Understanding the disaster profile of WHO-regions is crucial for anticipating future needs for mobilizing emergency medical teams and enhancing healthcare surge during disasters.

This study provides an overview of disaster profile and associated health needs globally and regionally.

Secondary data were retrieved from multiple open data sources. 50-year disaster trends were assessed. Global and regional disaster patterns, cumulative crude and standardized incidence and health impact for the last 16 years were calculated, and regional disparities were compared.

Climate-related disasters have significantly increased globally, especially floods and storms. They, along with droughts, lead to the highest humanitarian needs and displacement, increasing healthcare demands. Conflicts, notably in the Eastern-Mediterranean region, have also increased, causing substantial health impacts.

Epidemics caused the highest morbidity and earthquakes caused the highest mortality, especially in fragile and conflict-affected states (FCAS), where disaster frequencies per population are significantly higher than in non-FCAS. Storms and extreme temperatures also contribute significantly to disaster-mortality, especially in Southeast-Asia and Europe.

Africa experienced the highest number of disasters, while the Western-Pacific bore the highest crude health impact. However, Southeast-Asia, Eastern-Mediterranean, and African regions - where access to healthcare is limited- showed a higher disaster incidence rate and health impact per 100,000 population. Within regions, disparities are prominent, with some FCAS exhibiting exceptionally high disaster rates and impacts, exceeding regional and global averages.

Investment in regional and national emergency medical teams and equivalent rapid response capacities, adapting tailored strategies to regional disaster profiles, is urgently needed, especially for FCAS in Southeast-Asia, Eastern-Mediterranean, Africa regions.

The Ethiopian Emergency Medical Team (EMT) Strategic Plan (2024-2029) is critical to strengthen the nation’s capacity to respond to health emergencies. It provides a structured approach to developing a comprehensive, standardized, and resilient national EMT system that meets international standards.

To establish a robust framework for developing, maintaining, and enhancing a nationally coordinated EMT system. The plan aims to ensure that Ethiopia is well-prepared to respond to health emergencies timely, efficiently, and effectively at national, continental, and global levels.

The strategic plan was developed through a collaborative process involving experts from various disciplines. A thorough situational analysis was conducted, assessing the strengths, weaknesses, opportunities, and threats of the current EMT system. This analysis was aligned with the institutional mission, vision, and values, as well as national and international humanitarian and health standards, regulations, and frameworks.

The strategic plan outlines six key initiatives to operationalize the EMT framework. These include establishing governance and leadership structures, enhancing stakeholder collaboration, implementing digital information and knowledge management systems, continuous capacity building for EMT members, strengthening operations and logistics support (OSL) systems, and ensuring standardization through the establishment of subnational EMTs. These initiatives are supported by actionable steps with a monitoring and evaluation mechanism to ensure effective implementation.

The EMT Strategic Plan for Ethiopia is a critical document setting foundation for a responsive and resilient EMT. By integrating governance, collaboration, technology, training, logistics, and quality assurance, Ethiopia aims to create a world-class EMT system dedicated to saving lives and alleviating suffering during public health emergencies.

The episodic nature of crises necessitates the right-siting of resources. By leveraging the capabilities of the private sector, the MOH can remain focused on its core functions without being encumbered by logistics management and manpower concerns.

In under 18 months, The Ministry of Health (MOH) of Singapore advanced the Singapore Emergency Medical Team (SGEMT) classification by adopting a whole-of-government and private sector collaborative approach.

In-depth appreciation of WHO EMT requirements and recognition of MOH own limitations, MOH tapped into the expertise of medical practitioners and incorporated insights from the Singapore Armed Forces and Singapore Civil Defence Force, who brought valuable experience from past humanitarian missions.

MOH made the strategic decision to outsource non-core functions such as warehousing, equipment maintenance, and ready-pool of technicians that can be rapidly mobilized. These functions were outsourced to a stringently selected service provider.

