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Original research
Critical COVID-19 patient evacuation on an amphibious assault ship: feasibility and safety. A case series
  1. Cédric Nguyen1,
  2. A Montcriol1,
  3. F Janvier1,
  4. P-J Cungi1,
  5. P Esnault1,
  6. Q Mathais1,
  7. C Vallet2,
  8. S Boussen3,
  9. P-Y Cordier4,
  10. L Serpin5,
  11. L Papazian3 and
  12. J Bordes1
  1. 1Anesthesiology and Intensive Care, HIA Sainte Anne, Toulon Armees, France
  2. 2French Navy, Toulon, France
  3. 3APHM, Marseille, Provence-Alpes-Côte d'Azur, France
  4. 4Anesthesiology and Intensive Care, HIA LAVERAN, Marseille, France
  5. 5Emergency, Hospital Centre Ajaccio, Ajaccio, France
  1. Correspondence to Cédric Nguyen, Anesthesiology and Intensive care, HIA Sainte Anne, Toulon Armees, France; ced040{at}hotmail.fr

Abstract

Introduction An amphibious assault ship was deployed on 22 March in Corsica to carry out medical evacuation of 12 critical patients infected with COVID-19. The ship has on-board hospital capacity and is the first time that an amphibious assault ship is engaged in this particular condition. The aim is to evaluate the feasibility and safety of prolonged medical evacuation of critical patients with COVID-19.

Methods We included 12 patients with confirmed COVID-19 infection: six ventilated patients with acute respiratory distress syndrome and six non-ventilated patients with hypoxaemia. Transfer on an amphibious assault ship lasted 20 hours. We collected patients’ medical records: age, comorbidities, COVID-19 history and diagnosis, ventilation supply and ventilator settings, and blood gas results. We calculated oxygen consumption (OC).

Results All patients had a medical history. The median delay from onset of symptoms to hospitalisation was 8 (7–10) days. The median Sequential Organ Failure Assessment score on admission was 3 (2–5). There was no significant increase in oxygen during ship transport and no major respiratory complication. There was no significant increase in arterial oxygen pressure to fractional inspired oxygen ratio among ventilated patients during ship transport. Among ventilated patients, the median calculated OC was 255 L (222–281) by hours and 5270 L (4908–5616) during all ship transport. Among non-ventilated patients, the median calculated OC was 120 L (120–480) by hours and 2400 L (2400–9600) during all ship transport.

Conclusion The present work contributes to assessing the feasibility and safety condition of critical COVID-19 evacuation on an amphibious assault ship during an extended transport. The ship needs to prepare a plan and a specialised intensive team and conduct patient screening for prolonged interhospital transfers.

  • intensive & critical care
  • respiratory infections
  • health & safety
  • quality in health care
  • public health

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bmjmilitary-2020-001520

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    Footnotes

    • Contributors CN wrote the paper. AM, SB, LS, FJ and P-YC managed the data collection. CV, P-JC, PE, QM, LP and JB participated in critical revision of the manuscript. All authors have contributed to the writing of the manuscript and have approved the final manuscript. CN conceived the study and is its guarantor.

    • 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.

    • Ethics approval The Sainte-Anne Military Hospital Ethics Committee approved this study.

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

    • Data availability statement No data are available.