully integrating emergency care into ongoing universal health coverage planning processes.

“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. All people around the world should have access to the timely, life-saving care they deserve.”

Recent studies have ranked components of emergency care as among the most cost-effective public health interventions. Strengthening prehospital care by training community-based providers and using staffed community ambulances has been estimated to cost less than US$ 100 per life saved, and has been shown to reduce mortality by 25-50% in some low- and middle-income country contexts.

The World Health Assembly resolution seeks to overcome some of the main challenges facing countries, including poor coordination of prehospital and facility-based care; limited or no coverage of prehospital systems, especially in rural areas; shortage of fixed staff assigned to emergency units; lack of standards for clinical management and documentation; and insufficient funding. In addition, a lack of security for prehospital and facility-based emergency care staff remains a challenge in many countries.

The resolution suggests that all Member States, regardless of available resources, can take steps towards strengthening their emergency care systems. Recommended activities for Member States include creating policies to ensure universal access to emergency care for all; conducting a WHO emergency care system assessment to identify gaps and priorities for action; developing clinical protocols identified in the WHO Emergency Care Systems Framework; and providing emergency care training for all relevant health providers. The WHO Secretariat is invited to expand its technical support to Member States. 

In the coming years much of WHO’s support to Member States on emergency and trauma care will be provided through the Global Emergency and Trauma Care Initiative, launched with the AO Foundation in December 2018. The Initiative seeks to rapidly increase capacities to provide quality emergency care in countries and to foster awareness through a global advocacy campaign about its potential to save lives.  

Well-organized emergency care is a key mechanism for achieving a range of Sustainable Development Goal targets, including those on universal health coverage, road safety, maternal and child health, noncommunicable diseases, infectious diseases, disasters and violence. It also helps WHO to fulfill the mandate of its Thirteenth General Programme of Work 2019-2023 to strengthen health systems, widen coverage of essential health services and improve integrated service delivery.

WHO launches the Global Emergency and Trauma Care Initiative


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.

Related links

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

New WHO report highlights insufficient progress to tackle lack of safety on the world’s roads


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 type
 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.   

RELATED LINKS:   

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/    

SaveLIVES: a road safety technical package http://www.who.int/violence_injury_prevention/publications/road_traffic/save-lives-package/en/ 

Violence and injuries account for 1 in 11 deaths worldwide

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.

Related links

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/

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The Health Act 2017 – Emergency Care

 


 

Thank you for all the support in 2017. We look forward to providing you with even greater emergency care content in 2018. From all of us at the Emergency Medicine Kenya Foundation, HAPPY NEW YEAR!

And don’t’ forget…

 

The Health Act 2017 – Emergency Care