To complement these efforts, the MOH engaged in learning from regional partners, participating in study trips, and regional exercises. This ensured a comprehensive understanding of best practices from the EMT global community. Additionally, the MOH participated in regional disaster response framework, which includes the ASEAN EMT SOP.

The MOH’s foresight in partnering with the Ministry of Foreign Affairs has fortified the SGEMT’s global operational capabilities, ensuring support from Singapore’s diplomatic network worldwide when required.

This strategic alliance underscores Singapore’s dedication to global health security and exemplifies a proactive approach to emergency preparedness and response, demonstrating the nation’s readiness to tackle crises effectively.

This strategic alliance underscores Singapore’s dedication to global health security and exemplifies a proactive approach to emergency preparedness and response, demonstrating the nation’s readiness to tackle crises effectively.

Research was conducted to identify needs for policy and legislation changes aimed at creating enabling environment for the implementation of the Emergency Medical Teams (EMT) Regional Action Plan 2024-2030 (RAP) to be facilitated by the WHO Regional European EMT Capability Hub (REECH).

• Establishing commonalities and differences in EMT-related policy and legislation in countries representing different subregions of the WHO/Europe.

• Informing the RAP policy and legislation framework development.

An analysis of the legal and normative frameworks governing EMTs in the selected countries – Spain, the UK, Georgia, Kyrgyzstan. The study involves reviewing legislative documents, policy frameworks, and operational guidelines that regulate EMTs’ integration into national health systems and emergency response coordination mechanisms.

Common characteristics of national legislation and policy frameworks include clear legal mandates, integration with national health systems, and alignment with national health policies. Differences identified: EMT governance and subordination (e.g., health sector in Georgia and UK, civil protection domain in Spain and Kyrgyzstan); patterns of international collaboration (e.g., stronger engagement with EUCPM for Spain, WHO guidance and support for Kyrgyzstan and Georgia).

The WHO European region’s diversity informs different approaches to policies and legislation aimed at supporting RAP. Enablers include clear EMT mandates and their integration with national health systems and international mechanisms. However, routes to these enablers vary due to differences in policies, health system design, and legislation adoption procedures. Future research will include more countries and a detailed list of research questions to identify patterns in legislation and policy enablers for achievement of the Global EMT goals.

Persons with disabilities (PWD) in developing countries are particularly affected by climate change-related disasters.

To explore the health impacts of climate change-related natural disasters on persons with pre-existing physical and mental disabilities in developing countries.

The Joanna Briggs Institute evidence synthesis guideline was applied and results were reported following PRISMA guidelines. PubMed, PsycINFO, Scopus, and Embase databases were searched using terms related to ‘persons with disabilities,’ ‘climate change,’ and “developing countries.” The database search retrieved 406 articles, forty-two articles were eligible for full-text review and 14 met the inclusion criterion which were reviewed and thematic analysis was performed.

The 14 articles included 5 studies generalized across multiple countries and nine profiled specific developing countries. Five key themes were identified: impact on PWD physical health and mental health, resilience, and coping strategies of PWD in disasters, PWD involvement in inclusive disaster planning, and climate-change related natural disasters on PWDs in developing countries as a human rights issue.

Additional research is needed to better understand the negative health impacts of climate change-related natural disasters on persons with pre-existing physical and mental disabilities in developing countries. Contributing social and economic factors as well as facilitative coping and resilience strategies of the affected population in this context also require further study. Addressing these research gaps can inform development of effective, disability-inclusive disaster management practices which contribute to more equitable climate-change related health and rights-based outcomes for PWDs in developing countries. Resulting trauma can concomitantly result in increased acute demand for physical rehabilitation therapy services.

Extreme heat waves are a growing global health concern, with their frequency and intensity escalating due to climate change. Understanding past trends in heat wave impacts is crucial for informing effective mitigation and adaptation strategies.

This study aims to analyze the historical impact of extreme heat waves on global mortality and morbidity, identifying geographical and temporal trends to inform public health interventions.

