Enhancing trauma care in Ukraine amid conflict: A successful implementation of the modified advanced trauma life support course in an active war zone
Corresponding Author
Ali Dzhemiliev
Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Correspondence
Ali Dzhemiliev, Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 230 Gerry Rd, Boston, MA 02467, USA.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorBeck Lienau
Division of Trauma, Burns, Surgical Critical Care and Emergency General Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorNelya Melnitchouk
Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorAlexis Schmid
Global Health Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorGideon Loevinsohn
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Validation, Writing - original draft
Search for more papers by this authorOleksii Lopatniuk
International Medical Corps, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Supervision, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorNoah Carton-Rossen
Harvard School of Public Health, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Supervision, Visualization, Writing - review & editing
Search for more papers by this authorMeaghan Sydlowski
International Medical Corps, Los Angeles, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorAnton Darnytskyi
International Medical Corps, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Supervision, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorKathleen Murray
Emergency Health Systems, Harvard Humanitarian Initiative, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorOlha Kushner
International Medical Corps, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Resources, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorJonathan Strong
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Formal analysis, Investigation, Methodology, Resources, Supervision, Visualization, Writing - original draft
Search for more papers by this authorLindsey Martin
Global Disaster Response and Humanitarian Action, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing - review & editing
Search for more papers by this authorJaved Ali
International Medical Corps, Los Angeles, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Writing - original draft
Search for more papers by this authorJohn Roberts
International Medical Corps, Los Angeles, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft
Search for more papers by this authorDavid Mooney
Trauma Center, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Investigation, Methodology, Project administration, Software, Validation, Writing - original draft
Search for more papers by this authorBeth Hochman
Division of Acute Care Surgery, Department of Surgery at NYU Grossman School of Medicine, New York, New York, USA
Contribution: Conceptualization, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft
Search for more papers by this authorMike Owens
Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
Contribution: Conceptualization, Formal analysis, Methodology, Project administration, Resources, Validation, Visualization, Writing - original draft
Search for more papers by this authorFeroze Sidhwa
Department of Surgery, San Joaquin General Hospital, French Camp, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Writing - original draft, Writing - review & editing
Search for more papers by this authorIvan Rudas
V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorVladyslav Hvozd
V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - review & editing
Search for more papers by this authorSusanna Aksenkova
V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft
Search for more papers by this authorOleg V. Mazurenko
Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorKyrylo Kliukach
Dnipro Regional Center of Emergency and Disaster Medicine, Dnipro, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorSean M. Kivlehan
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Emergency Health Systems, Harvard Humanitarian Initiative, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorGeoffrey A. Anderson
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Division of Trauma, Burns, Surgical Critical Care and Emergency General Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Ali Dzhemiliev
Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Correspondence
Ali Dzhemiliev, Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 230 Gerry Rd, Boston, MA 02467, USA.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorBeck Lienau
Division of Trauma, Burns, Surgical Critical Care and Emergency General Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorNelya Melnitchouk
Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorAlexis Schmid
Global Health Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorGideon Loevinsohn
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Validation, Writing - original draft
Search for more papers by this authorOleksii Lopatniuk
International Medical Corps, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Supervision, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorNoah Carton-Rossen
Harvard School of Public Health, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Supervision, Visualization, Writing - review & editing
Search for more papers by this authorMeaghan Sydlowski
International Medical Corps, Los Angeles, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorAnton Darnytskyi
International Medical Corps, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Supervision, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorKathleen Murray
Emergency Health Systems, Harvard Humanitarian Initiative, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorOlha Kushner
International Medical Corps, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Resources, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorJonathan Strong
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Conceptualization, Formal analysis, Investigation, Methodology, Resources, Supervision, Visualization, Writing - original draft
Search for more papers by this authorLindsey Martin
Global Disaster Response and Humanitarian Action, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing - review & editing
Search for more papers by this authorJaved Ali
International Medical Corps, Los Angeles, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Validation, Writing - original draft
Search for more papers by this authorJohn Roberts
International Medical Corps, Los Angeles, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft
Search for more papers by this authorDavid Mooney
Trauma Center, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Investigation, Methodology, Project administration, Software, Validation, Writing - original draft
Search for more papers by this authorBeth Hochman
Division of Acute Care Surgery, Department of Surgery at NYU Grossman School of Medicine, New York, New York, USA
Contribution: Conceptualization, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft
Search for more papers by this authorMike Owens
Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
Contribution: Conceptualization, Formal analysis, Methodology, Project administration, Resources, Validation, Visualization, Writing - original draft
Search for more papers by this authorFeroze Sidhwa
Department of Surgery, San Joaquin General Hospital, French Camp, California, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Writing - original draft, Writing - review & editing
Search for more papers by this authorIvan Rudas
V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorVladyslav Hvozd
V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - review & editing
Search for more papers by this authorSusanna Aksenkova
V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft
Search for more papers by this authorOleg V. Mazurenko
Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorKyrylo Kliukach
Dnipro Regional Center of Emergency and Disaster Medicine, Dnipro, Ukraine
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Resources, Software, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorSean M. Kivlehan
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Emergency Health Systems, Harvard Humanitarian Initiative, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Writing - original draft, Writing - review & editing
Search for more papers by this authorGeoffrey A. Anderson
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Division of Trauma, Burns, Surgical Critical Care and Emergency General Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorAli Dzhemiliev and Beck Lienau both the authors contributed equally to this work.
Abstract
Background
Following the 2022 Russian invasion, Ukraine's healthcare system suffered extensive damage, with over 1000 medical facilities destroyed, exacerbating the trauma care crisis. The absence of standardized trauma training left Ukrainian healthcare providers ill-equipped to manage the surge in trauma cases amid conflict. To bridge this gap, we implemented advanced trauma life support (ATLS) courses in Ukraine amid active warfare, aiming to enhance trauma care expertise among healthcare professionals.
Methods
A consortium, including the International Medical Corps, Harvard Humanitarian Initiative, and others, responded to a request from the Ukrainian Ministry of Health. The ATLS curriculum, translated into Ukrainian, guided the training, with US-based instructors sent to Ukraine for teaching. Despite logistical challenges, such as missile attacks and curfews, the courses ran in multiple Ukrainian cities over 3 months. Course effectiveness was evaluated through pre- and post-course knowledge tests, self-efficacy surveys, and satisfaction assessments.
Results
Ten ATLS courses trained 213 Ukrainian healthcare providers across five deployments. Significant improvements in knowledge scores (p < 0.05) and enhanced self-reported confidence in trauma management were observed. Notably, no casualties were reported among instructors or students, highlighting program safety despite security challenges.
Conclusions
Our study demonstrates successful ATLS course implementation in an active war zone, filling a critical gap in trauma education in Ukraine. Despite challenges, the program significantly enhanced participants' trauma care knowledge and confidence. Collaboration between international and local partners was pivotal. This model can serve as a valuable framework for trauma education globally, improving outcomes in conflict zones and resource-limited settings.
CONFLICT OF INTEREST STATEMENT
The authors confirm there are no financial or other conflicts of interest.
Supporting Information
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| wjs12362-sup-0001-table_s1.pdf98.4 KB | Table S1 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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