Enhancing trauma care in Ukraine amid conflict: A successful implementation of the modified advanced trauma life support course in an active war zone.

Abstract

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. 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 3months. Course effectiveness was evaluated through pre- and post-course knowledge tests, self-efficacy surveys, and satisfaction assessments. 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. 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.