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  1. Article ; Online: Deployment of a mobile military ICU embedded in a civilian hospital during the second COVID-19 outbreak in Mayotte, France.

    Mathais, Quentin / Swiech, Astrée / De Rocquigny, Gaël / Thill, Chloé / Aries, Philippe

    Anaesthesia, critical care & pain medicine

    2021  Volume 40, Issue 4, Page(s) 100888

    MeSH term(s) COVID-19 ; Comoros ; Disease Outbreaks ; France/epidemiology ; Hospitals ; Humans ; Intensive Care Units ; Military Personnel ; SARS-CoV-2
    Language English
    Publishing date 2021-05-21
    Publishing country France
    Document type Letter
    ISSN 2352-5568
    ISSN (online) 2352-5568
    DOI 10.1016/j.accpm.2021.100888
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  2. Article ; Online: Penetrating thoracic injuries: a retrospective analysis from a French military trauma centre.

    Swiech, Astree / Boddaert, G / Daban, J-L / Falzone, E / Ausset, S / Boutonnet, M

    BMJ military health

    2019  Volume 167, Issue 1, Page(s) 33–39

    Abstract: Background: Penetrating thoracic injuries (PTIs) is a medicosurgical challenge for civilian and military trauma teams. In civilian European practice, PTIs are most likely due to stab wounds and mostly require a simple chest tube drainage. On the ... ...

    Abstract Background: Penetrating thoracic injuries (PTIs) is a medicosurgical challenge for civilian and military trauma teams. In civilian European practice, PTIs are most likely due to stab wounds and mostly require a simple chest tube drainage. On the battlefield, combat casualties suffer severe injuries, caused by high-lethality wounding agents.The aim of this study was to analyse and compare the demographics, injury patterns, surgical management and clinical outcomes of civilian and military patients with PTIs.
    Methods: All patients with PTIs admitted to a Level I Trauma Centre in France or to Role-2 facilities in war theatres between 1 January 2004 and 31 May 2016 were included. Combat casualties' data were analysed from Role-2 medical charts. The hospital manages military casualties evacuated from war theatres who had already received primary surgical care, but also civilian patients issued from the Paris area. During the study period, French soldiers were deployed in Afghanistan, in West Africa and in the Sahelo-Saharan band since 2013.
    Results: 52 civilian and 17 military patients were included. Main mechanisms of injury were stab wounds for civilian patients, and gunshot wounds and explosive fragments for military casualties. Military patients suffered more severe injuries and needed more thoracotomies. In total, 29 (33%) patients were unstable or in cardiac arrest on admission. Thoracic surgery was performed in 38 (55%) patients (25 thoracotomies and 13 thoracoscopies). Intrahospital mortality was 18.8%.
    Conclusion: War PTIs are associated with extrathoracic injuries and higher mortality than PTIs in the French civilian area. In order to reduce the mortality of PTIs in combat, our study highlights the need to improve tactical en route care with transfusion capabilities and the deployment of forward surgical units closer to the combatants. In the civilian area, our results indicated that video-assisted thoracoscopic surgery is a reliable diagnostic and therapeutic technique for haemodynamically stable patients.
    MeSH term(s) Adult ; Female ; France/epidemiology ; Humans ; Injury Severity Score ; Male ; Retrospective Studies ; Thoracic Injuries/epidemiology ; Thoracic Injuries/therapy ; Thoracotomy/methods ; Thoracotomy/statistics & numerical data ; Trauma Centers/organization & administration ; Trauma Centers/statistics & numerical data ; Wounds, Penetrating/epidemiology ; Wounds, Penetrating/therapy
    Language English
    Publishing date 2019-06-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 3011686-7
    ISSN 2633-3775 ; 2633-3767
    ISSN (online) 2633-3775
    ISSN 2633-3767
    DOI 10.1136/jramc-2019-001159
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    Un I Zs.541: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Strategic air medical evacuation of critically ill patients involving an intensive care physician: A retrospective analysis of 16 years of mission data.

    Ponsin, Pauline / Swiech, Astrée / Poyat, Chrystelle / Alves, François / Jacques, Anne Emmanuelle / Franchin, Marylin / Raynaud, Laurent / Boutonnet, Mathieu

    Injury

    2020  Volume 52, Issue 5, Page(s) 1176–1182

    Abstract: Background: Strategic medical evacuation (MEDEVAC) allows airborne repatriation of soldiers injured or sick on missions to their national territory. The aim of this study was to describe the epidemiology of strategic MEDEVAC performed by intensive care ... ...

