Four years of orthopaedic activities in Chinese Role 2 Hospital of eastern Mali peacekeeping area

2018 ◽  
Vol 166 (3) ◽  
pp. 156-160 ◽  
Author(s):  
Dawei Zhang ◽  
Z Li ◽  
X Cao ◽  
B Li
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Treatment Facility ◽  
Improvised Explosive Devices ◽  
Skill Sets ◽  
Medical Treatment Facility ◽  
Chinese Military ◽  
Surgical Teams ◽  
Improvised Explosive ◽  
Explosive Devices

IntroductionThe Chinese Role 2 Hospital (CHN-Role 2H) Medical Treatment Facility (MTF) was founded in July 2013 as part of the Chinese commitment to Multidimensional Integrated Stabilization Mission in Mali (MINUSMA). It provides medical care for approximately 5200 personnel of the whole Sector East of MINUSMA including UN military personnel, UN police and UN civilian staff. The aim of this study was to determine the orthopaedic surgical activity over a 4-year period to facilitate the training of future Chinese military surgical teams.Materials and methodsSurgical records of all patients operated on at the CHN-Role 2H between 28 March 2014 to 28 March 2018 were identified, and all orthopaedic activity were analysed.ResultsDuring this period, 1190 patients underwent 2024 surgical procedures. Orthopaedic procedures represented 961/2024 (47.5%) of all the procedures. Battle injury (BI) represented 43% of patients. Improvised explosive devices (IEDs) were responsible for 15.8 % casualties. Fractures (49%) and soft tissue injures (43%) were the most common injuries, with 61% of the fractures being open. Damage control surgery including debridement (23.52%) and external fixation (17.90%) were the most frequently performed interventions.ConclusionOrthopaedic surgery is the most frequently performed surgery in the CHN-Role 2H in Mali. The complexity and severity of injuries demonstrate the urgent need for tailored training and extended skill sets for deploying military orthopaedic surgeons.

Peacekeepers suffered combat-related injuries in Mali: a retrospective, descriptive study

2018 ◽  
Vol 166 (3) ◽  
pp. 161-166
Author(s):  
Zhao Yongqiang ◽  
H Dousheng ◽  
L Yanning ◽  
M Xin ◽  
W Kunping
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Descriptive Study ◽  
Body Parts ◽  
Medical Treatment Facility ◽  
Chinese Military ◽  
Overseas Operations ◽  
Minor Injuries ◽  
Improvised Explosive ◽  
Explosive Devices

PurposeTo describe the combat-related injuries cured by Chinese Level 2 medical treatment facility (CHN L2) in Mali from 1 March 2016 to 1 March 2018, including type of weapon, mortality, nature of injuries, degree and location of injuries and surgical procedures.Methods A retrospective, descriptive study of 176 injured cases that met the terrorist attacks was conducted. The medical data were collected by an electronic database system. All collected data were entered into an Excel spreadsheet for calculation.ResultsWe found that improvised explosive devices (114/176, 65%) were the most commonly used weapons of attack in Mali. 68.75% of the injuries (121/176) were classified as 'minor injuries according to Abbreviated Injury Scale score. As one patient may suffer multiple injuries, each location and nature of injuries was counted separately. Surface injuries were the top (116/197, 58.88%), followed by orthopaedic injuries (52/197, 26.39%) and internal injuries (29/197, 14.72%). The extremities were the most frequently injured body parts (144/197, 73.09%). We operated 175 surgeries to deal with the 176 combat-related injuries, which accounted for 40.05% of all 437 surgeries. The surgical debridement to remove fragments of explosive was the most frequently performed surgery. We also admitted 20 cases (18/176, 34%) into intensive care unit and transferred 40 cases to Level 3 medical facility.Conclusion Peacekeepers taking protective measures for head and trunk frequently got surface injuries. And their unprotected extremities often got injured. The fragment removal was the top surgery and the damage control surgery was the highly technical nature surgery we performed. Chinese military should offer advanced surgical training course to military surgeons who carry out overseas operations.

scholarly journals Utilization profile of the Canadian-led coalition Role 2 Medical Treatment Facility in Iraq: the growing requirement for multinational interoperability

2018 ◽  
pp. S195-S202
Author(s):  
Mark P. DaCambra ◽  
Raymond L. Kao ◽  
Christopher Berger ◽  
Vivian C. McAlister
Keyword(s):  
Medical Treatment ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Armed Forces ◽  
Mass Casualty ◽  
Clinical Activity ◽  
Treatment Facility ◽  
Similar Frequency ◽  
Medical Treatment Facility ◽  
Battle Injuries

