المؤلفون: Gignoux-Froment, Frédérique, Martinez, Thibault, Derely, Jean, Turc, Jean, Corcostegui, Simon-Pierre, Derkenne, Clément, Peigne, Vincent, Trousselard, Marion, Bazin, Angèle, Lamblin, Antoine

المصدر: Military Medicine ; ISSN 0026-4075 1930-613X

الوصف: Russia’s invasion of Ukraine has triggered the biggest conflict in Europe since the Second World War. It has forced countries to prepare for engagement on a massive scale, namely, a high-intensity war between nation states. A potential massive influx of wounded personnel risks saturating logistical supply chains and requires changes to not only medical care but also a paradigm shift. In this context, the principle of distributive justice is key. The aim is to save as many lives as possible through triage, which consists in “doing the greatest good for the greatest number.” This idea is fundamental, as an emergency that has passed is no longer an emergency. However, international texts and treaties not only underline that the sole criterion for triage is clinical severity, but they also fail to take into account the patient’s status (civilian, friend, and foe). In a high-intensity warfare situation, these texts, and the medical-surgical triage criteria they provide are insufficient, as caregivers may be required to make decisions based on the status of the patient. The need to make such choices could cause psychological suffering among military caregivers, as individuals are recurrently faced with difficult ethical dilemmas. One way to prevent this happening is to provide predeployment training in wartime medical ethics. The latter would include both instruction in international humanitarian law and practical simulations of clinical situations where the person is faced with an ethical dilemma.

الإتاحة: https://doi.org/10.1093/milmed/usae165Test

المؤلفون: Pouessel Kafka, Tara, Soniak, Claire, Benbrika, Widad, Vacher, Antony, Boutonnet, Mathieu, Martinez, Thibault

المصدر: Military Medicine ; ISSN 0026-4075 1930-613X

مصطلحات موضوعية: Public Health, Environmental and Occupational Health, General Medicine

الوصف: Introduction With the evolution of educational tools, the French Military medical service has created a podcast program, Traum’Cast, about the principles of war medicine, accessible online for free. Method Our objective was to measure the learning effect of the Traum’Cast program’s first episode. A non-randomized pilot trial between July and December 2021 included 80 health care providers: 40 in the video podcast group compared to 40 in a group reading a pdf file providing the same information. Using a 10 MCQs, we evaluated knowledge acquisition before, just after, and 2 weeks after the intervention. It was measured using metacognition tools based on confidence marking (number of correct answers, score weighted by certainty level, and realism). Results Knowledge acquisition was better in the podcast group than in the pdf file group immediately after the intervention (correct answers: 9.0 [9.0–10.0] vs 9.0 [7.8–9.0], P = 0.015; weighted score: 177.0 [159.0–198.0] vs 160.0 [129.5–176.5], P = 0.020). This difference was persistent 2 weeks after (weighted score: 127.5 [101.8–145.2] vs 105.5 [74.2–128.5], P = 0.023). Conclusion This podcast is an innovative teaching tool which has proven to strengthen the knowledge of the principles of war medicine.

الإتاحة: https://doi.org/10.1093/milmed/usae011Test

المؤلفون: Py, Nicolas, Martinez, Thibault, Boyé, Matthieu, Tourtier, Jean-Pierre, Meaudre, Eric, Benbrika, Widad, Ausset, Sylvain, Pasquier, Pierre

المصدر: Military Medicine ; ISSN 0026-4075 1930-613X

الوصف: Introduction Military anesthesiologists from the French Military Medical Service (FMMS) are part of the Forward Surgical Teams deployed in overseas military operations. The practice of anesthesia in combat zones requires specific skills that are not taught during the initial curriculum for French civilian anesthesiologist. The Pre-Deployment Advanced Course in Anesthesia and Resuscitation (DACAR) program was developed to prepare military anesthesiologist from the FMMS before their deployment in overseas military operations. Methods Created in 2013 by the French Military Medical Academy, the DACAR program is divided into two modules and carried out once a year. The DACAR program trains all military anesthesiologist residents at the end of their curricula. Since 2019, a number of Certified Registered Nurse Anesthetists have completed the DACAR program. The DACAR program is organized around the main axes of experience feedback from previous deployments in combat zones as well as didactic learning and practical training using high-fidelity simulation. Results Since 2013, a total of 99 trainees completed the DACAR program during six complete cycles of two modules. The DACAR program has gradually been enriched from 14 courses in 2013 to 28 in 2019. Participants’ reported satisfaction rates have increased steadily since 2016, when 88% of courses were rated as “interesting” or “very interesting,” and only 4% as “not very interesting.” By 2019, those figures had improved to 96% and 2%, respectively. Conclusion The DACAR program is a structured and adapted military medical course aimed at completing the curriculum of military anesthesiologists from the FMMS before deployment in overseas military operations. Regular audits and updates ensure that the DACAR training program maintains the highest standards of quality and rigor.

الإتاحة: https://doi.org/10.1093/milmed/usab035Test