Pakistan floods: innovations and guidance for the response.

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Principal Investigator: Carrie Teicher, Epicentre


The goal of the RAPID study was to fundamentally transform the way serious injuries are managed after earthquakes and other disasters by introducing a novel, cost-effective, and locally appropriate method for pain control.

This study aimed to demonstrate that local medical providers could be trained to perform regional anesthesia safely and effectively. It sought to validify an intensive, two-day training in regional anesthesia for a group of international physicians, and a subsequent identical training provided for a small group of local physicians in the immediate aftermath of an earthquake.

The study also planned to enroll patients in the aftermath of a major earthquake to determine whether regional anesthesia, either with or without ultrasound-guidance, could reduce suffering from lower limb injuries. These are the most common earthquake-related injury. The hope was to demonstrate that regional anesthesia could revolutionize trauma care in disaster settings by significantly improving pain management over the current standard of care. This could reduce the pain and suffering for hundreds of thousands of individuals injured in major earthquakes each year.

Carrie Teicher


Conducting high-quality health research in the acute phase of a major disaster presents extraordinary challenges. Through a combination of targeted research funding, strong academic and humanitarian partnerships, and a good deal of advanced planning, we believe that these challenges can be overcome. Indeed, we owe it to the millions of people affected by disaster each year to find a way to ensure that they have access evidence-based therapies that have been proven effective for the types of injuries and conditions they are most likely to experience.

Carrie Teicher


It is amazing that a grant mechanism like R2HC’s Rapid Response facility exists. It is one of the few ways that RCTs can be conducted for emergency medicine in a humanitarian context.  It brings great added value, especially in helping practitioners to partner with academics who have specific technical expertise.

Programmes and Outcomes Achieved

This ‘rapid response’ project was reliant on there being a suitable earthquake which would enable the research study to take place. As no earthquake took place in the timeline, the full research study was not triggered. However Standard Operating Procedures have been designed which can be used in future research, and protocols have been published. Lessons were learned about the development of a clinical trial for management of injuries in an earthquake context, which will inform future research studies, including how to deliver effective training on regional anaesthesia to medical responders.


Article, Peer Reviewed

Regional Anesthesia for Painful Injuries after Disasters (RAPID): study protocol for a randomized controlled trial in Regional Anesthesia Techniques for Planned Randomized Controlled Trial in a Disaster Setting

Peer Reviewed

Focused Training for Humanitarian Responders in Regional Anesthesia Techniques for a Planned Randomized Controlled Trial in a Disaster Setting

Key outputs:

  • Study protocols published in peer-reviewed journal
  • Study findings on impact of regional anaesthesia training published in peer-reviewed journal

Next steps:

Standard Operating Procedures have been developed which are ready to be used for research if/when a suitable acute trauma/earthquake scenario occurs in future (funding dependent)

Latest Updates

The RAPID Study: Research in Crisis

Jul 2016

Due to the effects of population growth and increasing urbanization, earthquakes now account for the largest burden of injury among all geophysical disasters, claiming an average of 27,000 lives each…


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