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Is E-FAST possible and useful on the battlefield? A feasibility study during medical courses in hostile environment (MEDICHOS): preliminary results
  1. Aurélien Renard1,
  2. C Martinet1,
  3. P J Cungi2,
  4. E Combes1,
  5. G Gasperini1,
  6. N Cazes3,
  7. C Carfantan4,
  8. A Faivre2,
  9. S Travers5,
  10. C Kelway6 and
  11. P Benner1
  1. 1 Service des urgences, HIA Sainte Anne, Toulon, Provence-Alpes-Côte d'Azur, France
  2. 2 Service Anesthesie et réanimation, HIA Sainte Anne, Toulon Armees, Provence-Alpes-Côte d'Azur, France
  3. 3 Service Médical du Bataillon des Marins Pompiers de Marseille, Marseille, France
  4. 4 Division Opérations, Etat-Major Opérationnel Santé, Direction Centrale du Service de Santé des Armées, Paris, France
  5. 5 2ème Centre Médical des Armées, 12ème Antenne Médicale–Ecole du Val de Grâce, Paris, France
  6. 6 Reanimation, Centre Hospitalier Intercommunal Toulon–La Seyne-sur-Mer, Toulon, Provence-Alpes-Côte d'Azur, France
  1. Correspondence to Col Aurélien Renard, Service des urgences, HIA Sainte Anne, Toulon 13003, Provence-Alpes-Côte d'Azur, France; aurelien.renard211{at}


Introduction The extent of the French forces’ territory in the Sahel band generates long medical evacuations. In case of many victims, to respect the golden hour rule, first-line sorting is essential. Through simulation situations, the aim of our study was to assess whether the use of ultrasound was useful to military doctors.

Methods In combat-like exercise conditions, we provided trainees with a pocket-size ultrasound. Every patient for whom the trainees chose to perform ultrasound in role 1 was included. An extended focused assessment with sonography for trauma (E-FAST) was performed with six basic sonographic views. We evaluated whether these reference views were obtained or not. Once obtained by the trainees, pathological views corresponding to the scenario were shown to assess whether the trainees modified their therapeutic management strategy and their priorities.

Results 168 patients were treated by 15 different trainee doctors. Of these 168 patients, ultrasound (E-FAST or point-of-care ultrasound) was performed on 44 (26%) of them. In 51% (n=20/39) of the situations, the practitioners considered that the realisation of ultrasound had a significant impact in terms of therapeutic and evacuation priorities. More specifically, it changed therapeutic decisions in 67% of time (n=26/39) and evacuation priorities in 72% of time (n=28/39).

Conclusion This original work showed that ultrasound on the battlefield was possible and useful. To confirm these results, ultrasound needs to be democratised and assessed in a real operational environment.

  • ultrasound
  • military medicine
  • battlefield
  • triage

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  • Contributors AR led the project and wrote the article. PB developed the concept. CM, EC, GG and ST collected the data. PJC did the statistical analysis. CC, AF and NC reviewed the article. CK is a native English speaker and she reviewed and brought the necessary corrections.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.