    Abstract Background: Strategic medical evacuation (MEDEVAC) allows airborne repatriation of soldiers injured or sick on missions to their national territory. The aim of this study was to describe the epidemiology of strategic MEDEVAC performed by intensive care physicians (ICP) and to analyze the role of the ICP in the management of critical care situations in flight.
    Methods: All soldiers who had high or medium dependency conditions and who benefited from a strategic MEDEVAC with an ICP on board between 1 January 2001 and 30 November 2017 were included in this epidemiological retrospective study.
    Results: A total of 452 soldiers were repatriated; the causes of repatriation were either trauma (n = 245; 54%) or medical pathologies (n = 207; 46%). Two hundred and seventy-six (61%) evacuations were performed within 48 h. The median annual number of strategic MEDEVAC with an ICP was 26 [20-32]. One hundred and fifty-five (34%) patients were mechanically ventilated and 103 (23%) received catecholamines. The median SAPS II score was 13 [8-24]. One hundred and seventy-eight adverse events were identified, of which 123 (69%) related to a worsening of the patient's clinical condition and 30 (20%) related to a technical problem. Forty-seven (20%) patients who initially appeared stable worsened during the flight. No deaths occurred on board, however, and no flights had to be diverted due to an uncontrolled care situation.
    Conclusion: The results suggested that the presence of an ICP ensured a continued high-level care for patients with serious trauma and medical injuries, due to the medical and aeronautical expertise that resulted from the theoretical and practical training of the personnel on board. Based on these results, lessons regarding future MEDEVAC flights could be learned in order to continue to improve patient outcome.
    MeSH term(s) Air Ambulances ; Critical Care ; Critical Illness ; Humans ; Military Medicine ; Military Personnel ; Physicians ; Retrospective Studies ; Wounds and Injuries/therapy
    Language English
    Publishing date 2020-10-06
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2020.10.010
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    Zs.A 778: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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    Zs.MO 10: Show issues

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  4. Article ; Online: Use of serious games to facilitate the predeployement training of Combat Life Savers.

    Pasquier, Pierre / Swiech, Astrée / Boutonnet, Mathieu / de Rudnicki, Stéphane / de Saint Maurice, Guillaume Pelée

    Injury

    2016  Volume 47, Issue 6, Page(s) 1357–1358

    MeSH term(s) Humans ; Video Games
    Language English
    Publishing date 2016
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2016.03.040
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    Zs.A 778: Show issues Location:
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    Zs.MO 10: Show issues

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  5. Article ; Online: Lung ultrasound for chest tube insertion.

    Martinez, Thibault / Pasquier, Pierre / Swiech, Astrée / Kearns, Kevin / Dubost, Clément / Mérat, Stéphane

    The American journal of emergency medicine

    2015  Volume 33, Issue 8, Page(s) 1095–1096

    MeSH term(s) Chest Tubes ; Female ; Hemothorax/etiology ; Hemothorax/therapy ; Humans ; Male ; Thoracic Injuries/complications ; Wounds, Nonpenetrating/complications
    Language English
    Publishing date 2015-08
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2015.04.022
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    Zs.A 2005: Show issues Location:
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  6. Article ; Online: Terrorist threat: Creating a nationwide damage control training program for non-trauma care providers.

    Swiech, Astrée / de Rocquigny, Gaël / Martinez, Thibault / Loarer, Gwion / Vico, Sylvain / Planchon, Jérôme / Le Goff, Arnaud / Bertho, Kilian / Derkenne, Clément / Travers, Stéphane / Malgras, Brice / Martinaud, Christophe / Carfantan, Cyril / Gaudry, Stéphane / Boutonnet, Mathieu / Pasquier, Pierre

    Anaesthesia, critical care & pain medicine

    2019  Volume 39, Issue 1, Page(s) 59–64

    Abstract: Introduction: The current terrorist threat challenges nations to train numerous non-trauma care providers with different backgrounds in damage control (DC) strategies. The purpose of this work was to propose a specific DC training program.: Methods: ... ...

    Abstract Introduction: The current terrorist threat challenges nations to train numerous non-trauma care providers with different backgrounds in damage control (DC) strategies. The purpose of this work was to propose a specific DC training program.
    Methods: A Task Force of 16 civilian and military physicians met for a 24-hour session, to propose the construction of a DC training program for non-specialised caregivers.
    Results: Existing DC training programs are heterogeneous, mainly theoretical and almost only for physicians. A program entitled Damage Control for Terrorist Attack Victims (DC-TAV) was then proposed. Identified training targets were care providers from prehospital and hospital staffs, with no experience in trauma care. The training objectives were the improvement of individual and collective skills in managing terrorist attacks casualties. The tools selected for training concerned e-learning on a dedicated digital teaching platform (including a core section of four modules with types and mechanisms of injury, basic DC techniques, triage, organisation of emergency medical response and two complementary modules for doctors with DC resuscitation including remote transfusion and DC surgery), hands-on workshops with procedural simulation and full-scale simulation exercises, technical (tourniquets, haemostatic gauzes, needle thoracostomy, chest tube drainage, management of airway, coniotomy) and non-technical (leadership, communication, coordination and triage, decision-making, appropriate use of resources) skills. Finally, an evaluation of the DC-TAV program was planned.
    Conclusions: The DC-TAV program is an ambitious, civilian-military, nationwide and long-term program, based on a harmonised standard of care and including multidimensional training. Further studies are required to assess its efficacy.
    MeSH term(s) Clinical Competence ; Emergency Medical Services ; France ; General Surgery ; Health Personnel/education ; Health Planning ; Humans ; Military Personnel ; Personnel, Hospital/education ; Physicians ; Terrorism ; Triage
    Language English
    Publishing date 2019-10-12
    Publishing country France
    Document type Journal Article
    ISSN 2352-5568
    ISSN (online) 2352-5568
    DOI 10.1016/j.accpm.2019.09.011
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