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NCD care in an emergency: the essentials

Participant handout · WHO, UNHCR and inter-agency guidance · gpreasoning.uk/global

Reasoning GP
Global Primary Care

Find first

  • Anyone on insulin.
  • Epilepsy on medicines.
  • Severe asthma or COPD.
  • Ask everyone: do you take a medicine every day?

Triage NCD emergencies

Brief history, then ABCDE. Treat now and refer: chest pain, heart failure, very high BP with symptoms, stroke, DKA, hypoglycaemia, severe asthma or COPD, fits that do not stop.

Restart treatment

  • Hypertension: restart from protocol; amlodipine needs no tests.
  • Type 2 diabetes: metformin, then gliclazide (not glibenclamide).
  • Insulin: human insulin, syringes, glucose checks.
  • Asthma or COPD: usual inhaler with a spacer.
  • Epilepsy: one reliable antiepileptic; never stop suddenly.

Food short?

Gliclazide and insulin can cause lows. Ask about meals, lower doses if needed, make sure people carry sugar.

Supplies

  • IEHK: general kit, few NCD medicines.
  • NCD Kit 2022: 10,000 people for 3 months, with insulin cold chain, equipment and glucometer.
  • Short list from WHO Model List and national list; buffer stock.

Organise

  • One protocol per condition, same at every site.
  • Register: who is due, who missed, who is controlled.
  • Patient-held card with diagnosis, medicines, doses.
  • Referral routes agreed; plan handover to national services.

Say it simply

Keep this card with you and show it at any clinic. Come back before your tablets run out, even if you feel well.

Sources

UNHCR and International Rescue Committee. Integrating non-communicable disease care in humanitarian settings: an operational guide. 2020. Jacquerioz Bausch F, Beran D, Hering H and others (Conflict and Health). Operational considerations for the management of non-communicable diseases in humanitarian emergencies. 2021. World Health Organization. Noncommunicable diseases kit (NCDK) 2022. 2022. World Health Organization. Interagency Emergency Health Kit 2024. 2024. World Health Organization. Diagnosis and management of type 2 diabetes (HEARTS-D). 2020. World Health Organization. Guideline for the pharmacological treatment of hypertension in adults. 2021. International Rescue Committee. Package of essential non-communicable diseases interventions for humanitarian settings (PEN-H). 2020.
Adapted from WHO guidance; not endorsed by WHO. This page paraphrases and adapts the WHO publications listed under Sources, which are licensed CC BY-NC-SA 3.0 IGO; the adapted text is shared under the same licence for non-commercial education. Reasoning GP is not affiliated with WHO or any other organisation named here. Use it alongside your national guidelines, essential medicines list and formulary, and your clinical judgement. Doses are given only where they come from a WHO source; otherwise follow your national guideline or formulary.