We conducted a retrospective analysis using data from the Emergency Events Database. This comprehensive database provided records of heat wave events and associated mortality and morbidity data spanning recent decades. Statistical analysis was performed to identify trends and patterns in heat wave occurrences and their health impacts.

Our analysis reveals a concerning increase in both the frequency and severity of extreme heat waves globally. This trend corresponds with a significant rise in heat-related mortality and morbidity, particularly in regions with limited adaptive capacity and among vulnerable populations such as the elderly and those with pre-existing health conditions.

The findings underscore the urgent need for proactive measures to mitigate the health risks posed by extreme heat. These include strengthening healthcare infrastructure to manage heat-related illnesses, developing effective early warning systems, and implementing community-based interventions to reduce heat exposure. This research provides a critical historical perspective on the growing threat of extreme heat, emphasizing the importance of global cooperation and immediate action to protect populations from this escalating public health challenge.

The role of rehabilitation in EMTs remains unclear. Due to this and reasons related to inadequate initial planning, the role of rehabilitation professions in emergencies is understated. Further, there is no one-size-fits-all approach to rehabilitation in emergencies.

The IFRC Rehabilitation Technical Working Group proposes solutions to address these challenges.

There are three main challenges for EMTs to deliver rehabilitation in emergency settings. Firstly, a universal definition of ‘rehabilitation’ remains absent. Secondly, advocacy to integrate rehabilitation into EMTs is often not enough to ensure success. Thirdly, various rehabilitation needs may not match current offerings in EMTs.

First, ‘rehabilitation’ must be defined based on its impact, interventions, and goals to encompass both specialized services and services integrated into the wider health system and a universal definition which creates wider understanding must follow. Second, the end recipients of rehabilitation service delivery prior, during or following emergencies, should be clearly accounted for at the outset of emergencies. Planning exit strategies post-emergencies involves choosing the appropriate iteration of rehabilitation in the local context that is socially acceptable and sustainable. Examples include modularization of rehabilitation services outside of traditional field hospitals, and extending services beyond traditional time frames.

The role of rehabilitation in EMTs is often overlooked due to three key challenges which may be addressed through clearly defining rehabilitation and its role in EMTs, adequately preparing for sustainable post-emergency rehabilitation handovers in local contexts and creating and delivering various rehabilitation offerings within EMTs. Research should explore the effect of these potential solutions in emergency settings.

The Korea Disaster Relief Team (KDRT) plays a crucial role in international humanitarian assistance and disaster relief. Effective administration and organizational management are vital for the success.

This study compares KDRT’s administration and organizational management with other emergency medical teams (EMTs) through a comprehensive literature review, ultimately providing recommendations to strengthen KDRT’s framework.

Using PRISMA methodology, a comprehensive literature search was conducted across major databases including PubMed, EMBASE, Cochrane Library based on their relevance to EMT initiatives, administration and organizational management, and disaster response strategies. Articles were analyzed to identify governance structures, defined roles and responsibilities, and regular organizational evaluations with SWOT analysis.

Out of 20,343 articles, 18 were selected. The review identified key aspects of effective administration and organizational management in EMTs, including clear governance structures, well-defined roles, and continuous evaluations. For articles not included in the KDRT system, the SWOT analysis revealed strengths such as local knowledge (Japan), strong frameworks (USA), and clear funding strategies (Finland). Weaknesses included limited scalability (Japan), bureaucratic delays (USA), and funding limitations (Finland). Opportunities were found in community engagement (Japan), streamlined processes (USA), and increased donor engagement (Finland), while threats included policy misalignment (Japan), administrative burdens (USA), and financial instability (Finland).

This study highlights the need to reinforce KDRT’s administration and organizational management to improve its disaster response efficiency. Recommendations include improving resource allocation, integrating local knowledge, simplifying processes, diversifying funding, and enhancing transparency. By addressing these areas, KDRT can enhance its capability to provide effective humanitarian assistance and disaster relief internationally.

