Minutes from the EMERGENCY's presentation at the World Anaesthesia Congress 2011, 11-15 April in Rome (Italy). http://www.worldanesthesia.com

1. Pain Therapy in crisis areas
World Anaesthesia Congress 2011, Rome 11-15 April
Medical Division/
Board of Anaesthesiology & Intensive care

2. EMERGENCY / Rationale
In today’s conflicts 90% of the victims are civilians.
Poverty causes great Public Health crises.
Scarcity of high standard, free-of-charge
Health facilities and local specialized staff.
Lack of lasting effectiveness in co-operation.
Pain Therapy in crisis areas – NWAC 2011 / 2

3. EMERGENCY / What
Founded in Italy in 1994.
Provides high-quality and free-of-charge
health care to the victims of war, anti-
personnel mines and poverty
Promotes a culture of peace, solidarity,
and respect for human rights
Pain Therapy in crisis areas – NWAC 2011 / 3

4. EMERGENCY / How
We assess health needs and make a project
proposal to local communities.
We plan, build and run in the long-term Health
facilities overseas.
We deliver quality care equally, on the sole
basis of needs.
We strive to effectively train local staff.
Pain Therapy in crisis areas – NWAC 2011 / 4

5. EMERGENCY / Where
Today operational in 7 countries.
Officially recognised charity in Italy, USA, UK,
Japan and Switzerland.
Partner of the United Nations, DPI/NGO
Pain Therapy in crisis areas – NWAC 2011 / 5

6. PAIN THERAPY / The issue for us
Article 1
All human beings are born free and equal in dignity and rights.
Article 27
Everyone has the right (…) to share in scientific advancements and its benefits.
Universal Declaration of Human Rights, 10 December 1948
We work to implement Human Rights based
Health projects.
Effective pain management in countries who
are low-resource dependent is part of this
vision.
Pain Therapy in crisis areas – NWAC 2011 / 6

7. PAIN RELIEF / Why
NOT EFFECTIVE PAIN RELEIF
> Increase in morbidity and mortality
> Increase in clinical complications
> May lead to chronic pain conditions
> Decreased quality of life
PROBLEMS IN LOW-RESOURCES SETTINGS
> Lack of education and cultural barriers
> Inadequate resources (drugs and equipment)
> Financial constraints
> Lack of government priority
Pain Therapy in crisis areas – NWAC 2011 / 7

8. PAIN MANAGEMENT / How
TRAINING AND EFFICIENCY
> Education
> Effective training programmes
> Appropriate use of available drugs
> Multimodal Analgesia
> Reliable suppliers, on-the-field whenever is possible
Pain Therapy in crisis areas – NWAC 2011 / 8

9. PAIN MANAGEMENT / How
GUIDELINES AND PROTOCOLS
> Simple to understand
> Simple to use
> Easy to implement
> Adapted to operational context
Pain Therapy in crisis areas – NWAC 2011 / 9

10. PAIN MANAGEMENT / How
PAIN ASSESSMENT
> Visual Analogue Scale (VAS)
> Faces Pain Scale for low-compliance patients & children
> CHEOPS Scale for children aged < 3
PAIN TREATMENT
> Protocols based on WFSA Analgesic Ladder
> Protocols based on available drugs, facilities & equipment
Pain Therapy in crisis areas – NWAC 2011 / 10

11. PAIN MANAGEMENT / When
TO BE APPLIED
> From the admission in OPD, also in case of Mass Casualty Plan
> In emergency and elective surgical cases
> Surgical and medical pain
> Acute and chronic pain
> As part of daily therapeutic plan
Pain Therapy in crisis areas – NWAC 2011 / 11

12. EMERGENCY/ Treatment of pain
WAR INJURIES
> traumatic amputation
> penetrating injuries
> vascular injuries
> fractures
> mine/shell/bullet injuries
Pain Therapy in crisis areas – NWAC 2011 / 12

13. EMERGENCY/ Treatment of pain
WAR INJURIES
> traumatic amputation
> penetrating injuries
> vascular injuries
> fractures
> mine/shell/bullet injuries
Pain Therapy in crisis areas – NWAC 2011 / 13

14. EMERGENCY/ Treatment of pain
ROAD/TRAFFIC
> accidents (FFH)
Pain Therapy in crisis areas – NWAC 2011 / 14

15. EMERGENCY/ Treatment of pain
BURNS
> war-related or not
Pain Therapy in crisis areas – NWAC 2011 / 15

16. EMERGENCY/ Treatment of pain
PAINFUL medical diseases
> Abdominal pain & colic
> Treatment of labour
> Sickle cell disease
Pain Therapy in crisis areas – NWAC 2011 / 16

17. EMERGENCY/ Learnt
EFFECTIVE PAIN RELIEF IN CRISIS AREAS
> Is not only a crucial part of high quality health care, is POSSIBLE
> Can be managed efficiently by means of local resources
> Should be respectful of local culture
Pain Therapy in crisis areas – NWAC 2011 / 17

18. WORK WITH US/ recruiting@emergency.it