Psychological first aid in operation for military healthcare providers : a study on pre-deployment training.

INTRODUCTION: During operational missions, while the management of physical injuries in the field remains the priority, the identification of operational incapacity of psychological origin is necessary as it is equally crucial for the safety of the individual, the group and the mission. The French Military Health Service has developed a Psychological First Aid Training in Operation (PFATO) course based on relational simulations, for military service members. The aim is to identify the early signs of psychological distress in a comrade and to adopt an adapted and protective attitude. PFATO training is also offered to healthcare providers. METHODS: We conducted a descriptive cross-sectional study using a self-administered online questionnaire which was sent after deployment to all physicians or nurses trained in PFATO between July 2019 and July 2021 (n=80). The main objective of our work was to evaluate the relevance of this awareness training among physicians and nurses and to identify specific complementary expectations in operational psychiatry for this population. RESULTS: We obtained a response rate of 55%. Significantly, 21.62% of participants used PFATO during their last deployment and another 20% observed a team member using PFATO. The circumstances of use as reported by participants included acute stress related to combat, conflict with hierarchy or comrades, and suicidal crisis. Among those who used PFATO, the training helped 87.5% of them to identify signs of psychological distress and 100% of them to assist combatants . All respondents stressed the added value of practical simulations during PFATO education. Moreover, this study also makes it possible to identify adaptations needed to optimize this module for healthcare providers. CONCLUSION: The results suggest the value for healthcare provider of training in first-response psychological care using relational simulation based on the model of raising awareness about PFATO.

What should a surgeon know about hidradenitis suppurativa?

Otherwise known as Verneuil's disease, hidradenitis suppurative (HS) is a severe dermatosis of heterogeneous appearance affecting 1% of the population. Its pathophysiology is multifactorial, involving genetic predisposition, inflammatory disorder and environmental elements. Its diagnosis is based on the association of three clinical characteristics: characteristic lesions, typical localizations, and the chronic and recurrent nature of the lesions. Given its diversified aspects, diagnosis can be difficult to achieve. As its manifestations often include abscesses, it is important for the surgeon to know how to detect this pathology. The development of biologics has improved treatment of this disease, treatment that necessitates a multidisciplinary medical and surgical approach involving dermatologists and proctologists as well as surgeons. The objective of this report is to synthesize what a surgeon will need to know so as effectively treat HS patients.

Surgical Experiences From a French Forward Surgical Team on Board of the Landing Helicopter Deck MISTRAL.

INTRODUCTION: Onboard surface ships like destroyers and frigates, there is ROLE 1, whereas on a three-landing helicopter deck (LHD) and aircraft carrier, there is ROLE 2, with a surgical team. At sea, evacuation takes more time than on any other theater of operation. It also costs more money, so we wanted to analyze how many patients have been maintained onboard, thanks to ROLE 2. Moreover, we wanted to analyze the surgical activities on the LHD MISTRAL ROLE 2. METHODS: We performed a retrospective observational study. We retrospectively analyzed all surgery cases performed on the MISTRAL between January 1, 2011, and June 30, 2022. During this period, there were only 21 months with a surgical team ROLE 2 onboard. We included all consecutive patients who underwent minor or major surgery onboard. RESULTS: A total of 57 procedures were performed during the period, involving 54 patients (52 males and 2 females) with an average age of 24.4 ± 1.9 years. The most frequent pathology was abscess (pilonidal sinus abscess, axillary abscess, or perineal abscess) (n = 32; 59.2%). Only two Medical Evacuations were conducted because of surgery; the other patients who underwent surgery were maintained onboard. CONCLUSIONS: We have shown that using ROLE 2 aboard the LHD MISTRAL decreases the use of Medical Evacuation. It also helps to perform surgery under better conditions for our sailors. Doing everything to keep sailors onboard seems to be an important point.

[Reception and involvement of soldiers' families]. / Accueil et implication des families de militaires.

Faced with a mental health crisis, the intervention of nurses, psychologists and psychiatrists is rarely limited to an individual approach. Our team has chosen to structure and systematise the involvement of the families of hospitalised soldiers.A family psychotherapy consultation has also been reinforced in orderto favourthe inclusion of the families of soldiers in crisis. These two tools are complementary and have enabled us to enrich the multidisciplinary work within the unit, as well as the relationship with the patients and families confronted with a crisis.