This study is a scoping review to identify literature pertinent to the question: “What are the criteria for deployment of the United States National Guard (USNG) to domestic sudden-onset natural disasters (SODs)?” As this question relies on factors across many disciplines—legal, medical, technical, cultural—and as there is no foundational body of academic literature or unified governmental or USNG policy addressing this question, a scoping review was designed to identify the body of literature on which further research and policy decisions surrounding this question may be based.

To perform a scoping review identifying the criteria for the deployment of the United States National Guard (USNG) to domestic sudden-onset natural disasters to identify the body of literature on which further research and policy decisions may be based.

On January 23, 2023 a modified PRISMA-ScR search was performed using an online search engine of the following databases: Academic Search Premier, Google Scholar, JSTOR, PubMed, Web of Science, and WorldCat. The inclusion criteria included the involvement of the USNG response to U.S. domestic SOD. Non-SOD results were excluded. Results from all years and of any type of literature were considered and were limited to the English language. First, titles and abstracts were screened by 2 independent reviewers. Then, a full-text review was performed by 2 independent reviewers. Finally, data were extracted from included texts by 2 independent reviewers. A third reviewer resolved any discrepancies at each stage. This study did not require approval of an institutional review board.

Out of the 886 results identified by the original search, after the complete review process, 34 sources were relevant to the research question. Fifteen criteria for the deployment of the USNG to SODs were identified. Overwhelmed local responders, utility failure, the need for the provision of security, and the need for logistical coordination were the most commonly identified criteria. Hurricanes were the most common SOD addressed in the included literature, and most results were event reports.

This modified PRISMA-ScR identified a foundation on which elected officials, USNG leadership, and the larger disaster response community may develop policies and disaster response plans to optimize available resources through the activation of the USNG when responding to SODs.

Disaster Medical Assistance Teams (DMATs) are essential during emergencies. To optimize efficiency and readiness, the Saudi DMAT established comprehensive Standard Operating Procedures (SoPs) so that it could pursue with vigorous implementation the goals outlined in Saudi Vision 2030 and the Ministry of Health’s strategic plans. These operational models, incident management systems, and procedures govern team deployment, operations, and demobilization in disaster response settings.

This paper discusses the development and implementation of new standardized protocols for DMATs in Saudi Arabia, highlighting challenges, strategic decisions, and enhancements in team preparedness and performance.

The S-DMAT SoPs were developed through a detailed review of international standards and best practices, tailored to Saudi Arabia’s specific needs. Stakeholder consultations, iterative revisions, and pilot testing ensured the medical response teams are knowledgeable and ready for efficient, timely, and resource-adequate deployment.

The standardized protocols significantly improved S-DMATs’ readiness and operational performance. Enhanced coordination with local and international agencies, better resource allocation, and effective incident management were achieved. The SoPs provided a structured approach to deployment, triage, and patient care, ensuring high-quality medical assistance in critical situations. Evaluations showed that S-DMAT consistently met or exceeded key performance indicators, demonstrating quick mobilization and efficient execution.

Establishing standardized SoPs for S-DMAT has been pivotal in advancing disaster response in Saudi Arabia. The protocol development process emphasizes maintaining relevant training, meticulous review, and flexibility in disaster preparedness. These results offer valuable insights for future improvements to DMAT protocols and contribute to global best practices in disaster medical response.

The requirement for timely, agile, effective, and scalable local EMT response is well demonstrated in disasters and complex emergencies. Given ongoing climate and geopolitical challenges, potential for civil conflict, and the stress on prehospital and health systems post COVID; it is imperative that we ensure local EMTs are appropriately trained and prepared. In recent years a focus for WHO has been to build strong national disaster medical responses, through developing national standards, and embracing community readiness and resilience. Early local disaster medical responses, is considered most important in major emergencies.

