Special care services delivery at disaster
scenes: a systematic review

Special care services delivery at disaster
scenes: a systematic review

Disaster, Hazard-induced emergencies, Public health response, Health system resilience, Disaster
preparedness and coordination, Special care services, Prehospital care, Advanced life support

Abstract
Background Disasters create strain on health systems and require significant preparedness to reduce mortality
and morbidity. Special care services; e.g. Advanced Life Support, critical care interventions (intubation; vasopressor
therapy) and point of care diagnostics (ultrasound) may be provided in disaster-settings, although actual use of
services is dependent on logistical, operational and contextual issues. This systematic review identifies an important
gap to understand the effectiveness, feasibility and barriers to, special care services.The overall aim of this systematic
review is to synthesise global evidence on the evidence-based practices and improve disaster response.
Methods This systematic review utilized PubMed, Scopus, Web of Science, Embase, and grey literature from the
time of inception of the different databases to January 2025, from which a total of 4465 records were identified. After
a thorough, organized review of the identified records based on our exclusion criteria and inclusion criteria, a total
of 31 articles were retained. The systematic review followed PRISMA 2020, and searched for studies on special care
services in a pre-hospital disaster setting, and included primary research and review articles that described advanced
interventions, and which had no time restrictions on date of publication. Articles that were waived from the cost of
in-app purchasing were excluded due to limited resources and could limit the studies that were included. Quality
assessment using STROBE, SANRA and checklists, along with the categories of findings using a thematic content
analysis based on the dimensions of prehospital care.
Results Thematic analysis revealed six broad themes: Patient Care and Clinical Management, Operational Efficiency
and Logistics, Personnel and Training, Technology and Equipment, System Coordination and Preparedness, and Ethical
and Contextual Considerations. Advanced functions like REBOA, ultrasound and AI-related diagnostics improved
survival and neurological outcomes, However, they were restricted due to limited resources, lack of training, and lack
of coordination, particularly in low resource contexts.
Conclusions The reviewed literature demonstrated that critical-care services such as Advanced Life Support (ALS),
intubation, and ultrasound resulted in improved morbidity and mortality outcomes in disaster settings but were

limited due to resource constraints, lack of training and inadequate coordination all the more pertinent to low-
resource settings.

Clinical trial number Not applicable.

Mohammad Masbi1

, Nader Tavkoli2

, Hamid Payrovi3

and Mohsen Dowlati4*

https://doi.org/10.1186/s12245-025-01041-9

2025

Peri Irawan

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