French Navy: What is the Impact of Minor Surgery Emergencies in an Isolated Sea-Based Environment?

Research Paper Title

Impact of Minor Surgery Emergencies in Isolated Sea-Based Environment: The French Navy Experience.

Background

The aim of this article was to determine whether some of the urgent (<24 hours) medical evacuations (MEDEVACs) (from French Navy surface ships in isolated situations but with an embarked medical officer) of patients suffering from minor surgical emergencies could have been avoided, and if so, which ones.

Methods

This was a retrospective descriptive study of all MEDEVAC’s performed between 2009 and 2014. This was done by an analysis of the records held at the French Naval Medical Headquarters that included both MEDEVAC signals and anonymised files called “Patient Movement Request.”

Results

560 MEDEVACs were performed from French Navy surface ships in which most had an embarked medical officer but which were in isolated situations. Only 34 (6.1%) of the total evacuations were suffering from minor surgical emergencies. The majority of these were non-urgent MEDEVAC’s of whom 17 (50%) had no surgical procedure attempted on board. Seven (20%) underwent urgent MEDEVAC and only 2 of them had undergone the indicated therapeutic procedure on board. The most common pathology was displaced fracture of the fifth metacarpal (29.4%) before deep abscess e(17.6%).

Conclusions

Contrary to the researchers initial expectation, the operational impact of minor surgical emergencies remains low, which might suggest that a French naval medical doctor’s training is sufficient in this particular field. However, 50% of the overall evacuated patients and 71% of the “urgent” MEDEVACs (<24 hours) did not undergo the indicated, simple surgical procedure before evacuation. The idea of introducing a specific training programme for these procedures may therefore still have value.

Reference

Guénot, F., Leigh-Smith, S., Perrichot, C. & Pontis, J. (2017) Impact of Minor Surgery Emergencies in Isolated Sea-Based Environment: The French Navy Experience. Military Medicine. 182(11):e2027-e2031. doi: 10.7205/MILMED-D-17-00070.

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