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Alice Harvey, BSc, MSc, MCSP
Handicap International
The UK International
Emergency Trauma Register
The incorporation of
rehabilitation professionals
Overview
Background to why rehabilitation is essential in sudden
onset disasters / conflict
Introduction to the UK International Emergency Trauma
Register
Setting the scene for later session on BACPAR
involvement and Gaza deployment
Rehabilitation In Emergencies
Importance of rehabilitation
in emergencies
Prevent and minimise
impairment
Address co-morbidities
Teach essential self-
management for
discharge
Ensure long term follow
up looking at disability
NOT just impairment.
Who provides rehabilitation in
response to conflict and
catastrophe?
Depends on existing national rehab framework
(governmental, private, DPOs)
Existing structures may need support due to
structural/staff loss and overwhelmed services
May be scarce or no rehab services pre existing
Rehab focussed INGOs/NGOs
More frequently as part of INGOs with a broader focus
Capacity building should be a focus
Main injuries requiring
rehabilitation
Amputations
Fractures and dislocations
Spinal cord injuries
Traumatic nerve injuries
Burns and significant soft tissue injuries
+ Second wave of increased NCDs, neuro developmental,
infections etc.
Positioning and early
mobilisation
Early mobilisation speeds
recovery and discharge and
reduces complications
Avoid contractures and
potentially lethal pressure sores
Identifies complications
Essential emergency
rehabilitation
Range of motion and strengthening
Essential emergency
rehabilitation
Mobility and positioning devices
Preparation for prosthetic
limb fitting
Essential emergency
rehabilitation
Pain management
Patient education
Psychosocial support
Holistic thinking
Essential emergency
rehabilitation
Continuity into the
community
Why?
“Rehabilitation specialist support embedded within the team can offer
triage and peri-operative advice as well as rehabilitation post surgery,
and have been shown to reduce length of stay.”
(Norton et al 2013)
“Surgery provided without any immediate rehabilitation can result in a
complete failure in restoring functional capacities of the patient.”
“Early rehabilitation can greatly increase survival and enhance the
quality of life for injured survivors.”
(Sphere 2011)
Rehabilitation in Haiti
Earthquake: just some of the
issues
Overwhelmed and weak rehab
network
Quantity and experience of rehab
providers who arrived
Equipment under availability/over
availability (and quality)
Co-ordination
Need to build capacity
Sustainability of programmes
Rehabilitation in Catastrophe:
Haiti Earthquake
‘4 months after the
earthquake more than half
patients accessing rehab
services were not
earthquake related’
Background of this project
Goal: The integration of a minimum
of 30 trained experienced
rehabilitation professionals into an
emergency roster for rapid
deployment to natural disasters
Rationale: Rehabilitation realities in
emergencies.
Evidence base and guidelines.
Reducing impairment and disability.
Handicap International and
the UKIETR
Handicap International and the
UKIETR
Technical training to rehab staff on the register
Supervision to rehab staff deployed with register
Rehab and disability input into surgical platform
development and other trainings
Rehab Project Manager currently deploys in initial phase
deployments.
Link other field teams to the UK-EMT to support
discharge planning, with a focus on long term care and
rehab.
Progress so far
60 PTs and OTs (13%) registered with UK IETR
Rehab Project Manager in initial deployments to
Philippines and Gaza
Three multidisciplinary teams deployed to Gaza
Initial core training conducted, 20 trained
Further trainings Nov/Dec 2014
Special interest groups involved in developing highly
specialised face to face and on line trainings
Progress so far
Progress so far
Training opportunities
Essential UK Med Pre-deployment course
Opportunity to take part in ‘under canvas’ course
3 day highly specialised core rehab training
E-learning modules
1 day specialised top up trainings
• Amputation
• PNI and splinting
• SCI
Who should join the register?
Anyone with HCPC registration can join the register
Particularly
Looking for broad Brush acute skills, ideally across Paeds and
Adults
Or Clinical Specialists to deliver highly specialised training in
appropriate fields – including BACPAR!
Minimum 4 years clinical experience
Demonstrable experience of working in a high pressure
environment
Experience of working abroad an advantage
Must have attended core rehab and pre-departure
trainings in order to deploy.
What are the commitments?
Willing to commit to attending free trainings offered in
your own time at your own cost.
To be available to be deployed at short notice
To be willing to travel to insecure environments
Willing to work exceptionally long hours with little or no
break
What are the benefits for your
employer?
Free specialist clinical training or staff
Staff learn advanced management and coping strategies
Cross cultural experience for staff
Positive media exposure for the organisation
Posts are funded by DfID while on deployment
What now?
Register with UK Med to join the UK IETR
www.uk-med.org to re
Further queries:
Pete Skelton, Rehab Programme Manager
Alice Harvey [email protected]
Handicap International UK
www.handicap-international.org.uk
