Five years of prolonged field care: prehospital challenges during recent French military operations
| Autor: | Clément Derkenne, Cyril Carfantan, Romain Kedzierewicz, Antoine Luft, Luc Aigle, Stéphane Travers, Andrew P. Cap, Marilyn Franchin, Pierre Pasquier, Olivier Dubourg, Aurelien Renard, Christophe Martinaud, Sylvain Ausset, Christian Bay |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Emergency Medical Services Resuscitation Immunology Psychological intervention 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Interquartile range Kilometer medicine Immunology and Allergy Humans Blood Transfusion Military Medicine Hemopneumothorax Medical treatment business.industry Hematology Air Ambulances medicine.disease Military personnel Military Personnel Military health Wounds and Injuries Female Medical emergency France business Airway 030215 immunology |
| Zdroj: | Transfusion. 59(S2) |
| ISSN: | 1537-2995 |
| Popis: | Background French military operations in the Sahel conducted since 2013 over more than 5 million square kilometers have challenged the French Military Health Service with specific problems in prolonged field care. Study design and methods To describe these challenges, we retrospectively analyzed the prehospital data from the first 5 years of these operations within a delimited area. Results One hundred eighty-three servicemen of different nationalities were evacuated, mainly as a result of explosions (73.2%) or gunshots (21.9%). Their mean number evacuation was 2.2 (minimum, 1; maximum, 8) per medical evacuation with a direct evacuation from the field to a Role 2 medical treatment facility (MTF) for 62% of them. For the highest-priority casualties (N = 46), the median time [interquartile range] from injury to a Role 2 MTF was 130 minutes [70 minutes to 252 minutes], exceeding 120 minutes in 57% of cases and 240 minutes in 26%. The most frequent out-of-hospital medical interventions were external hemostasis, airway and hemopneumothorax management, hypotensive resuscitation, analgesia, immobilization, and antibiotic administration. Prehospital transfusion (RBCs and/or lyophilized plasma) was started three times in the field, two times during helicopter medical evacuation, and five times in tactical fixed wing medical aircraft. Lyophilized plasma was confirmed to be particularly suitable in these settings. One of the specific issues involved in lengthy prehospital time was the importance to reassess and convert tourniquets prior to Role 2 MTF admission. Conclusion Main challenges identified include reducing evacuation times as much as possible, preserving ground deployment of sufficiently trained medics and medical teams, optimization of transfusion strategies, and strengthening specific prolonged field care equipment and training. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text