An example of extreme cardiology: chest pain on the high seas and helicoptered medical evacuations: the French Navy experience.
Medicalized high sea rescue is very different from prehospital medical evacuation. It requires specifically trained medical teams because the difficulties are marine, aerial, and medically related. The French Navy provides medical evacuations by helicopter on the Atlantic coast, up to 320 km offshore and under all weather conditions. The epidemiology of acute chest pain in the high seas has been poorly described. Therefore, in this retrospective study, we aimed to assess the prevalence and constraints found in the management of these emergencies. From January 1, 2000, to April 30, 2009, 286 medical evacuations by helicopter were performed, 132 of which were due to traumatological emergencies, and 154 to medical emergencies. Acute chest pain, with 36 missions, was the leading cause of medical evacuation. All evacuated patients were men who were either professional sailors or ferry passengers. The median age was 48 years (range, 26-79). The most common prehospital diagnosis was coronary chest pain in 23 patients (64%), including 11 patients with acute coronary syndrome with ST-segment elevation. Thirty-two patients were airlifted by helicopter. All patients benefited from monitoring, electrocardiogram, peripheral venous catheter, and medical management as soon as the technical conditions allowed it.
Clermont Tonnerre Hospital of Military Training, Brest BP41 BCRM 29240 Brest Cedex 9, France. ulric.vinsonneau@orange.fr
Ulric
U
Vinsonneau
Christiane
C
Cavel
Christophe
C
Bombert
Laurent
L
Lely
Nicolas
N
Paleiron
Claude
C
Vergez-Larrouget
Jean-Christophe
JC
Cornily
Philippe
P
Castellant
Martine
M
Gilard
Paule
P
Paule
Jean-Ariel
JA
Bronstein
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000368:Aged; D017732:Air Ambulances; D001267:Atlantic Ocean; D002637:Chest Pain / Q000175:diagnosis / Q000628:therapy*; D004630:Emergencies; D004632:Emergency Medical Services; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D009326:Naval Medicine; D012189:Retrospective Studies