open access

Vol 69, No 2 (2018)
Case report
Submitted: 2018-03-25
Accepted: 2018-05-16
Published online: 2018-06-22
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Management of a polytrauma in the maritime environment

Cécile Montocchio-Buadès1, Maëlle Daurat1, Macha Ducombs2, Charles-Edouard Vallet2
·
Pubmed: 29939389
·
IMH 2018;69(2):126-128.
Affiliations
  1. French Society for Maritime Medicine, Brest, France
  2. French Navy

open access

Vol 69, No 2 (2018)
MARITIME MEDICINE Case report
Submitted: 2018-03-25
Accepted: 2018-05-16
Published online: 2018-06-22

Abstract

Background: A polytraumatised person is a severely injured patient with an association of several injuries
including at least one life-threatening. In an isolated and hostile environment like the maritime
environment, the principles of early care and fast evacuation of a polytraumatised person are sometimes
difficult to apply.


Clinical case: We report the story of a patient with a bilateral fracture of the lower extremities following an
accident on board a Moldavian tugboat off the coasts of Djibouti. He received a medical treatment thanks
to the intervention of a French military frigate after receiving a message of assistance by very high frequency,
and then a helicopter evacuation to the Medicine and Surgery “Bouffard” Hospital. The pre-hospital
care of a polytraumatised patients with limb injuries and the specificities of an intervention in a maritime
environment are described. The maritime international conventions relating to rescue at sea as well as
the specificities of the management of an injured person on a ship sailing under the Moldavian flag are
explained. Emphasis is placed on the importance of watchkeeping at sea and the presence on board of
trained first-aid personnel. Finally, a point is made on the French organisation of health support for ships,
through the Maritime Medical Consultation Centre and the Regional Operational Centres for Surveillance
and Rescue.


Conclusions: This case illustrates that the solidarity of the seafarers allows a seriously wounded person to
maintain, despite a degraded and isolated situation, the chances of successful management and preserve
the functional prognosis.

Abstract

Background: A polytraumatised person is a severely injured patient with an association of several injuries
including at least one life-threatening. In an isolated and hostile environment like the maritime
environment, the principles of early care and fast evacuation of a polytraumatised person are sometimes
difficult to apply.


Clinical case: We report the story of a patient with a bilateral fracture of the lower extremities following an
accident on board a Moldavian tugboat off the coasts of Djibouti. He received a medical treatment thanks
to the intervention of a French military frigate after receiving a message of assistance by very high frequency,
and then a helicopter evacuation to the Medicine and Surgery “Bouffard” Hospital. The pre-hospital
care of a polytraumatised patients with limb injuries and the specificities of an intervention in a maritime
environment are described. The maritime international conventions relating to rescue at sea as well as
the specificities of the management of an injured person on a ship sailing under the Moldavian flag are
explained. Emphasis is placed on the importance of watchkeeping at sea and the presence on board of
trained first-aid personnel. Finally, a point is made on the French organisation of health support for ships,
through the Maritime Medical Consultation Centre and the Regional Operational Centres for Surveillance
and Rescue.


Conclusions: This case illustrates that the solidarity of the seafarers allows a seriously wounded person to
maintain, despite a degraded and isolated situation, the chances of successful management and preserve
the functional prognosis.

Get Citation

Keywords

polytrauma, maritime conventions, Search and Rescue

About this article
Title

Management of a polytrauma in the maritime environment

Journal

International Maritime Health

Issue

Vol 69, No 2 (2018)

Article type

Case report

Pages

126-128

Published online

2018-06-22

Page views

1499

Article views/downloads

1376

DOI

10.5603/IMH.2018.0018

Pubmed

29939389

Bibliographic record

IMH 2018;69(2):126-128.

Keywords

polytrauma
maritime conventions
Search and Rescue

Authors

Cécile Montocchio-Buadès
Maëlle Daurat
Macha Ducombs
Charles-Edouard Vallet

References (14)
  1. Kroupa J. Definition of « polytrauma » and « polytraumatism »]. Acta Chir Orthop Traumatol Cech. 1990; 57(4): 347–360.
  2. Stahel P, Heyde C, Ertel W. Current Concepts of Polytrauma Management. Eur J Trauma. 2005; 31(3): 200–211.
  3. Maritime Transportation Research Board, Commission on Sociotechnical Systems, National Research Council. 1979.
  4. Napoleone P. Accidents on board merchant ships. Suggestions based on Centro Internazionale Radio Medico (CIRM) experience. Int Marit Health. 2016; 67(1): 21–23.
  5. Department of Economic Development. Medical care onboard ship and ashore. Maritime Labour Notice.
  6. Admiralty and Maritime Law Guide, International Conventions. Convention for the Unification of Certain Rules of Law with respect to Collisions between Vessels. 1910.
  7. International conference on safety of life at sea. Text of the convention for the safety of life at sea. London, 1914.
  8. Armateurs de France. La convention de Montego Bay en 50 leçons.
  9. International Convention on Maritime Search and Rescue (SAR). avr 27. 1979.
  10. International Maritime Organization. Medical Assistance at Sea. MSC/Circ. 960 juin, 2000.
  11. International Maritime Organization. Adoption of amendments to the international aeronautical and maritime search and rescue (IAMSAR) manual. MSC.1/Circ. 1289 déc, 2008.
  12. Maritime code of the Republic of Moldova. sept 30. 1999.
  13. Lee C, Porter KM. Prehospital management of lower limb fractures. Emerg Med J. 2005; 22(9): 660–663.
  14. Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev. 2004(1): CD003764.

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