35e Régiment d'infanterie, CMA Belfort, quartier Maud'Huy, BP 529, 90016, Belfort Cedex, France.
28e Régiment de transmission, CMA Clermont-Ferrand, Quartier de Bange, avenue de Bange, 63500, Issoire, France.
Eur J Trauma Emerg Surg. 2019 Jun;45(3):437-443. doi: 10.1007/s00068-018-0915-x. Epub 2018 Feb 2.
French military physicians serving in deployment are confronted with pediatric polytrauma patients (PPP) during the provision of medical aid to civilian populations. The objectives of this study were to describe the current care of PPPs during these missions, to report difficulties encountered and to evaluate the training of doctors for management of PPPs in the field.
A descriptive epidemiological study based on a questionnaire sent to physicians who had been deployed overseas.
91 doctors participated. Their mean age was 35 years. 86% of the doctors managed children whilst serving overseas, of which 54% were PPPs. The incidence of pediatric polytrauma varied according to the country, but overall from 1129 emergencies reported during overseas missions, 11% were PPPs. Penetrating traumas represented 37% of cases; 24% were circulatory distress and 19% were massive bleeding. 80% of the doctors reported a lack of pediatric trauma experience, less than 5% had received appropriate in-service training and only 9% had worked in pediatric emergency facilities in France. The equipment available for PPPs in the field was often poorly understood and frequently considered to be insufficient.
The occurrence of PPPs of war is rare and complex, but care of older children it is similar to that required for adults. Preparation for PPP management, it could be optimized by identifying risks which alter depending on the country of deployment, such as the logistical organization of the battlefield chain of care. Improvements in doctors' pediatric trauma training should be individualized, based on their mission needs.
III.
在向平民提供医疗援助时，在部署中的法国军医会遇到儿科多发伤患者（PPP）。本研究的目的是描述这些任务中 PPP 的当前治疗情况，报告遇到的困难，并评估医生在现场管理 PPP 的培训情况。
这是一项基于向海外部署的医生发送问卷的描述性流行病学研究。
91 名医生参与了研究。他们的平均年龄为 35 岁。86%的医生在海外服务期间管理儿童，其中 54%为 PPP。儿科多发伤的发生率因国家而异，但在海外任务中报告的 1129 次紧急情况中，总体发生率为 11%。穿透性创伤占 37%；24%为循环障碍，19%为大量出血。80%的医生报告缺乏儿科创伤经验，不到 5%接受过适当的在职培训，只有 9%在法国的儿科急救设施工作过。现场 PPP 可用的设备往往理解不足，且经常被认为不足。
战争中 PPP 的发生很少见且复杂，但对大孩子的治疗与对成年人的治疗相似。通过确定因部署地点而异的风险（例如战场护理链的后勤组织），可以优化 PPP 管理的准备工作。应根据任务需求，对医生的儿科创伤培训进行个性化改进。
III 级。
