Meeting the challenges of spinal cord injury care following sudden onset disaster: lessons learned.

Improved disaster response has led to higher survival rates and an increasing number of injuries in relation to deaths (injury to death ratio). Recent earthquakes, in particular, have led to unprecedented numbers of spinal cord injuries. Meeting the needs of individuals with spinal cord injuries is particularly challenging when disaster strikes a low resource environment. Clinicians who care for spinal cord injuries can learn from prior experiences and proactively address how to best meet needs in future disasters. Here we review and propose measures targeted to specific challenges including: coordination and mobilization; identification and procurement of required expertise; initial survey and assessment; health care delivery; community reintegration and health maintenance; and sustainability and capacity building.