Trauma stabilization points: key to optimized trauma care in Gaza

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For the first time in Gaza, the Palestinian Ministry of Health, in collaboration with partners and with technical support from WHO, has established trauma stabilization points (TSPs) throughout the critical zones of Gaza in order to respond to the mass influx of casualties as a result of the ongoing violence. Five Ministry of Health TSPs and 5 Palestinian Red Crescent Society TSPs were established along the Gaza Strip, only minutes away from the border fence.

TSPs perform 2 main roles:

1. Triage, treatment and discharge of patients with minor injuries;

2. Triage, stabilization and referral of critical patients with life-threatening or limb-threatening injuries.

Both of these functions can substantially decrease the burden on referral hospitals.

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A critically injured patient is taken from the point of injury to a TSP in Gaza.
Photo credits: WHO oPt
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Airway management in a critically injured patient carried out at a TSP. TSPs across Gaza are providing life- and limb-saving interventions, as well as acting as a buffer zone to treat minor and mild injuries, thus reducing the burden on hospitals. Scarce hospital resources are being spared and patients are being given an increased chance of survival.
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From 30 March to 19 May, a total of 4255 tear gas inhalation cases have been treated at TSPs, according to latest available figures from the Ministry of Health, reducing the burden already overloaded hospitals. At the onset of this initiative, TSPs in Gaza were staffed with primary health care physicians, nurses, and paramedics. Today, TSPs have been further capacitated to include surgeons and intensive care .
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TSPs serve to triage and resuscitate patients. Once stabilized, seriously wounded patients are transported by ambulance from TSPs to hospitals in Gaza.
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To ensure that patients have a better chance of survival from the point of injury, a total of 10 TSPs are currently operational in Gaza to receive critically injured patients, who arrive from the so-called points of injury. Depending on the severity of trauma and the capacity of the facilities, patients are rushed to the nearest TSP for treatment and stabilization.
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TSPs in Gaza undertake the challenging task of the initial evaluation of patients who are critically injured critically from multiple traumas. TSPs are a special kind of emergency medical team (Type 1) where initial outpatient emergency care of injuries and other significant health care needs are provided. Key services include triage, first aid, stabilization, referral of severe trauma, non-trauma emergencies, and care for minor .
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Medical teams at frontline TSPs throughout Gaza treat dozens of patients, many of whom are women and children.
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Life-saving stabilization and emergency care is provided to Palestinians demonstrating near the security fence in Gaza. In essence, TSPs need to be established close to points where injuries are expected to ensure that life-threatening injuries can be dealt with in a timely and effective manner.
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Doctors try to keep pace with the steady stream of injured arriving at TSPs in Gaza.
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Doctors and nurses working in the TSPs close to the mass demonstrations have been affected by attacks on health care. From 30 March to 20 May, 245 health workers were affected by attacks, according to data provided by the Palestinian Ministry of Health, Palestinian Red Crescent Society, Palestinian Medical Relief Society and the Union of Health Work Committees.
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Each TSP is equipped with beds, emergency equipment and surgical items, supported by doctors, nurses and paramedics.
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Once severely injured patients are stabilized at a TSP, ambulances rush them to nearby hospitals for further treatment.
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Since the start of demonstrations on 30 March, 40 ambulances have been damaged, according to data provided by the Palestinian Red Crescent Society, the Palestinian Medical Relief Society and the Ministry of Health in Gaza.
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Since the start of the demonstrations on 30 March, a growing number of attacks on health facilities and health personnel working on the frontline in Gaza has been witnessed, which is affecting the ability to treat and save lives.
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Demonstrators gather near the ambulances that assist the injured and transfer them from the point of injury to the TSPs.
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A patient is referred from a TSP to Al Shifa hospital in Gaza. Ensuring timely referrals from TSPs to hospitals is critical to saving lives.
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Al Awda hospital, Gaza. According to the Ministry of Health in Gaza, as of 22 May, there have been 1293 casualties with lower limb injuries.
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Since 30 March to 26 May, a total of 6180 people had been treated at TSPs in Gaza, according to figures provided by the Ministry of Health.
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TSPs provide crucial life- and limb-saving stopover interventions for those patients who would otherwise die on their way to hospitals.