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The Military Medical Service of the French Forces insures the support of 29,000 French servicemen spread around the world each year and performs as such their medical evacuation by air towards France to guarantee their adequate treatment as soon as possible. This knowledge is sometimes also used for a national civilian abroad. We propose to describe the epidemiology of medical evacuation (MEDEVAC) made in the past 10 years.
We analysed data for every patient evacuated since 1 January 2000 and noted the destination, the number of patients per flight, the age, the gender, the status (military or civilian), the pathology, the presence of a specialist in the medical team (intensivist, cardiologist, psychiatrist) and the recipient hospital. The presence of an intubated ventilated patient or transfusion in flight was studied.
A total of 420 strategic MEDEVACs were carried out in 10 years (per year: 42 ± 6.9) in favor of 529 patients, among whom 90% were French servicemen. Each flight carried between one and 15 patients. Europe represents 42% of the original location of evacuation, Africa 39% and the Middle East 17%. An anesthetist-resuscitator reinforced the medical team in 51.7% of the evacuations. The patients with respiratory assistance are present in 19.8% of the flights and transfusion occurred in 3.1% of the flights. Traumatic pathology is predominant (49.5% of patients), divided into three major causes nearly equally: road traffic accident, ballistic and others. Burns represent a significant proportion (6.8%) of the causes of evacuation. Other causes are represented by 30.2% for medical conditions (n = 160 among which 59 cardiac affections), 10.2% for nontraumatic surgical affections and 2% for psychiatry. Finally 25.5% of the patients were accommodated in an ICU, 6% in a specific center for treatment of burns, 35.3% in a service of surgery and 24.6% in medicine.
If the number of MEDEVACs is relatively stable over the past decade, destinations and causes are changing. Africa remains an usual location of evacuation, the part of Europe tends to decrease for the benefit of the Middle East, which became in 2009 the predominant destination (21/47) stretching out the duration of flights. The causes of evacuations testify to the intensity of the commitment of French forces through traumatic affections, and in particular of ballistic origin, which are in 2009 the main traumatic affections (15/31). The corollary is an increase of the appeal to the resuscitators to deal with trauma patients.