Afflux massif: Que fait on vraiment ?

Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis.

Schauer SGet Al. Prehosp Disaster Med. 2017 Aug;32(4):465-468

 

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Finalement des choses simples à faire PARFAITEMENT, et pas forcément par des médecins. On note quand même la présence des immobilisations des verrous salés et de gestes comme des exsufflations thoraciques ou des coniotomies.

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BACKGROUND:

Mass-casualty (MASCAL) events are known to occur in the combat setting. There are very limited data at this time from the Joint Theater (Iraq and Afghanistan) wars specific to MASCAL events. The purpose of this report was to provide preliminary data for the development of prehospital planning and guidelines.

METHODS:

Cases were identified using the Department of Defense (DoD; Virginia USA) Trauma Registry (DoDTR) and the Prehospital Trauma Registry (PHTR). These cases were identified as part of a research study evaluating Tactical Combat Casualty Care (TCCC) guidelines. Cases that were designated as or associated with denoted MASCAL events were included. Data Fifty subjects were identified during the course of this project. Explosives were the most common cause of injuries. There was a wide range of vital signs. Tourniquet placement and pressure dressings were the most common interventions, followed by analgesia administration.

 

Oral transmucosal fentanyl citrate (OTFC) was the most common parenteral analgesic drug administered. Most were evacuated as "routine." Follow-up data were available for 36 of the subjects and 97% were discharged alive.

CONCLUSIONS:

The most common prehospital interventions were tourniquet and pressure dressing hemorrhage control, along with pain medication administration. Larger data sets are needed to guide development of MASCAL in-theater clinical practice guidelines. 

 

L'essence du triage

Ce témoignage exprime parfaitement tous les enjeux du sauvetage au combat en montrant qu'il s'agit d'un concept de prise en charge intégrant toutes les dimensions dela traumatologie moderne (préparation,  savoir faire personnel, travail en équipe: son équipe et les autres, délégation, leadership, gestion du stress). 

Etre fort dans sa tête, dans son savoir pour pouvoir former ses personnels et les guider au moment de l'action en ayant pris le recul suffisant.

Actu santé.pdf