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Synthesizing the evidence base to enhance coordination between humanitarian mine action and emergency care for casualties of explosive ordnance and explosive weapons: a scoping review

Synthesizing the evidence base to enhance coordination between humanitarian mine action and emergency care for casualties of explosive ordnance and explosive weapons: a scoping review
Synthesizing the evidence base to enhance coordination between humanitarian mine action and emergency care for casualties of explosive ordnance and explosive weapons: a scoping review

Background: humanitarian mine action (HMA) stakeholders have an organized presence with well-resourced medical capability in many conflict and post-conflict settings. Humanitarian mine action has the potential to positively augment local trauma care capacity for civilian casualties of explosive ordnance (EO) and explosive weapons (EWs). Yet at present, few strategies exist for coordinated engagement between HMA and the health sector to support emergency care system strengthening to improve outcomes among EO/EW casualties. 

Methods: a scoping literature review was conducted to identify records that described trauma care interventions pertinent to civilian casualties of EO/EW in resource-constrained settings using structured searches of indexed databases and grey literature. A 2017 World Health Organization (WHO) review on trauma systems components in low- and middle-income countries (LMICs) was updated with additional eligible reports describing trauma care interventions in LMICs or among civilian casualties of EO/EWs after 2001. 

Results: a total of 14,195 non-duplicative records were retrieved, of which 48 reports met eligibility criteria. Seventy-four reports from the 2017 WHO review and 16 reports identified from reference lists yielded 138 reports describing interventions in 47 countries. Intervention efficacy was assessed using heterogenous measures ranging from trainee satisfaction to patient outcomes; only 39 reported mortality differences. Interventions that could feasibly be supported by HMA stakeholders were synthesized into a bundle of opportunities for HMA engagement designated links in a Civilian Casualty Care Chain (C-CCC). 

Conclusions: this review identified trauma care interventions with the potential to reduce mortality and disability among civilian EO/EW casualties that could be feasibly supported by HMA stakeholders. In partnership with local and multi-lateral health authorities, HMA can leverage their medical capabilities and expertise to strengthen emergency care capacity to improve trauma outcomes in settings affected by EO/EWs.

and operative (ECO) care, blast injury, civilian casualties, conflict, critical, emergency, explosive ordnance, explosive weapons, low- and middle-income countries, low-resource settings, prehospital trauma care, trauma systems, trauma training
1049-023X
421-435
Wild, Hannah
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LeBoa, Christopher
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Markou-Pappas, Nikolaos
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Trautwein, Micah
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Persi, Loren
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Loupforest, Christelle
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Hottentot, Elke
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Calvello Hynes, Emilie
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Denny, Jack
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Alizada, Firoz
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Muminova, Reykhan
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Jewell, Teresa
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Kasack, Sebastian
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Pizzino, Stacey
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Hynes, Gregory
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Echeverri, Lina
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Salio, Flavio
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Wren, Sherry
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Mock, Charles
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Kushner, Adam L.
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Stewart, Barclay T.
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et al.
Wild, Hannah
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LeBoa, Christopher
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Markou-Pappas, Nikolaos
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Trautwein, Micah
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Persi, Loren
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Loupforest, Christelle
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Hottentot, Elke
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Calvello Hynes, Emilie
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Denny, Jack
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Alizada, Firoz
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Muminova, Reykhan
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Jewell, Teresa
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Kasack, Sebastian
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Pizzino, Stacey
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Hynes, Gregory
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Echeverri, Lina
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Salio, Flavio
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Wren, Sherry
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Mock, Charles
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Kushner, Adam L.
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Stewart, Barclay T.
4151f564-7638-4abf-a39d-ae59755613ae

Wild, Hannah, LeBoa, Christopher and Markou-Pappas, Nikolaos , et al. (2025) Synthesizing the evidence base to enhance coordination between humanitarian mine action and emergency care for casualties of explosive ordnance and explosive weapons: a scoping review. Prehospital and Disaster Medicine, 39 (6), 421-435. (doi:10.1017/S1049023X24000669).

Record type: Article

Abstract

Background: humanitarian mine action (HMA) stakeholders have an organized presence with well-resourced medical capability in many conflict and post-conflict settings. Humanitarian mine action has the potential to positively augment local trauma care capacity for civilian casualties of explosive ordnance (EO) and explosive weapons (EWs). Yet at present, few strategies exist for coordinated engagement between HMA and the health sector to support emergency care system strengthening to improve outcomes among EO/EW casualties. 

Methods: a scoping literature review was conducted to identify records that described trauma care interventions pertinent to civilian casualties of EO/EW in resource-constrained settings using structured searches of indexed databases and grey literature. A 2017 World Health Organization (WHO) review on trauma systems components in low- and middle-income countries (LMICs) was updated with additional eligible reports describing trauma care interventions in LMICs or among civilian casualties of EO/EWs after 2001. 

Results: a total of 14,195 non-duplicative records were retrieved, of which 48 reports met eligibility criteria. Seventy-four reports from the 2017 WHO review and 16 reports identified from reference lists yielded 138 reports describing interventions in 47 countries. Intervention efficacy was assessed using heterogenous measures ranging from trainee satisfaction to patient outcomes; only 39 reported mortality differences. Interventions that could feasibly be supported by HMA stakeholders were synthesized into a bundle of opportunities for HMA engagement designated links in a Civilian Casualty Care Chain (C-CCC). 

Conclusions: this review identified trauma care interventions with the potential to reduce mortality and disability among civilian EO/EW casualties that could be feasibly supported by HMA stakeholders. In partnership with local and multi-lateral health authorities, HMA can leverage their medical capabilities and expertise to strengthen emergency care capacity to improve trauma outcomes in settings affected by EO/EWs.

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synthesizing-the-evidence-base-to-enhance-coordination-between-humanitarian-mine-action-and-emergency-care-for-casualties-of-explosive-ordnance-and-explosive-weapons-a-scoping-review - Version of Record
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Accepted/In Press date: 10 September 2024
e-pub ahead of print date: 24 January 2025
Published date: 24 January 2025
Keywords: and operative (ECO) care, blast injury, civilian casualties, conflict, critical, emergency, explosive ordnance, explosive weapons, low- and middle-income countries, low-resource settings, prehospital trauma care, trauma systems, trauma training

Identifiers

Local EPrints ID: 499308
URI: http://eprints.soton.ac.uk/id/eprint/499308
ISSN: 1049-023X
PURE UUID: 2a4805d8-d5ba-4479-a944-9f18feb7ea65
ORCID for Jack Denny: ORCID iD orcid.org/0000-0003-3181-4747

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Date deposited: 14 Mar 2025 17:40
Last modified: 22 Aug 2025 02:24

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Contributors

Author: Hannah Wild
Author: Christopher LeBoa
Author: Nikolaos Markou-Pappas
Author: Micah Trautwein
Author: Loren Persi
Author: Christelle Loupforest
Author: Elke Hottentot
Author: Emilie Calvello Hynes
Author: Jack Denny ORCID iD
Author: Firoz Alizada
Author: Reykhan Muminova
Author: Teresa Jewell
Author: Sebastian Kasack
Author: Stacey Pizzino
Author: Gregory Hynes
Author: Lina Echeverri
Author: Flavio Salio
Author: Sherry Wren
Author: Charles Mock
Author: Adam L. Kushner
Author: Barclay T. Stewart
Corporate Author: et al.

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