Global health, global surgery and mass casualties: II. Mass casualty centre resources, equipment and implementation

Aguilera S.; Quintana L.; Khan T.; Garcia R.; Shoman H.; Caddell L.; Latifi R.; Park K.B.; Garcia P.; Dempsey R.; Rosenfeld J.V.; Scurlock C.; Crisp N.; Samad L.; Smith M.; Lippa L.; Jooma R.; Andrews R.J. · BMJ Global Health (2020) · DOI: 10.1136/bmjgh-2019-001945

Resumen

Trauma/stroke centres optimise acute 24/7/365 surgical/critical care in high-income countries (HICs). Concepts from low-income and middle-income countries (LMICs) offer additional cost-effective healthcare strategies for limited-resource settings when combined with the trauma/stroke centre concept. Mass casualty centres (MCCs) integrate resources for both routine and emergency care - from prevention to acute care to rehabilitation. Integration of the various healthcare systems - governmental, non-governmental and military - is key to avoid both duplication and gaps. With input from LMIC and HIC personnel of various backgrounds - trauma and subspecialty surgery, nursing, information technology and telemedicine, and healthcare administration - creative solutions to the challenges of expanding care (both daily and disaster) are developed. MCCs are evolving initially in Chile and Pakistan. Technologies for cost-effective healthcare in LMICs include smartphone apps (enhance prehospital care) to electronic data collection and analysis (quality improvement) to telemedicine and drones/robots (support of remote regions and resource optimisation during both daily care and disasters) to resilient, mobile medical/surgical facilities (eg, battery-operated CT scanners). The co-ordination of personnel (within LMICs, and between LMICs and HICs) and the integration of cost-effective advanced technology are features of MCCs. Providing quality, cost-effective care 24/7/365 to the 5 billion who lack it presently makes MCCs an appealing means to achieve the healthcare-related United Nations Sustainable Development Goals for 2030. © Author(s) (or their employer(s)) 2020.

Instituciones: Universidad Peruana Cayetano Heredia