Critical Care Skill Triad for Tactical Evacuations

Area of Science:

• Military Medicine
• Emergency Medicine
• Critical Care

Background:

• The French Military Medical Service (FMMS) provides medical support to deployed soldiers globally.
• En-route critical care is vital for maintaining patient safety during tactical medical evacuation (MEDEVAC).
• FMMS training programs for en-route critical care require continuous updates based on operational experience.

Purpose of the Study:

• To identify and characterize essential critical care skills for tactical MEDEVAC missions utilizing fixed-wing aircraft.
• To inform the development and refinement of training curricula for flight surgeons involved in critical care air transport.

Main Methods:

• A 10-item survey was distributed to 22 flight surgeons with prior deployment experience in the Sahel-Saharan Strip.
• Eight survey questions focused on assessing basic critical care competencies.
• Two questions evaluated flight surgeons' interest in pre-deployment training in critical care and transfusion medicine.

Main Results:

• 14 out of 22 flight surgeons responded to the survey.
• Nearly all respondents encountered situations requiring critical care skills during their deployments.
• The most frequently required critical care skills were mechanical ventilation management, catecholamine administration, and blood product transfusion.
• Five respondents reported performing on-board blood transfusions, including red blood cells, lyophilized plasma, and fresh whole blood.

Conclusions:

• The survey underscores the necessity for MEDEVAC teams to possess robust critical care medicine expertise.
• A core set of critical care skills for managing severe casualties during tactical MEDEVAC includes mechanical ventilation, catecholamine infusion, and blood product transfusion.