Aims To describe the injury patterns and strategies employed by a Specialised Care Team managing direct and indirect injuries during the Gaza war, with particular emphasis on injuries from explosive weaponry.

Methods This descriptive observational study was analysed retrospectively from data by four specialised care teams mobilised into Rafah between February and June 2024. All cases with an orthopaedic component were included. Injuries were categorised according to region and acuity. Procedures were classified using standard orthopaedic terminology. Data were analysed descriptively. Any possible associations were assessed using appropriate statistical analysis.

Results 2340 patients were managed, of which 55.73% had acute injuries and 26.32% were of the high-velocity type. Children constituted 32.71% of cases seen. Lower limb injuries predominated and were significantly more likely to require surgical intervention (p<0.001). Among the procedures performed, wound debridement, change of dressings, and toilette and suturing accounted for over 80% of the operative workload, reflecting a damage-control approach. More than 65% of the workload related to managing musculoskeletal infection.

Conclusions Blast injuries from explosive weaponry generate a high burden of limb trauma necessitating a damage-limiting approach in a resource limited environment. Our findings highlight the essential role non-governmental organisations play in delivering life and limb saving assistance in Gaza.

Background Emergency response care providers including military medics, firefighters, paramedics and law enforcement officers deliver time-critical care in complex operational environments. Despite their frontline role, these professionals remain underrepresented in research activity and no validated instrument exists to assess research engagement barriers and enablers in this workforce.

Methods A cross-sectional survey instrument was developed using Cooke’s Research Capacity Development Framework, capturing individual, organisational and cultural influences on research engagement. Items were generated through literature synthesis and expert consultation and deployed via Qualtrics. Content validity was assessed using a structured Content Validity Index (CVI) process in which an expert panel rated item relevance on a four-point scale. Item-level CVI (I-CVI) was calculated as the proportion of experts rating items 3 or 4. Items with I-CVI below 0.80 were removed or revised.

Results Eighteen experts assessed 32 items. Thirty items (93.8%) met the retention criterion (I-CVI≥0.80) and were retained with minor refinements; two items (I-CVI=0.78) were removed. Retained item I-CVI values ranged from 0.83 to 1.00, with excellent scale-level content validity (S-CVI/Ave=0.93). Qualitative feedback informed improvements to clarity and cross-context applicability, with common themes around organisational culture, leadership endorsement, mentoring access and recognition.

Conclusion This study reports the systematic development and content validation of a novel instrument to assess research engagement barriers and enablers across emergency responder disciplines, providing a foundation for pilot testing and psychometric validation.