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

peter.skelton@hi-uk.org

Alice Harvey aliharvey99@hotmail.com

Handicap International UK

www.handicap-international.org.uk