The WHO Emergency Care System

Framework and Assessment Tool

Dr. dr. H. Muhammad Isman Jusuf

Rektor Universitas Muhammadiyah
Gorontalo

Diadaptasi dari:
Presentasi Helena Hailu &Teri Reynolds

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
Calls on member states and WHO to assess, establish and monitor
integrated prehospital and facility-based emergency care
systems…

Urges Member States “to identify and prioritize a core set of emergency
and essential surgery and anaesthesia services at the primary health
care and first-referral hospital level…”

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
REPUB
DARI MDGs MENUJU TPB/SDGs
LIK
INDON
ESIA

2016-2030

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention 3
REPUB
EMPAT PILAR PELAKSANAAN TPB/SDGs
LIK
INDON
ESIA

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention 4
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency Care for the SDGs
3.1 Reduce by three quarters, between 2015 and 2030, the maternal mortality ratio
Treatment for obstetric emergencies

3.2 Reduce by three quarters, between 2015 and 2030, the under-five mortality rate
Treatment for acute paediatric conditions including diarrhea and pneumonia

3.3 Reverse the incidence of malaria and other major diseases and reduce deaths caused by half by 2030
Treatment of acute infections and sepsis

3.4 By 2030, reduce by one-third premature mortality from NCDs

Treatment of acute exacerbations of NCDs

3.5 Strengthen the treatment of substance abuse

Emergency care and harm reduction interventions

3.6 Halve the number of global road traffic crash fatalities and serious injuries by 2020
Post-crash emergency care

3.8 Achieve universal health coverage including financial risk protection and access to quality essential healthcare
Emergency care is an essential component of universal health care

3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals
Treatment for acute exposure to hazardous materials

11.5 By 2030, significant reduce the number of deaths caused and people affected by disasters
Disaster preparedness and response for resilient health systems

16.1Significantly reduce all forms of violence and related death rates everywhere
Treatment for victims of violence

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 DCP3
• The Disease Control Priorities project estimates that…

• more than half (24 million out of 45 million) of the

deaths that occur in LMICs each year are from
conditions…

• that could be addressed by organized prehospital

and facility-based emergency care.

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 What is emergency care?

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Emergency Care
• Emergency Care: The initial evaluation, diagnosis,
treatment and disposition of any patient requiring
expeditious surgical, medical or psychiatric care
– Trauma
– Acute HIV emergencies
– OB emergencies
– Intra-abdominal surgical pathology
– Pneumonia and diarrheal emergencies
– Orthopedic emergencies
– Management of acute exacerbations of chronic disease
• Emergency Departments provide a valuable service

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Emergency Care System
Community lay-person first response

Ambulance service response

(if available)

Acute care - Emergency Department

Definitive care - surgical, medical

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Bystand Right Person, Right Place, Right Time
er First Emergency Chain of Survival Rehabilitation
Aid

Emergency
Service Intensive Care
Dispatch

Field based
Early
Critical
Specialist
Intervention
Intervention
Transport to
Appropriate Rapid
Unit Early Diagnosis
Resuscitation

Emergency, Trauma and Acute Care 11

Field Based Care Facility Based Care
Department for Management of NCDs, Disability, Violence and Injury Prevention Definitive Care
 Safely from the world  care
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
 Who needs emergency care?

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Scene

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Transport

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Facility arrival

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Facility-based care

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
 Emergency Care System Assessment

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Areas covered by the WHO ECSA
• System organization and governance
• Financing
• Emergency care data
• Quality improvement
• Scene care
• Transport and transfer
• Facility-based care
• Rehabilitation for emergency conditions
• Emergency and disaster preparedness

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 ECSA Data Visualization

MEAN

Lowest answer Highest answer

2 5

3.9

Blank space = “I don’t know” Color = Agreement

or did not respond (green = high, red = low)

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention