Que font les israéliens en role 1

Role I trauma experience of the Israeli Defense Forces on the Syrian border

Benov A. et All. J Trauma Acute Care Surg. 2014 Sep;77(3 Suppl 2):S71-6

Une des particularités des actions conduites en role 1 par les équipes israéliennes est la maîtrise par leurs personnels des gestes de contrôle des voies aériennes, qu'il s'agisse de médecins ou de paramédic EMT-P. Cette publication l'illistre et confirme l'importance actuelle de ce savoir faire qui est donc ESSENTIEL pour une médicalisation réelle de l'avant.

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" Two-hundred fifty-eight casualties arrived at the border, 60 of whom were evaluated and returned to Syria. Of those, 15 received basic care and did not require any additional intervention, 39 experienced chronic conditions with no immediate need for medical attention, and 6 were dead on arrival. ......................Data from all echelons including prehospital information were available for 178 (90%) of the 198 patients, and this group constituted the study cohort. The extent of medical evacuation among the 178 casualtiesis as follows: 8 (4%) required only Role I care (debridement of wounds, removal of fragments, or death despite resuscitation attempts); 65 (36%) were evacuated to a Role 2+ facility and were later discharged; and 84 (47%) were evacuated to Role 3 civilian hospitals.  ................................Eighteen patients underwent advanced airway procedures. Of 14 patients with a documented oxygen saturation of less than 90%, 5 improved following oxygen supplementation and did not require airway intervention. Of the 18 patients undergoing definitive airway management, head and face injury was present in two thirds (n = 11) of these, whereas a quarter (n = 4) had thoracic injury. The procedures were endotracheal intubation (ETI) (n = n = 15) and cricothyroidotomy (CRIC) (n = 10). Seven of eight casualties underwent CRI following failed initial attempt at ETI, and one patient was able to have mask ventilation following failed ETI. In three cases, CRIC was the first choice of airway management, two patients experiencing severe maxillofacial injury and one with severe laryngeal edema. There were no cases of preventable death due to airway obstruction and no complications from airway interventions. Forty-three casualties experienced thoracic injuries, five underwent chest decompression at a Role I facility by either needle decompression (n = 3) or insertion of a chest drain (n = 2).