title: Predeployment training for forward medicalisation in a combat zone: the specific policy of the French Military Health Service.
abstract: BACKGROUND
  To improve the mortality rate on the battlefield, and especially the potentially survivable pre-Medical Treatment Facility deaths, Tactical Combat Casualty Care (TCCC) is now considered as a reference for management of combat casualty from the point of injury to the first medical treatment facility. TCCC comprises of a set of trauma management guidelines designed for use on the battlefield. The French Military Health Service also standardised a dedicated training programme, entitled "Sauvetage au Combat" (SC) ("forward combat casualty care"), with the characteristic of forward medicalisation on the battlefield, the medical team being projected as close as possible to the casualty at the point of injury. The aim of our article is to describe the process and the result of the SC training.
  
  
  METHODS
  Records from the French Military Health Service Academy - École du Val-de-Grâce administration, head of the SC teaching programme, defining its guidelines, and supporting its structure and its execution, were examined and analyzed, since the standardisation of the SC training programme in 2008. The total number of trainees was listed following the different courses (SC1, SC2, SC3).
  
  
  RESULTS
  At the end of 2013, every deployed combatant underwent SC1 courses (confidential data), 785 health-qualified combatants were graduated for SC2 courses and 672 Role 1 physician-nurse pairs for SC3 courses.
  
  
  CONCLUSIONS
  The SC concept and programmes were defined in France in 2007 and are now completely integrated into the predeployment training of all combatants but also of French Military Health Service providers. Finally, SC teaching programmes enhance the importance of teamwork in forward combat medicalisation settings.
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Bégin (Military Teaching Hospital), Saint-Mandé, France. Electronic address: pasquier9606@me.com.
authors: Pierre
authors: P
authors: Pasquier
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Bégin (Military Teaching Hospital), Saint-Mandé, France. Electronic address: clement.dubost@hotmail.fr.
authors: Clément
authors: C
authors: Dubost
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Percy (Military Teaching Hospital), Clamart, France. Electronic address: mathieuboutonnet@hotmail.com.
authors: Mathieu
authors: M
authors: Boutonnet
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Bégin (Military Teaching Hospital), Saint-Mandé, France. Electronic address: anne.chrisment@hotmail.com.
authors: Anne
authors: A
authors: Chrisment
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Bégin (Military Teaching Hospital), Saint-Mandé, France. Electronic address: t-ville@orange.fr.
authors: Thierry
authors: T
authors: Villevieille
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Bégin (Military Teaching Hospital), Saint-Mandé, France. Electronic address: ebtjm@free.fr.
authors: Emmanuel
authors: E
authors: Batjom
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Bégin (Military Teaching Hospital), Saint-Mandé, France. Electronic address: lbordier@club-internet.fr.
authors: Emmanuel
authors: E
authors: Bordier
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Percy (Military Teaching Hospital), Clamart, France. Electronic address: sylvain.ausset@gmail.com.
authors: Sylvain
authors: S
authors: Ausset
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Desgenettes (Military Teaching Hospital), Lyon, France. Electronic address: marc.puidupin@gmail.com.
authors: Marc
authors: M
authors: Puidupin
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Desgenettes (Military Teaching Hospital), Lyon, France. Electronic address: jyvesmartinez@yahoo.com.
authors: Jean-Yves
authors: JY
authors: Martinez
authors: Tactical Care Training Department, French Military Health Service Academy - École du Val-de-Grâce, Paris, France. Electronic address: Christian.bay@sante.defense.gouv.fr.
authors: Christian
authors: C
authors: Bay
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Desgenettes (Military Teaching Hospital), Lyon, France. Electronic address: jacques.escarment@yahoo.fr.
authors: Jacques
authors: J
authors: Escarment
authors: French Military Health Service Academy - École du Val-de-Grâce, Paris, France. Electronic address: francois.pons@sante.defense.gouv.fr.
authors: François
authors: F
authors: Pons
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Percy (Military Teaching Hospital), Clamart, France. Electronic address: Bernard.lenoir@sante.defense.gouv.fr.
authors: Bernard
authors: B
authors: Lenoir
authors: Department of Anesthesiology and Intensive Care Unit, Hôpital d'Instruction des Armées Bégin (Military Teaching Hospital), Saint-Mandé, France. Electronic address: merat.stephane@wanadoo.fr.
authors: Stéphane
authors: S
authors: Mérat
mesh_terms: D055826:Afghan Campaign 2001-; D004632:Emergency Medical Services / Q000458:organization & administration*; D005602:France; D006077:Government Agencies; D006801:Humans; D015601:Injury Severity Score; D054542:Iraq War, 2003-2011; D008887:Military Medicine / Q000193:education*; D008889:Military Personnel; D011785:Quality Assurance, Health Care; D014857:Warfare; D014947:Wounds and Injuries / Q000401:mortality*
keywords: Forward medicalisation; French policy; Predeployment training; Tactical Combat Casualty Care