Understanding surge capacity needs and EMT response following disasters is pivotal to improve the capacities to provide appropriate healthcare to populations affected. Although some research has analyzed individual EMT deployments in response to disasters, a comprehensive review of deployments since the 2010 Haiti earthquake has not been undertaken yet.

This review aims to gather information on the deployment of EMTs used as surge capacity in the aftermath of various disasters since 2010, including information on the disasters that required mobilization of such capacities.

A scoping review methodology was followed. We conducted an electronic search during July until October 2023 to gather data on deployments from 2010-2023 using PubMed, Google Scholar, and other key websites.

We found around 80 disasters that triggered EMT response, involving more than 450 deployments. Epidemics were the most frequent disaster type triggering response and earthquakes were the disaster type causing the largest EMT mobilization to a single event. Meteorological disasters also triggered a significant number of deployments. Very few reports documented responses to conflicts. Most disasters triggering deployments were registered in the African and Western Pacific regions and few deployments were registered in the European region. The geographical distribution of EMT responses highlights imbalance between needs and capacities and underlines the need to invest in EMT development in certain regions.

Current available data on EMT deployments is insufficient and of low quality. Reporting and data sharing should be encouraged to enhance accountability and allow needs-based improvements within the EMT initiative.

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 use of diagnostic technology at the bedside is increasingly common in hospitals and is spreading to EMS.

To detect the contexts in which the use of point-of-care blood test and ultrasound is feasible and provides benefit in an EMT1 fixed.

Review of the procedures of the SAMUR-Protección Civil and the bibliography that supports them. Summary of the publications carried out by our group.

The basic blood analysis with blood gases, biochemistry and electrolytes allows to detect electrolyte disturbances secondary to gastrointestinal infection, diabetic decompensation, and others, to estimate the severity of a trauma patient that is not clearly unstable, to guide resuscitation in shock, to study the patient with chest pain, to assess organic involvement in infectious conditions, etc.

The use of ultrasound at the bedside has shown to be a great diagnostic aid in many pathologies: trauma (frequent in the context of a catastrophe), COVID-19 (detection of infiltrates), cardiorespiratory arrest (reversible causes), pulmonary embolism (high risk in people trapped), study of collections and abscesses, heart disease, etc. and it is useful for multiple techniques such as vascular cannulations (peripheral and central), orotracheal intubation, and drainage.

The ESP EMT1 SAMUR-PC is equipped with ultrasound and point-of care blood analysis, as well as our ALS units in Madrid.

The inclusion of ultrasound and blood tests among the diagnostic capabilities of an EMT1 fixed can improve the ability to detect serious pathology and guide initial treatment.

Emergencies and disasters are causing devastating impacts on populations around the world. Protecting health from emergencies and climate change and strengthening health systems are goals in the WHO’s thirteenth and fourteenth Global Program of Work (GPW 13 and GPW 14).

Robust scientific evidence is needed to inform effective policies and practices across emergency prevention, preparedness, response, and recovery. However, the conduct of the reliable research to produce this evidence has proven challenging before, during, and after emergencies and disasters.

To help meet these challenges, WHO established the Thematic Platform for Health Emergency and Disaster Risk Management Research Network (Health EDRM RN) in 2018, aiming to facilitate research collaboration and promote knowledge transfer including for EMTs. In 2021, the WHO Center for Health Development, the Health EDRM RN secretariat, led the development of the WHO Guidance on Research Methods for Health EDRM in a collaborative effort involving 164 experts from 30 countries.

The WHO Guidance on Research Methods for Health EDRM was expanded in 2022 with a chapter on research in the context of COVID-19 and in 2023 with a supplementary suite of online learning materials for education and training globally.

An executive summary for policy makers and program managers has recently been developed to enhance dissemination and strengthen research capacity building to advance health EDRM. Further collaboration is underway with regions and countries, academics, practitioners, and the public to generate new scientific evidence to protect health from the risks associated with all types of emergencies and disasters.

On February 6, 2023, a 7.8 earthquake hit Gaziantep, Türkiye, causing massive destruction, over 59,000 deaths, and displacing millions. EMT Aceh from Indonesia was deployed to provide medical aid.

This research aims to evaluate EMT Aceh’s disaster response during the 2023 Türkiye earthquake, identifying key successes and challenges. It offers recommendations for improving future responses and examines the importance of international collaboration, community acceptance, and government support in the effectiveness of foreign medical teams.

The study used an intrinsic descriptive case study method, including interviews with EMT members and thematic analysis of primary and secondary data.

Key findings show EMT Aceh’s success stemmed from strategic resource use, local collaboration, and public acceptance. Challenges included extreme climate and language barriers.

In conclusion, EMT Aceh’s experience underscores the importance of preparedness, collaboration, and adaptability in disaster response. Recommendations include improving communication skills, fostering teamwork, enhancing logistical preparedness, and promoting community engagement to ensure more efficient and effective responses in future disasters.

There is a lack of ethical triage and treatment guidelines for the entrapped and mangled extremity (E&ME) in resource scarce environments: mass casualty incidents, low- to middle- income countries, complex humanitarian emergencies including conflict, and prolonged transport times (RSE).