Review capacity and standards for Victorian Medical Assistance Teams (VMAT’s) within national and global contexts

We undertook a review of a State based jurisdictional EMT the Victorian Medical Assistance Teams (VMAT) to assess the current state of cache, staffing, training, and exercising via stakeholder surveys and onsite visits. In addition, we undertook a literature review including, Medline search, local and international policies, standards and reviewed best practice international and national exemplar EMTs.

In the post pandemic recovery phase, the local Emergency Medical teams have had substantial pressures that negatively impacted training and exercising, and were compounded by staff turnover, maintenance of equipment cache and deployment challenges.

Due to post pandemic pressures, we note the significant challenges to EMTs. As a result of our review, we have formed a local EMT working group to look at outcomes for consideration of number and placement of teams in order to facilitate best practice in team and kit management, rapid mobilization, training and exercising.

Historically, medical response efforts to large-scale disaster events have highlighted significant variability in the capabilities of responding medical providers and emergency medical teams (EMTs). Analysis of the 2010 Haiti earthquake response found that a number of medical teams were poorly prepared, inexperienced, or lacked the competencies to provide the level of medical care required, highlighting the need for medical team standards.

The World Health Organization (WHO) EMT initiative that followed created minimum team standards for responding international EMTs to improve the quality and timeliness of medical services. At the present time however, there remains a lack of globally recognized minimum competency standards at the level of the individual disaster medical responder, allowing for continued variability in patient care.

This study examines existing competencies for physicians, nurses, and paramedics who are members of deployable disaster response teams.

A scoping review of published English-language articles on existing competencies for physicians, nurses, and paramedics who are members of deployable disaster response teams was performed in Ovid MEDLINE, Ovid Embase, CINAHL, Scopus, and Web of Science Core Collection. A total of 3,474 articles will be reviewed.

Data to be analyzed by October 1, 2024.

There is a need to develop minimum standards for healthcare providers on disaster response teams. Identification of key existing competencies for disaster responders will provide the foundation for the creation of globally recognized minimum competency standards for individuals seeking to join an EMT in the future and will guide training and curricula development.

The PT EMT plays a crucial role in emergency assistance during disasters, outbreaks, and mass gatherings, alleviating pressure on hospital emergency departments and supporting local health systems. The EMT Initiative ensures that health services provided in emergencies are safe, timely, equitable, and efficient. This initiative supports the deployment of teams and the development of structures necessary to deliver quality health services in host countries.

Benchmarking for EMT development and deployment to ensure consistent and quality clinical governance and preparedness.

Analysis of clinical management and supply chain practices based on PT EMT’s experience.

To enhance clinical performance, the Portuguese team supplemented WHO’s Minimum Standards by developing 25 clinical guides. These guides help in precise assessment of clinical consumables, ensuring the module’s self-reliance and reducing material wastage. They also facilitate the preparation of cargo manifests and optimize the packaging and transport of clinical supplies, adhering to safety standards.

Using WHO’s Essential Medicines List and considering potential deployments in Portuguese-speaking countries, the PT EMT established a robust inventory of essential clinical consumables. This inventory ensures authorized entry into host countries and continuity of care post-deployment. The organization of clinical supplies into three kits allows for autonomous care for up to 15 days, supporting 100 patients daily. This preparedness was recognized and integrated into WHO’s revised Bluebook in 2021.

Since 2019, this approach has been tested and refined at major events like Fatima’s mass gathering and World Youth Day 2023, demonstrating increased operational efficiency and sustained emergency response capabilities for the PT EMT.

The role of Mental Health and Psychosocial Support (MHPSS) in EMTs is crucial, especially during emergencies and disasters, which elevate mental health risks. According to the WHO, timely MHPSS interventions can reduce these risks, promote recovery, and enhance resilience. In the PT EMT, psychologists support the EMT team’s stability and functionality and intervene with patients or affected populations as needed. Their interventions include managing complex emotional situations, providing psychoeducation, and assisting in grief processes and referrals.

Reflect on the importance of MHPSS in EMT deployments, analyzing psychologists’ interventions and key lessons learnt.

