Page 87 - JSOM Winter 2021

2021 Combat Medical Care (CMC)

Conference Abstracts

Force Health Protection – A Short Story of Mice, (SOST). In this context, a BEL SOST was deployed in IRQ
Men and Microbes in 2017. In three weeks’ time, it took care of more than 250
Bender K, Ltr SanGrp KSM wounded patients.
orce Health Protection (FHP) and field hygiene are not the A retrospective study of the SOST casualty logbook was car-
Ffirst aspects coming to mind when planning the medical ried out, with as primary objective, to evaluate the surgical
support of Special Forces operations. But maintaining the sol- management performed and to compare it with the results of
dier`s health can prevent derogation of combat strength of a other military surgical teams. The secondary objectives were
whole unit or team. threefold: investigate the inadequacy between the actual doc-
trine and patients’ survival; define which invasive procedures
According to the Allied Joint Medical Force Health Protection should be implemented to reduce preventable mortality in pre-
Doctrine (AJMed-P 4; Field Hygiene and Sanitation), histori- hospital environment; implement the actual doctrine.
cally around 80% (!) of reported casualties among U.S. mili-
tary personnel have been attributed to disease non-battlefield This study showed that the fifteen most frequent Damage Con-
Injuries (DNBI). While Direct Action (DA) missions require trol Resuscitation and Surgery procedures during these three
fast-track preparation facing other issues and priorities, strat- weeks accounted for 87% of all the invasive procedures per-
egy for long-term missions (like Special Reconnaissance (SR) formed at the casualty collection point where the BEL SOST
and Military Assistance (MA) missions) should include FHP was based.
and preventive medicine measures. Therefore, implementing these procedures in military medical
On the basis of the made experiences during a MA mission in doctrine so that they can be performed as quickly as possible
the sub-Sahara region, recommendations and examples for the after a trauma by the lowest echelon possible would reduce
successful implementation of FHP and field hygiene aspects preventable trauma-related mortality. It also seems essential to
are given. teach these critical procedures to surgical teams, both military
and civilian, before being deployed to combat zones.
The leading special forces officers should be aware of possible
environmental risks and the recommended mitigation mea-
sures to prevent a spreading of infectious diseases or other Terrorist Attacks in Paris: Managing Mass
environmental health risks among their soldiers. FHP and pre- Casualties in a Remote Trauma Center
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ventive medicine measures should be part of the medical con- Florent Femy , Arnaud Follin , Philippe Juvin , Anne-Laure
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cept as soon as planning for long-term missions starts. Feral-Pierssens ; Departments of Emergency, Intensive Care
Unit, Georges Pompidou European Hospital, Assistance
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Publique - Hôpitaux de Paris, Medical School, Paris Descartes
Tactical Medicine and Tactical Combat Casualty University, Paris, France
Care: Singapore’s Perspective Objective: On 13 November 2015, Paris was the target of
David Chew multiple terrorist attacks responsible for a massive influx of
ven though Singapore is a relatively safe country with low casualties in emergency departments (EDs). Because of the ac-
Eincidences of violence, constant vigilance is key to secu- tivation of a local crisis plan and the arrival of extra staff, our
rity. Over the years, Tactical Medicine and TCCC have gone capacities increased markedly. Our aim was to analyze whether
through significant development and adoption in Singapore. our center, in this challenging context, efficiently managed this
The evolution of medical care in austere environments has massive influx of patients. Patients and methods: We carried
been key in our capability development and improving the op- out a monocentric retrospective study. All patients received
erational efficiency of the uniform personnel from different in the first 24 h were included (isolated psychological trauma
agencies and services. Case studies will be discussed in this with no physical injury excluded). Our main endpoint was
presentation to give the audience a better understanding on to assess patient diversion through early secondary transfers
the impact of Tactical Medicine and TCCC in the manage- (≤ 24 h) because of an overrun of our capacities. Results: A
ment of casualties in terrorist attacks and the battlefield both total of 53 victims were sent to our center in a 4 h timeframe;
current and future. 12 patients were excluded (no physical injury). We analyzed
41 victims. Their median injury severity score was 4 (1;9).
Three (7%) patients were transferred after ED management
Critical Skills in Austere Environment to a nearby hospital within the first 24 h for minor orthopedic
JC de Schoutheete, Queen Astrid Military Hospital and University surgery. There was a significant increase in medical/surgical
Hospitals Leuven – Belgium
staff (eight ED physicians instead of two; six intensivists vs.
assive bleeding remains the leading cause of preventable two; three orthopedic surgeons vs. one). Among the victims,
Mdeath in trauma patients. In order to remedy this, vari- 71% had firearms wounds and 30% had open fractures.
ous Western armies have tested in recent years a concept of Twenty surgeries were performed in the first 24 h. There were
“Forward Surgery” using Special Operations Surgical Team no in-hospital deaths. Conclusion: Faced with an unusual

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