28/07/2011
Equiments santé: Du nouveau !
Faisant suite au déploiement de la nouvelle trousse du combattant, de nouveaux équipements vont être mis progressivement en service. Ils viennent compléter la gamme actuelle.
Un sac léger d'intervention FOBSOL sac polyvalent.pdf , un organiseur déroulant DECLICK roll pack.pdf, une gamme de panneaux modulaires TOM panneau modulaire.pdf, un sac dédié à la médicalisation des hélicoptères FOBAERO sac O² polyvalent.pdf.
La DAPSA, qui a été le maître d'oeuvre de l'appel d'offre, a fait appel à toute l'expérience des personnels santé ayant exercé en afghanistan, notamment ceux de la brigade alpine et des forces spéciales, ainsi que sur la participation du DMAO de Mont de Marsan et du CITERA de l'HIA Desgenettes à Lyon.
26/07/2011
Un garrot: Oui mais surtout un garrot pneumatique
Un travail d'une portée majeure qui met en évidence l'importance de disposer de garrot pneumatique delfi dès que possible.
Les garrots du type du SOFTT ou du CAT doivent être posé à l'avant mais surtout doivent être doublé, associé à un pansement compressif et surtout remplacé le plus tôt possible par un garrot pneumatique du type du garrot DELFI EMT.
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An Evaluation of Two Tourniquet Systems for the Control of Prehospital Lower Limb Hemorrhage.
Taylor DM et all. (J Trauma. 2011;XX: 000–000) DOI: 10.1097/TA.0b013e31820e0e41
Background:
Hemorrhage remains the main cause of preventable death on the modern battlefield. As Improvised Explosive Devices in Afghanistan become increasingly powerful, more proximal limb injuries occur. Significant concerns now exist about the ability of the windlass tourniquet to control distal hemorrhage after mid-thigh application. To evaluate the efficacy of the Combat Application Tourniquet (CAT) windlass tourniquet in comparison to the newer Emergency and Military Tourniquet (EMT) pneumatic tourniquet.
Methods:
Serving soldiers were recruited from a military orthopedic outpatient clinic. Participants’ demographics, blood pressure, and body mass index were recorded. Doppler ultrasound was used to identify the popliteal pulses bilaterally. The CAT was randomly self-applied by the participant at midthigh level, and the presence or absence of the popliteal pulse on Doppler was recorded. The process was repeated on the contralateral leg with the CAT now applied by a trained researcher. Finally, the EMT tourniquet was applied to the first leg and popliteal pulse change Doppler recorded again.
Results:
A total of 25 patients were recruited with 1 participant excluded. The self-applied CAT occluded popliteal flow in only four subjects (16.6%). The CAT applied by a researcher occluded popliteal flow in two subjects (8.3%). The EMT prevented all popliteal flow in 18 subjects (75%). This was a statistically significant difference at p 0.001 for CAT versus EMT.
Conclusion:
This study demonstrates that the CAT tourniquet is ineffective in controlling arterial blood flow when applied at mid-thigh level. The EMT was successful in a significantly larger number of participants.
07/07/2011
Rachis: Immobilisation cervicale sans collier ?
Rachis: Immobilisation cervicale nécessaire au combat ?
L'immobilisation du rachis cervical n'estpas recommandée en CONDITION de combat d'INFANTERIE. Dans un travail effectué sur les blessés au Vietnam seuls % des blessés auraitent pu en tirer bénéfice. Mais la pose d'un collier cervical prend du temps exposant le sauveteur. 10% des blessés le sont à l'occasion de sauvetage.
En complément de l'article précédent:
"Care of the combat casualty with spinal column or spinal cord injury has not been previously described,
particularly in regards to spinal immobilization. The ultimate goal of spinal immobilization in the combat
casualty is to first ‘‘do no further harm’’ and then provide a stable, painless spine and an optimal
neurologic recovery. The protocol for treatment of the combat casualty with suspected spinal column
or spinal cord injury from the battlefield to final arrival at a definitive treatment center is discussed,
and the special considerations for medical evacuation off the battlefield and for aeromedical transport
are delineated. Selective prehospital spine immobilization, which involves spinal immobilization with
backboard, semi-rigid cervical collar, lateral supports, and straps or tape, is recommended if there
is suspicion of spinal column or spinal cord injury in the combat casualty and when conditions and
resources permit. The authors do not recommend spinal immobilization for the combat casualty with
isolated penetrating trauma. "