Civilian Prehospital Care in Armed Conflict - A Scoping Review

Introduction: Civilian prehospital care in armed conflicts has gained critical importance as modern warfare increasingly affects civilian populations. While prehospital care in conflict zones has traditionally focused on military personnel, the growing number of civilian casualties necessitates tailored approaches. This scoping literature review assesses current knowledge on civilian prehospital care in conflict zones, examining challenges, innovations, and potential directions for improving emergency responses in these high-risk environments. Methods: A systematic scoping review was conducted following the Joanna Briggs Institute guidelines. Research databases, including PubMed and Web of Science, were searched using keywords such as “prehospital,” “armed conflict,” and “civilian.” Studies were screened based on the inclusion criteria: non-military civilian populations, prehospital care, and set in armed conflict zones. Included studies were analyzed to identify common themes, challenges, and best practices. Results: Twenty articles met the inclusion criteria. The review highlighted several recurring themes: innovations adapted from military prehospital care, the critical role of Trauma Stabilization Points (TSPs), challenges in resource allocation, logistical barriers, and the psychological toll on patients and responders. Findings suggest that while military strategies like TSPs have shown potential when adapted for civilians, their implementation faces challenges due to limited resources, security risks, and a lack of trained personnel. Community-based first responders and non-governmental organizations (NGOs) play vital roles in providing care where formal medical systems are inadequate. Conclusion: Civilian prehospital care in conflict zones requires adaptable, resource-efficient strategies to manage logistical and operational constraints. The integration of technology, training of local responders, and community resilience building are essential for future progress. Further studies are urgently needed to assess and improve current practices in medical evacuation and stabilization in low-resource, unsafe environments.