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Master Thesis

Évacuations médicales stratégiques de patients critiques impliquant un médecin anesthésiste-réanimateur : analyse rétrospective de 16 ans d’expérience

Abstract : The strategic medical evacuation (MEDEVAC) allows the airborne repatriation to the metropolis of soldiers injured or sick on missions. The aim of the study was to describe the epidemiology of strategic MEDEVACs and to analyze the role of the anesthetist-intensive care physician (MAR) in the management of critical situations in flight. All soldiers who benefited from a strategic MEDEVAC with a MAR on board between 1 January 2001 and 30 November 2017 were included. A total of 452 soldiers were repatriated, 245 (54%) for traumatic reasons and 207 (46%) for medical reasons, with 276 (61%) evacuations within 48 hours of the event. The median annual number of strategic MEDEVACs with MAR was 26 [20-32]. One hundred and fifty-five (34%) patients were intubated, 103 (23%) on catecholamines and 188 (42%) in an early postoperative setting. The median IGS-2 score was 13 [8-24]. One hundred and seventy-eight adverse events were identified, 123 (69%) related to a worsening of the patient's clinical condition and 30 (20%) related to a technical problem. Forty-seven (20%) patients without apparent initial failure worsened in flight. No deaths occurred on board and no flights had to be diverted for an uncontrolled situation. The strategic early MEDEVAC is a determining element of the potential for the engagement of the armed forces in operations avoiding the saturation of the medical structures on the spot. The MAR ensures the continuity of care for serious traumatic and medical patients, based on medical and aeronautical expertise requiring theoretical and practical training that should be based on these lessons learned.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03209548
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Submitted on : Tuesday, April 27, 2021 - 11:56:09 AM
Last modification on : Saturday, September 4, 2021 - 3:26:07 AM

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  • HAL Id : dumas-03209548, version 1

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Pauline Ponsin. Évacuations médicales stratégiques de patients critiques impliquant un médecin anesthésiste-réanimateur : analyse rétrospective de 16 ans d’expérience. Médecine humaine et pathologie. 2019. ⟨dumas-03209548⟩

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