Transthoracic Doppler echocardiography during a military mission in a French role II in Mali: is it useful to learn this practice?

Author:

Martin Paul-Vincent1,Chataigneau Anaïs2,Arnaud François-Xavier3,Rozwadowski Faye4,Cournac Jean-Marie5,Martin Anne-Céline67

Affiliation:

1. Emergency department at the Percy Army training Hospital, 101 avenue Henri Barbusse, 92140 Clamart, France

2. Orthopedic and traumatology department at the Percy Army training Hospital, 101 avenue Henri Barbusse, 92140 Clamart, France

3. Radiology department at the Percy Army training Hospital, 101 avenue Henri Barbusse, 92140 Clamart, France

4. FAAFP, Primary Care Physician for U.S. Military Veterans, Tallahassee, Florida, 3231, USA

5. Internal Medecine department at the Percy Army training Hospital, 101 avenue Henri Barbusse, 92140 Clamart, France

6. Department of Cardiology, European Hospital Georges Pompidou, Paris, France

7. Université de Paris, Innovative Therapy in Haemostasis, INSERM 1140, Paris, France

Abstract

Abstract Introduction Ultrasound is now recognized as a key tool in the practice of medicine in isolated situations. This study aims to evaluate the impact of transthoracic echocardiography (TTE) in a military mission when performed by a trained military practitioner (MP). Materials and Methods We conducted a 2-month retrospective observational study on the use of TTE in a French medical complex in Mali with a mission that included providing a medical aid to the population. All patients were included. Every ultrasound performed by the MP was listed, and the epidemiologic data, indication for the exam and results were collected for each TTE. Results A total of 349 patients were included, 16 were war-wounded patients and 333 came for a general medical consultation. In all, 153 ultrasounds were performed, including 48 TTEs. Sixteen TTEs were performed to evaluate injuries in war-wounded patients. During the 333 medical consultations, 32 TTEs were realized. The indications were dyspnoea (10), heart murmur (7), acute chest pain (5) and assessment of heart disease (10). TTE permitted a direct positive diagnosis for 18 patients: 7 with acute heart failure and 11 with morphologic problems. The normality of the exam was a supplementary argument to exclude a cardiac implication for eight patients. Conclusions TTE can provide important information with a direct impact on the management of patients. Faced with cardiac emergencies, an adapted training can be proposed for the MP. Thereby, the transfer of conventional cardiac views could facilitate the advice of a cardiologist.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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5. Integrating extended focused assessment with sonography for trauma (eFAST) in the initial assessment of severe trauma: impact on the management of 756 patients;Zieleskiewicz;Injury,2018

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