Artur Munteanu

Moldova

Implementing the trauma team in R. Moldova: Strengthening emergency and trauma response to build national emergency care and response capacity

Artur Munteanu3,4,5, Julianna Deutscher1,2,3, Jodie Pritchard2,3, Vitalii Stetsyk3, Svetlana Sirbu3,4,5, Raed Habach3,4,5, Ion Chesov3,5, Iuliana Garam3

1. University of Toronto, Toronto, Ontario, Canada.
2. Queen’s University, Kingston, Ontario, Canada.
3. World Health Organization, Chisinau, Republic of Moldova.
4. Institutul de Medicina Urgenta, Chisinau, Republic of Moldova.
5. Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova

Abstract

Moldova faces significant challenges in emergency and trauma care, exacerbated by the ongoing conflict in neighboring Ukraine and the inflow of refugees. The country’s healthcare system requires substantial improvement in its trauma care capacity to address the growing demand for emergency services. Despite recent progress, gaps remain in resources, training, and coordination. The World Health Organization (WHO) and local experts have been collaborating to improve the response to trauma and emergency situations by strengthening emergency medical teams (EMTs) and improving trauma care through targeted training and simulation-based approaches.

To identify gaps in Moldova’s emergency care system, the Emergency Care Systems Assessment and Hospital Emergency Unit Assessment Tool were employed. The initial training focused on Basic Emergency Care (BEC), Advanced Trauma Life Support (ATLS), and ultrasound courses, led by WHO instructors in collaboration with a local simulation center. Trauma simulation sessions were conducted in the emergency department to improve team coordination, communication, and resuscitation techniques. A training video was created to support the dissemination of trauma care knowledge, including an evidence-based pre-hospital handover tool. Finally, a mass casualty simulation, led by Emergo Train System, tested the emergency department’s preparedness for large-scale events, emphasizing resource allocation and team coordination.

The training and simulation programs led to significant improvements in healthcare providers’ skills, communication, and teamwork. Emergency department personnel showed improved performance in trauma care scenarios, with better coordination and quicker responses. The Trauma Team Program, launched on July 1, 2024, marked a major milestone, with plans to extend this model to neighboring regions. The mass casualty simulation revealed areas for further improvement in resource management and rapid decision-making during high-pressure situations.

Moldova’s trauma care capacity has significantly improved through comprehensive training, simulation, and the implementation of structured trauma care protocols. The Trauma Team Program has laid a strong foundation for enhanced emergency care and response, with the potential to replicate this model across the region. These efforts will contribute to a more robust healthcare system, capable of managing trauma patients effectively and improving patient outcomes in emergencies.