PT  - JOURNAL ARTICLE
AU  - Cédric Nguyen
AU  - A Montcriol
AU  - F Janvier
AU  - P-J Cungi
AU  - P Esnault
AU  - Q Mathais
AU  - C Vallet
AU  - S Boussen
AU  - P-Y Cordier
AU  - L Serpin
AU  - L Papazian
AU  - J Bordes
TI  - Critical COVID-19 patient evacuation on an amphibious assault ship: feasibility and safety. A case series
AID  - 10.1136/bmjmilitary-2020-001520
DP  - 2020 Aug 06
TA  - BMJ Military Health
PG  - bmjmilitary-2020-001520
4099  - http://militaryhealth.bmj.com/content/early/2020/08/05/bmjmilitary-2020-001520.short
4100  - http://militaryhealth.bmj.com/content/early/2020/08/05/bmjmilitary-2020-001520.full
AB  - 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.