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  <head>
    <title>074-03 Management, monitoring, prevention, safety, ethics, systems issues, and longitudinal care</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Managing care under scarcity">
      <outline text="Essential resuscitation">
        <outline text="Airway: positioning, suction, bag-mask first">
          <outline text="Two-person mask may beat early intubation"/>
        </outline>
        <outline text="Oxygen is a finite drug">
          <outline text="Concentrators need power, vary with altitude"/>
          <outline text="Titrate, fix leaks, monitor supply"/>
        </outline>
        <outline text="Haemorrhage control before crystalloid">
          <outline text="Walking donors need advance protocols"/>
        </outline>
        <outline text="Fluid plans separate shock and dehydration">
          <outline text="Oral rehydration scalable if gut works"/>
          <outline text="Reassess after small volumes"/>
        </outline>
      </outline>
      <outline text="Infection prevention and treatment">
        <outline text="Water and sanitation beat broad antibiotics"/>
        <outline text="Separate clean and contaminated flow"/>
        <outline text="Empirical protocols reflect local resistance">
          <outline text="Indiscriminate courses promote resistance"/>
          <outline text="Source control remains essential"/>
        </outline>
        <outline text="Proportionate, feasible isolation">
          <outline text="Coercion drives concealment"/>
        </outline>
      </outline>
      <outline text="Evacuation and retrieval">
        <outline text="Stabilise airway, bleeding, splints, analgesia"/>
        <outline text="Transport physiology: cabin pressure, noise"/>
        <outline text="Destination by capability and capacity">
          <outline text="Direct transfer versus nearest resuscitation"/>
        </outline>
        <outline text="Transfer record survives electronic failure"/>
      </outline>
      <outline text="Ethical allocation">
        <outline text="Protocols developed publicly before crisis"/>
        <outline text="Exclude social worth, wealth, race">
          <outline text="Age not an unexamined exclusion"/>
        </outline>
        <outline text="Triage teams separate allocation from advocacy"/>
        <outline text="Withholding and withdrawing can be equivalent">
          <outline text="Withdrawal emotionally harder"/>
        </outline>
        <outline text="Disability assessed by clinical prognosis">
          <outline text="Audit tools for structural bias"/>
        </outline>
      </outline>
      <outline text="Responder protection and workforce">
        <outline text="Protective equipment, vaccination, rest, security"/>
        <outline text="Duty to care has limits">
          <outline text="Institutions owe reciprocal protection"/>
        </outline>
        <outline text="Rosters respect sleep and circadian physiology"/>
        <outline text="Confidential support over compulsory debriefing"/>
        <outline text="Adapted scope still needs supervision">
          <outline text="Unintegrated volunteers create risk"/>
        </outline>
      </outline>
      <outline text="Medicines, equipment, supply">
        <outline text="Essential-medicine lists">
          <outline text="Track consumption, expiry, cold chain"/>
          <outline text="Substitution protocols prevent improvised conversion"/>
        </outline>
        <outline text="Equipment must be maintainable locally">
          <outline text="Incompatible donations burden systems"/>
        </outline>
        <outline text="Pre-positioning reduces delay, risks expiry"/>
        <outline text="Logistics data are clinical data"/>
      </outline>
      <outline text="Chronic, maternal, and mental care">
        <outline text="Simplify regimens, avoid abrupt withdrawal">
          <outline text="Steroids, insulin, antiseizure drugs, opioids"/>
        </outline>
        <outline text="Refill points and paper summaries"/>
        <outline text="Maternal care and reproductive services">
          <outline text="Violence and unintended pregnancy may rise"/>
        </outline>
        <outline text="Psychological first aid and severe illness continuity">
          <outline text="Strengthen, not replace, local supports"/>
        </outline>
      </outline>
      <outline text="Recovery, resilience, equity">
        <outline text="Recovery restores more than buildings"/>
        <outline text="Humanitarian data minimum and purpose-limited">
          <outline text="Breach exposes people to violence, detention"/>
        </outline>
        <outline text="Find who aid systematically misses"/>
        <outline text="Local procurement over parallel systems"/>
        <outline text="After-action review with funded owners"/>
        <outline text="Build back better">
          <outline text="Recovery funds should not reproduce inequity"/>
        </outline>
      </outline>
      <outline text="Accountable flexibility">
        <outline text="Altered standards formally activated and ended">
          <outline text="Document why usual care was impossible"/>
        </outline>
        <outline text="Scarcity never justifies discrimination"/>
        <outline text="Consent and confidentiality persist"/>
        <outline text="Preparation reduces improvisation"/>
      </outline>
    </outline>
  </body>
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