Integrative literature review and PT EMT cases study.

The literature review emphasizes the importance of early psychological intervention during disasters, outbreaks, and complex emergencies. In PT EMT’s experience, nine psychologists, trained through the Disaster Response Core Training Course, have been deployed in seven missions. Their work highlights the need for psychologists in EMT deployments to ensure team well-being and effective patient care.

Considering this, a clinical guide for psychological intervention in disaster situations is being developed. INEM’s Psychologists are also advancing psychological first aid training for health professionals and providing advanced training for psychologists in emergency intervention. This initiative was vital during events such as World Youth Day 2023, a mass gathering event.

The experience in the PT EMT, allow us to recommend the Psychologists’ enrolment in the EMT deployments. This inclusion has shown significant benefits, reinforcing the need for ongoing training and the development of best practices for psychological support in disaster response.

RRMLs provide critical laboratory diagnostic support in crisis situations and are an important asset of the global health emergency workforce as part of the Global Outbreak Alert and Response Network (GOARN) global strategic group for Diagnostic Surge Capacities (DiSC). Minimum Operational Standards and a Typology (MOST) for RRMLs were designed to provide rapid and quality operational response tailored to the needs of affected communities, and to integrate RRMLs into existing coordination and response structures in emergencies.

An Interregional Field Simulation Exercise (IFX) Program was launched to assess applicability, feasibility, and comprehensiveness of MOST standards. The program also aimed to define recommendations aimed at strengthening coordination and interoperability of RRMLs with a wide range of operational partners.

Expanding upon an initial table-top exercise in Germany (May 2023), two full-scale field exercises of increasing complexity were conducted in Türkiye (June 2023) and Georgia (February 2024) uniting over 200 partners from all WHO regions. This collaborative effort has informed the finalization of the MOST, the update of the RRML typology.

As a result of the IFX implementation a comprehensive and applicable set of standards was agreed and endorsed by the RRML community of practice, supporting both a quality response and seamless integration of RRMLs into operations of the global health emergency corps.

This study underlines the benefit of field simulation exercises for the development of standards aimed at strengthening quality response, interoperability, and coordination in complex humanitarian settings through testing them in realistic and safe environment by a wide range of operational partners.

The Australian Medical Assistance Team (AUSMAT), a Type 2 Emergency Medical Team launched a project to ensure its surgical cache remains perpetually deployment ready for response to sudden-onset disasters and other health emergencies.

The objectives of this project included: inventory accuracy, compliance with standards, expiry date management, procurement and replenishment, functionality and condition, quality assurance, education and training, workforce review and budget compliance.

Two AUSMAT perioperative specialist nurses for a period of 8 months were appointed to critically audit the surgical cache through all phases of the perioperative environment with a major focus on the World Health Organization (WHO) Classification and Minimum Standards for Emergency Medical Teams and Australian Sterilizing Standards - AS5369:2023. The specialist nurses engaged with key stakeholders such as the AUSMAT Surgical Working Group and the AUSMAT Preparedness and Response Team. Furthermore, an online AUSMAT nursing workforce survey and review were completed.

The project involved detailed planning, development, and implementation, resulting in strategic recommendations for continuous quality improvement processes. Key outcomes included operational efficiency and an enhanced surgical educational program. Financial gains were realized through scrutiny of surgical equipment and rationalizing purchases while maintaining WHO EMT Type 2 verification status.

The project outcome includes strategic recommendations for continuous quality improvement processes and highlights the potential for further developing the AUSMAT Surgical Course. This initiative ensures operational efficiency and strengthens AUSMAT capacity to respond effectively to health emergencies.

Detention facilities, particularly in conflict settings, pose significant challenges for healthcare provision. These facilities, housing detainees, prisoners of war, or others in custody, often suffer from overcrowding, poor sanitation, and inadequate access to medical care. Unfortunately, medical planning within these environments is frequently insufficient.

