Page 126 - JSOM Spring 2023

collateral risks for the jump because of the material carried. Analysis and Discussion
The French military medical service is involved from selection
to support for paratroopers in operation, even embedded in We acknowledge major biases, such as a limited sample size
HAHO/HALO, thus consolidating its expertise in the field of and the declarative nature of the survey.
high altitude.
Conclusions and Perspectives
Keywords: Parachutism; HAHO HALO; military free fall; mili-
tary; hypobaria; altitude; barotrauma; hypoxia; decompres- SOF operators pay great attention to a high-quality diet, but
sion illness; decompression sickness; hypothermia they rarely get dietary information from a professional. Med-
ical SOF units may increase their knowledge in nutrition to
find the best way to communicate with the operators for a
References
1. Morand G, Haar A, Travers S, Aigle L, Dubecq C. The medical con- better reception.
straints of high altitude for the military parachutist at very great
height. Int Rev Armed Forces Medical Services. 2021;94(3):48–60. Dr Mathieu B is affiliated with the French Military Medical Service,
2. Jha VN. Supplemental oxygen for paratroopers and sky divers. De- 6ème Antenne Médicale Spécialisée, France.
fence Science Journal. 2012.
3. Petruso MJ, Philbrick SM. Definitive treatment of neurological de-
compression sickness in a resource limited location. Aerosp Med
Hum Perform. 2021. Pre-Hospital Burns
4. Butler FK. Decompression sickness presenting as optic neuropathy.
Aviat Space Environ Med. 1991.
5. Pilmanis AA, Webb JT. Altitude DCS research in support of Special Adapted for Prolonged Field Care (PFC)
Operations Forces (SOF). NATO RTO-MP- HFM-062. 2001.

Dr Gabriel M is affiliated with the French Military Medical Service,
4ème Antenne Médicale Spécialisée, France. Winston de Mello, MD

Learning Objectives
Nutritional Features 1. Stopping the burn process and cooling the burn up to 3
Among SOF Operators hours post-burn may reduce the percentage of total body
surface area burn and the depth of burn.
2. Nebulized epinephrine (1mg in 5mL to 10mL sterile water
or normal saline) may provide additional time before an
Mathieu B, MD advanced airway intervention is needed. Placing the burn
patient in Fowler’s position may negate the need for tra-
cheal intubation.
Introduction 3. “Big man, big burn, big bag; small man, small burn, small
bag” is a pragmatic approach to fluid resuscitation. Any
Special Operations Forces (SOF) operators can be considered
top athletes regarding their intensive training and the physical hypotension in the first 12 hours post-burn suggests an-
constraints they have to manage during Special Operations. other source of fluid/blood loss.
An international literature review on nutritional habits in the 4. Analgesic techniques: topical morphine (20mg in 10mL to
Armed Forces showed that nutritional education has a positive 20mL sterile water), early use of co-analgesics once neuro-
effect on physical performance and that the prevalence rate of pathic pain is suspected, using the painDETECT question-
ergogenic substances is higher during deployment than among naire and inhaled methoxyflurane for procedural pain.
soldiers in France. This study aimed to investigate more precisely 5. Escharotomy and fasciotomy (major bleeding and proce-
among the French SOF community their nutritional habits, their dural pain).
motivations, and their information sources by comparing sol- 6. For wound cleaning, use baby wipes and Octenilin Wound
diers in France and those abroad in military operations. Gel.
7. Physical therapy to chest and major joints and appropriate
splinting.
Methods 8. A recipe for an oral/enteral high-energy feeding solution
for burns.
This was a monocentric, declarative, retrospective study among
63 male operators during September 2022. 9. Palliation for those whose life expectancy may be less than
2 hours.
Main Results References
1. Battaloglu E, Greaseley L, Leon-Villapalos J, Young A, Porter
Most of the operators do not follow a diet (70% in France, K. Faculty of Pre-Hospital Care & British Burn Association Ex-
68% abroad), and, among those who do follow a diet, they pert Consensus Meeting. Management of Burns in Pre-Hospital
are largely high-protein diets, mainly during the mission (24% Trauma Care. 2020.
vs. 17%); half of operators take proteins, especially during the 2. De Mello WF, Greenwood NPA. The burns fluid grid: a pre-hos-
mission (59% vs. 46%); 51% found dietary information on pital guide to fluid resuscitation in burns. J R Army Med Corps.
the web, and only 20% got it from a health practitioner; and 2009;155(1):27–29.
the main motivations for taking dietary supplements are per-
formance and well-being, especially during the mission. COL (Ret) Winston de Mello is affiliated with College of Remote &
Offshore Medicine, Malta.

124 | JSOM Volume 23, Edition 1 / Spring 2023