Early transfusion on battlefield before admission to role 2: A preliminary observational study during “Barkhane” operation in Sahel

Vitalis, V.; Carfantan, Cyril; Montcriol, Ambroise; Peyrefitte, Sébastien; Luft, Antoine; Pouget, Thomas; Sailliol, A.; Ausset, Sylvain; Meaudre, Éric; Bordes, Julien

doi:10.1016/j.injury.2017.11.029

Cited by 24 publications

(49 citation statements)

References 21 publications

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“…Consistent data support the benefit of prehospital transfusion . Delayed evacuation further reinforces the importance of blood products being available closer to the site of injury and during evacuation, which justifies the provision of French lyophilized plasma (FLYP) for ground Role 1 medical teams and the transfusion of plasma and RBC during MEDEVAC since 2016 …”

Section: Discussionmentioning

confidence: 73%

“…Vitalis et al described that 25% of Alpha casualties received prehospital transfusion in a similar area of operations between April 2016 and April 2017. Our series also confirms the easy utilization of FLYP in the field.…”

Section: Discussionmentioning

confidence: 99%

“…The difficulties caused by distances of sometimes over 1000 kilometers between the point of injury and surgical teams, and the need to transfer casualties after surgery to international airports for strategic evacuations, have justified the deployment of fixed wing medical tactical aircraft (CASA) in addition to MEDEVAC rotary wing platforms . The procedures have also been gradually adapted to the constraints of the field, including the establishment of a comprehensive prehospital transfusion program …”

Section: Methodsmentioning

confidence: 99%

“…12 The procedures have also been gradually adapted to the constraints of the field, including the establishment of a comprehensive prehospital transfusion program. [12][13][14][15]…”

Section: Contextmentioning

confidence: 99%

“…2,3,[25][26][27][28] Delayed evacuation further reinforces the importance of blood products being available closer to the site of injury and during evacuation, which justifies the provision of French lyophilized plasma (FLYP) for ground Role 1 medical teams and the transfusion of plasma and RBC during MEDE-VAC since 2016. 13,14 Vitalis et al 13 described that 25% of Alpha casualties received prehospital transfusion in a similar area of operations between April 2016 and April 2017. Our series also confirms the easy utilization of FLYP in the field.…”

Section: Optimization Of Prehospital Transfusion Strategiesmentioning

confidence: 99%

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Five years of prolonged field care: prehospital challenges during recent French military operations

et al. 2019

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BACKGROUND French military operations in the Sahel conducted since 2013 over more than 5 million square kilometers have challenged the French Military Health Service with specific problems in prolonged field care. STUDY DESIGN AND METHODS To describe these challenges, we retrospectively analyzed the prehospital data from the first 5 years of these operations within a delimited area. RESULTS One hundred eighty‐three servicemen of different nationalities were evacuated, mainly as a result of explosions (73.2%) or gunshots (21.9%). Their mean number evacuation was 2.2 (minimum, 1; maximum, 8) per medical evacuation with a direct evacuation from the field to a Role 2 medical treatment facility (MTF) for 62% of them. For the highest‐priority casualties (N = 46), the median time [interquartile range] from injury to a Role 2 MTF was 130 minutes [70 minutes to 252 minutes], exceeding 120 minutes in 57% of cases and 240 minutes in 26%. The most frequent out‐of‐hospital medical interventions were external hemostasis, airway and hemopneumothorax management, hypotensive resuscitation, analgesia, immobilization, and antibiotic administration. Prehospital transfusion (RBCs and/or lyophilized plasma) was started three times in the field, two times during helicopter medical evacuation, and five times in tactical fixed wing medical aircraft. Lyophilized plasma was confirmed to be particularly suitable in these settings. One of the specific issues involved in lengthy prehospital time was the importance to reassess and convert tourniquets prior to Role 2 MTF admission. CONCLUSION Main challenges identified include reducing evacuation times as much as possible, preserving ground deployment of sufficiently trained medics and medical teams, optimization of transfusion strategies, and strengthening specific prolonged field care equipment and training.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…12 The procedures have also been gradually adapted to the constraints of the field, including the establishment of a comprehensive prehospital transfusion program. [12][13][14][15]…”

Section: Contextmentioning

confidence: 99%