The objectives are to (i) enhance medical planning in detention facilities within conflict settings (ii) support evidence-based definitions of care standards; (iii) identify the essential skills and competencies required by personnel to deliver optimal care in these constrained environments.

A mix-method approach will be employed in two phases: (i) a desk review to thoroughly understand current medical planning and standards of care in conflict-related detention facilities and (ii) Focus Group Discussions (FGDs) with experts and stakeholders working in this field. Method triangulation will be utilized to strengthen data analysis.

Preliminary analysis shows gaps and inequality in health services provided to detainees in conflict settings, most of the time even neglected. Detention facilities must be included in plans for mass casualties, mass gathering and outbreak of infectious diseases, and strengthen the capacity, capability, collaboration and coordination between local authorities and medical teams working in these facilities.

Addressing health gaps in detention facilities requires a multidisciplinary and collaborative approach. The lack of inclusion of detention facilities when planning health responses in conflict settings, challenges coordination and collaboration between medical teams with local authorities and organizations working in these facilities compromising access to quality care for detainees.

While balanced blood component therapy (BCT) is pivotal in trauma patient damage control resuscitation in well-resourced settings, disasters and mass casualty incidents (MCIs) pose significant challenges, especially in securing sufficient access to blood products. In this context, fresh whole blood (FWB) could be a feasible and rapidly available alternative to BCT for life-threatening hemorrhages.

This systematic review and meta-analysis aim to explore the utilization of fresh whole blood (FWB) transfusion as a potential alternative to BCT, informing future research and clinical strategies.

We searched PubMed, MEDLINE, Embase, CINAHL, the Cochrane Library and grey literature for articles identifying FWB transfusions. We evaluated the outcomes of post-FWB transfusion and conducted a meta-analysis comparing overall mortality in patients receiving FWB in addition to BCT during damage control resuscitation with those receiving BCT or single blood components alone.

Of the 4830 studies identified, only 74 articles met all the eligibility criteria; the majority of them were conducted in military contexts. Mortality outcomes did not differ between FWB vs BCT alone group, with a pooled OR of 0.61 (95% CI: 0.38 – 0.98) overall, and a pooled OR of 0.47 (95% CI: 0.25 – 0.87) after adjusting for confounders. FWB transfusion related complications rarely occurred.

While FWB shows potential as an alternative to BCT for managing severe hemorrhagic shock in disasters and MCIs, additional research is essential to validate FWB’s efficacy before considering it as a standard approach in civilian scenarios. Further studies focusing on the feasibility of implementing FWB in civilian contexts are also warranted.

In mass casualty incidents, patients with apparent hemodynamic and respiratory stability might have occult life-threatening injuries. These patients could benefit from more accurate evaluations to be sorted into triage categories for the purpose of treatment and priority transport decisions.

This study assessed the impact of point-of-care ultrasound (POCUS) on the accuracy of secondary triage conducted at an advanced medical post (AMP) to enhance the detection of patients who, despite their apparent clinically stable condition, had simulated occult life-threatening injuries.

To determine if a WHO EMT could potentially benefit from the utilization of POCUS to guide lifesaving interventions and priority transport decisions.

A mass casualty simulated incident consisting of a bomb blast in a remote area was conducted with 10 simulated casualties classified as YELLOW, delayed transport per Simple Triage and Rapid Treatment (START), at the primary triage scene.

Patients were evaluated by 4 physicians at an AMP. Three patients had, respectively, hemoperitoneum, pneumothorax, and hemothorax. All physicians were competent in the use of POCUS to assess trauma patients. Two of the four physicians were provided the use of POCUS.

All 4 physicians were able to suspect hemoperitoneum, but only physicians utilizing POCUS detected pneumothorax and hemothorax.

This study suggests that POCUS-enhanced secondary MCI triage at an AMP may represent an effective methodology to accurately detect non-apparent injuries that require life-saving interventions or priority transport. Further studies with larger samples conducted in varied MCI scenarios are warranted to provide the support for the WHO EMT to adopt POCUS as triage tool.