Scaling up emergency health services in eastern Ukraine: the ABCDE of trauma care

Scaling up emergency health... 1

“There are more than 500 000 people living in Mariupol, and approximately 100 000 of them are internally displaced. Injuries and trauma can hit anyone; therefore, such trauma care trainings are very important. I wish we could host more than one event to have more specialists familiarized with the key principles of trauma case management,” says Dr Ludmyla Sergeeva, Deputy Director of the Mariupol City Health Department.

Scaling up emergency health... 2

The standardized ABCDE (Airway, Breathing, Circulation, Disability, Exposure) approach to treating patients with injuries saves precious time. 

Scaling up emergency health... 3

“Working in an ambulance requires fast thinking and the ability to make important decisions under pressure. ABCDE is a unified patient examination protocol. It allows for quickly identifying and managing life-threatening health conditions,” says Anastasia Oparina, ambulance worker and one of the course facilitators from Kramatorsk, Donetsk region. 

Scaling up emergency health... 4

Endotracheal intubation is a new skill for trauma surgeon Dr Sergiy Rusanov. “Usually, intubation is performed by an anaesthesiologist. However, today at the training I tried it on a manikin. All the tips on teamwork and the ABCDE protocol are very valuable when you are the first person to examine a trauma patient brought by an ambulance. I have learned a lot!” he says. “In Mariupol, specialized hospitals serve as emergency units and provide urgent medical assistance to patients with trauma,” adds Sergiy.  

Scaling up emergency health... 5

Sergiy’s younger colleague and surgeon, Dr Kostyantyn Shulzhiskyi, moved to Mariupol in 2018. He stresses the heavy workload at the trauma care unit where two to three doctors on duty can see up to 80 patients per 24-hour shift. “This training is much needed as we learn evidence-based knowledge and best practices for emergency health care,” says Kostyantyn. 

Scaling up emergency health... 6

“Mariupol is an industrial city where accidents, occupational injuries and trauma cases happen frequently,” says Dr Oleksandr Ilchenko, an anaesthesiologist from the regional hospital. “There is always a certain fear when you see a person with injuries. Only the confidence in my skills and actions can beat this fear and help to provide immediate assistance. In addition to refreshing our knowledge, this training provides state-of-the-art theoretical and practical know-how allowing us to treat patients better and save more lives in critical situations,” adds Oleksandr.

Scaling up emergency health... 7

Dr Saveliy Bogoyko is an anaesthesiologist from the regional hospital. “Out-of-pocket payments, lack of medical equipment in hospitals and limited access to various educational courses for medical professionals negatively affect the quality of health care services,” he says, outlining the main challenges for the region’s emergency health care system.

Scaling up emergency health... 8

Anaesthesiologist Dr Oksana Kirsanova works at a maternity hospital. She says that the lack of continuous practice in, and updating of, practical skills is another challenge for the health care workforce. “I do not perform cardiopulmonary resuscitation [CPR] every day. Of course, I know it in theory, but the lack of regular practice can significantly reduce the outcome of CPR. WHO Advanced Trauma Care Training is so valuable because it gives an opportunity to practice the life-saving procedures. I wish all of my team could be here with me,” says Oksana.

Scaling up emergency health... 9

“WHO aims at bringing the world’s best trauma care practices to the conflict affected regions in Ukraine and to thereby enhance the capabilities of the health care workforce to manage various emergency situations ranging from a single accident to mass causalities,” says Dr Omar Saleh, a trauma care consultant for the WHO Health Emergencies Programme in Ukraine.

Scaling up emergency health... 10