Life-saving manual for medics treating children in war zones

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The life-saving manual was designed for use by medics in war zones (Julien Behal/PA)

The world’s first handbook for child blast injuries is a “shocking testimony to the failure of adults” to protect children in conflict, one of the aid workers who launched it said.

The life-saving manual was designed for use by medics in war zones and is the first comprehensive guide on how to treat damage suffered by children from air strikes, artillery and landmines.

It was put together over 15 months by the Paediatric Blast Injury Partnership (PBIP), a coalition of doctors and experts founded by Save the Children and Imperial College London.

At its first meeting two years ago, Syrian medics called the idea “the single most important thing that could affect children’s lives” in the country, the charity said.

James Denselow, head of the conflict and humanitarian team at Save the Children, said children were “dramatically more exposed” to explosive weapons due to the proliferation of militia and armed groups and increasingly longer conflicts which were also heaping pressure on medics in the field.

He told the Press Association: “The fact that we now have the world’s first ever paediatric blast manual is a shocking testimony to the failure of adults across this planet to better protect children in conflict.”

“Unfortunately with so many children living in conflict zones today it’s more needed than ever,” he added.

Children are not “adults in miniature” as they suffer unique patterns of injury and research has shown they are disproportionately affected by explosive weapons, Save the Children said.

The handbook is built to withstand hostile environments, is readable when the light is poor and contains instructions on how to resuscitate children on the battlefield, save limbs and provide psychosocial rehabilitation.

Mr Denselow said teams were at the beginning of a “particularly macabre” journey and are hoping to roll the manual out in Yemen, Afghanistan, Nigeria and Iraq, having distributed copies in Syria.

The charity is calling for a global paediatric trauma register that will ensure more thoroughly recorded data and help first responders learn more “about what keeps children alive”.

He also said it was important to consider producing similar guides for non medics, who may come across victims of explosions and terrorist attacks in their daily lives.

He said: “Often the ‘zero responders’ issue is one that we are increasingly seeing, so we could find ourselves in a world in which people on the streets of London, Paris, and anywhere else are a bit better prepared to deal with injured children they see if any bomb goes off.”

Dr Paul Reavley, a former UK military doctor and the lead author of the manual, recalled how he resuscitated an eight-year-old girl who had three limbs blown off by an explosive device in Afghanistan and was left shaken by her resemblance to his own daughter.

He said: “We used to call this aspect of it the emotional window, and as I stood at the end of this bed, I looked at this child and I thought ‘I know what to do medically, she looks the same age, the same sort of size, even the same sort of colouration as my daughter’…so it really brought home to me the barriers clinicians face when they’re treating severely injured children.”

He added: “The obvious concern is that when people see this manual it’s upsetting to realise that there’s a requirement to have this, and in an ideal world we wouldn’t be producing a manual for blast-injured children, but when it came to actually doing it the overwhelming feeling is positive, that we need to be able to produce this to improve trauma care whilst there is a situation that children are frequently exposed to conflict-type injuries around the world.”

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