Clinical Situations and Medical Procedures Performed by French Combat Medics in Military Operations: Implications for Training and Doctrine.

Abstract

Introduction: French combat medics (SC2) play a crucial role in managing battlefield casualties during overseas deployments. They are trained to manage a wide range of life-threatening conditions, sometimes without immediate medical support. This study aims to describe the clinical situations encountered by SC2 and the procedures they perform in operational environments.

Materials and methods: A retrospective study of professional practices based on an online questionnaire was conducted to identify the types of injuries managed by SC2 and the frequency of procedures performed. The exposure levels of SC2 and their proficiency in performing life-saving interventions were assessed. This research project was approved by the Ethics Committee of the French Research Bureau of the Directorate for Training, Research, and Innovation.

Results: Data from 374 questionnaires were analyzed in this study. Hemorrhage was the most frequent condition encountered, representing 56.3% of cases (n=209). Tourniquet application was performed by 48.5% of SC2 at least once, with a 92% success rate. Airway obstruction was managed in 15.8% of cases (n=58), with advanced airway procedures such as cricothyroidotomy being performed in 4.1% of cases (n=15). SC2 managed shock in 43.2% of cases (n=153) and severe traumatic brain injury in 46.4% (n=163).Vascular access was the most performed technical procedure, with 87.5% of personnel exposed (n=309). SC2 had to frequently manage these situations without nurse or physician support, in up to 42.6% of hemorrhagic cases.

Conclusions: Although hemorrhage control remains the primary challenge, SC2 must be prepared to handle a broad spectrum of battlefield injuries, including complex airway and circulatory management. In high-intensity conflicts, they may need to provide prolonged field care (PFC) without immediate SC3 support. These findings highlight the need to adapt training programs and doctrinal guidelines to better equip SC2 for independent casualty management in austere environments.