Management of a polytrauma in the maritime environment

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.