Background: The Canadian Armed Forces deployed a Role 2 Medical Treatment Facility (R2MTF) to Iraq in November 2016 as part of Operation IMPACT. We compared the multinational interoperability required of this R2MTF with that of similar facilities previously deployed by Canada or other nations. Methods: We reviewed data (Nov. 4, 2016, to Oct. 3, 2017) from the electronic Disease and Injury Surveillance Report and the Daily Medical Situation Report. Clinical activity was stratified by Global Burden of Diseases category, ICD-10 code, mechanism of injury, services used, encounter type, nationality and blood product usage. We reviewed the literature to identify utilization profiles for other MTFs over the last 20 years. Results: In total, 1487 patients were assessed. Of these, 5.0% had battle injuries requiring damage-control resuscitation and/or damage-control surgery, with 55 casualties requiring medical evacuation after stabilization. Trauma and disease non-battle injuries accounted for 44% and 51% of patient encounters, respectively. Other than dental conditions, musculoskeletal disorders accounted for most presentations. Fifty-seven units of fresh frozen plasma and 64 units of packed red blood cells were used, and the walking blood bank was activated 7 times. Mass casualty activations involved coordination of health care and logistical resources from more than 12 countries. In addition to host nation military and civilian casualties, patients from 15 different countries were treated with similar frequency. Conclusion: The experience of the Canadian R2MTF in Iraq demonstrates the importance of multinational interoperability in providing cohesive medical care in coalition surgical facilities. Multinational interoperability derives from a unique relationship between higher medical command collaboration, international training and adherence to common standards for equipment and clinical practice.

Blast injury of the hand related to warfare explosive devices: experience from the French Military Health Service

2020 ◽  
pp. jramc-2019-001326
Author(s):  
Georges Pfister ◽  
J-C Murison ◽  
A Grosset ◽  
A Duhoux ◽  
E Lapeyre ◽  
...  
Keyword(s):  
Health Service ◽  
Functional Result ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Blast Injury ◽  
Military Hospital ◽  
Skin Closure ◽  
Military Health ◽  
Medical Treatment Facility ◽  
Explosive Devices

IntroductionThe objective was to report on the experience of the French Army Health Service in the management of blast injury of the hands related to warfare explosive devices.MethodsA retrospective study was conducted in the Percy Military Hospital (role 4 medical treatment facility) among French soldiers who presented with a combat-related blast injury of the hand between 2002 and 2018. The functional result was assessed by the disabilities of the arm, shoulder and hand (DASH) and the Orthotics and Prosthetics User Survey (OPUS, upper extremity functional status) scores. Proximal amputations (PAs) and distal amputations (DAs) were distinguished for the analysis.ResultsFifteen patients with a mean age of 31±8 years were included. They totalised 20 blasted hands. There were 16 traumatic amputations: 8 in each of the PA and DA groups. Twelve patients had additional injuries, four of which were polytraumatic. Skin closure time and flap use were higher in the DA group. Only one thumb reconstruction was performed. At a mean follow-up of 6.5±4 years, the number of amputees wearing a prosthesis was higher in the PA group. The mean DASH and OPUS scores were 35.5%±24.0% and 64.0%±19.0%, respectively, with no difference between the two groups.ConclusionThe severity of hand blasts related to warfare explosive devices requires the systematic application of damage control surgery. PAs are frequent and secondary reconstruction options are limited. The functional result is poor and similar between proximal and distal amputees.

Reviewing the needs of forward deployed critical care: South Sudan and the future

2021 ◽  
Vol 167 (5) ◽  
pp. 372-374
Author(s):  
Victoria Bulleid ◽  
T Hooper ◽  
G Nordmann
Keyword(s):  
Critical Care ◽  
Damage Control ◽  
South Sudan ◽  
Damage Control Surgery ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
The Uk ◽  
Care Capacity ◽  
Battle Injuries ◽  
Ballistic Trauma

The UK military medical treatment facility (MTF) that deployed to the United Nations Mission in South Sudan in 2017 was based on a facility that can provide damage control surgery and resuscitation for soldiers with ballistic trauma injuries. It had to be supplemented with additional medical equipment and drugs that could support a peacekeeping mission in Africa. The clinicians used this experience and opportunity to review the critical care capability of UK Army Medical Services forward MTFs and recommend changes to reflect the increasing contemporaneous need on recent deployments to support more casualties with medical, infectious diseases and other non-battle injuries and illnesses. A concurrent review of the facility’s critical care transfer equipment was also undertaken and allowed it to be adapted for use as either transfer equipment or as a critical care surge capability, to increase the facility’s critical care capacity.

Detection and Imaging of Improvised Explosive Devices

2014 ◽  
Author(s):  
Ricardo von Borries
Keyword(s):  
Improvised Explosive Devices ◽  
Improvised Explosive ◽  
Explosive Devices

scholarly journals Frequency of Improvised Explosive Devices and Suicide Attempts in the U.S. Army

2017 ◽  
Vol 182 (3) ◽  
pp. e1697-e1703 ◽  
Author(s):  
Robert J. Ursano ◽  
Ronald C. Kessler ◽  
James A. Naifeh ◽  
Holly Herberman Mash ◽  
Carol S. Fullerton ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Improvised Explosive Devices ◽  
Improvised Explosive ◽  
Explosive Devices ◽  
The U.S
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