The aim of this study is to use a modified Delphi (mD) approach to produce statements to develop treatment guidelines of the E&ME in RSE to advance the 2021 WHO EMT Minimum Standards (EMT) treating the E&ME.

Experts rated their agreement with each statement on a 7- point linear numeric scale. Consensus amongst experts was defined as a standard deviation <= 1. Statements attaining consensus after the first round moved to the final report. Those not attaining consensus moved to the second round in which experts were shown the mean response of the expert panel and their own response for the opportunity to reconsider their rating for that round. Statements attaining consensus after the second round moved to the final report. This process repeated in the third round. Statements attaining consensus moved to the final report. The remaining statements did not attain consensus.

Seventy-seven experts participated in the first, 75 in the second, and 74 in the third round. Twenty-three statements attained consensus. Twenty-one statements did not attain consensus.

A Delphi technique was used to establish consensus regarding the numerous complex factors influencing treatment of the E&ME in RSEs. Twenty-three statements attained consensus and can be incorporated into guidelines to advance the EMT treating the E&ME.

Papua New Guinea (PNG) faces significant challenges from recurring disasters and health emergencies. There are critical gaps in frontline staff knowledge, skills, and equipment for basic emergency care (BEC). The PNG EMT has delivered basic training to HCWs in provinces. Many deployed teams provided training to local HCWs.

PNG EMT strengthening Emergency Care Systems by;

1. 1. delivering accredited contextualized training during deployments, and

2. 2. maintaining standardized contextualized resources as an aid for international EMTs in PNG.

PNG EMT currently has trainers in IITT, BEC and Oxygen delivery training (OSCAR-O2). There are locally contextualized, standardized resources available for use on deployment to train local health workers. Experiences training local health workers is an essential part of a pre-deployment orientation.

Since PNG EMT inception, a total of 7 trainings have been completed during deployments to provinces. Currently, 177 healthcare received training in oxygen delivery.

For BEC in 2024, PNG has 3 master trainers and 30 trainers nationally. TOT done in April 2023 with 5 EMT team members.

For IITT in 2024, PNG has 2 trainers for each of the 22 provinces. TOT done in Dec 2024. PNG EMT has 3 experienced trainers.

Strengthening the EMT’s role as a delivery mechanism for “just-in-time” training further enhances national efforts in developing robust ECS. Contextualized standard teaching aids are essential for deployed teams.

Emergency Medical Teams (EMTs) face significant psychological stress due to their exposure to traumatic events and high-pressure situations. Addressing these psychological challenges is essential for maintaining EMTs’ mental health and enhancing their performance in emergency responses.

This study aims to develop a comprehensive psychological resilience training program for EMTs to improve their coping mechanisms, emotional regulation, and overall resilience.

A comprehensive literature review was conducted to identify evidence-based techniques for building psychological resilience, including cognitive-behavioral therapy (CBT), mindfulness, and stress inoculation training. Based on these findings, a structured resilience training program was developed, incorporating workshops, scenario-based training, peer support networks, and access to professional mental health resources.

The proposed framework outlines a structured approach to incorporating psychological resilience training into existing EMT training programs. While the program has not yet been implemented, the literature indicates that such a framework could significantly improve EMTs’ ability to manage stress, reduce burnout, and enhance job satisfaction.

Integrating psychological resilience training into EMT professional development is crucial for fostering a mentally healthy and resilient workforce. The proposed framework, based on a comprehensive literature review, demonstrates the potential for significantly improving EMTs’ psychological well-being and effectiveness in emergency responses. Future implementation and evaluation of this framework are necessary to validate its impact and facilitate broader adoption across EMS organizations.

The Republic of Moldova needs a proactive approach in building their trauma and emergency care capacity given the neighboring conflict in Ukraine and inflow of refugees. The World Health Organization, in collaboration with local and international experts, has implemented a series of training programs to address the identified need for improved emergency and trauma care. These programs are critical for future EMT development.

Objectives of the training programs include:

1. 1. Strengthening emergency medicine and trauma expertise amongst interdisciplinary healthcare providers

2. 2. Improving trauma care through the development and implementation of a novel trauma team program

3. 3. Increasing capacity for mass casualty management

Emergency Care Systems Assessment and Hospital Emergency Unit Assessment Tool were used to identify gaps. Initial training focused on Basic Emergency Care, Advanced Trauma Life Support, and ultrasound courses led by WHO instructors in partnership with a local simulation center. A team of international experts, in partnership with local physicians, introduced trauma simulation sessions in the emergency department for multi-specialty teams to enhance their team communication and resuscitation skills. A training video was produced to improve dissemination of trauma care knowledge and instruction of an evidence-based pre-hospital handover tool. Finally, a table-top mass casualty simulation exercise was completed led by Emergo Train System instructors.

The Institutul de Medicină Urgentă launched the country’s first trauma team program on July 1, 2024 and neighboring regions will be replicating this approach.

A multi-faceted training approach allows for proactive strengthening of emergency and trauma care to improve local response capacity.