Module 1 | Comprehensive overview on war wounded and organisation of the FMHS during deployment abroad
▸ War wounded: epidemiology, initial support, principles of damage-control surgery, special features of wounding agents, rules of triage and use of antibiotics in war wounds ▸ Organisation of the FMHS: levels of care, rules, principles of tactical and strategic aeromedical evacuation and health products supply ▸ Officer's course in foreign deployment, legal concerns on the battlefield
| Demonstration and handling of technical equipment
▸ Presentation and assembling of an FST housed in tents ▸ Demonstration and handling of the equipments available in the FSTs (surgical equipment, principles of sterilisation and radiology)
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Module 2 | Management of limb and soft tissues injuries
▸ Burns: types of burns, dressing, escharotomy, fasciotomy, excision and skin grafting ▸ Soft tissue injuries: principles of debridement and negative pressure wound therapy ▸ Upper and lower extremity injuries: management of penetrating injuries, closed fractures and landmine foot ▸ Vascular injuries: epidemiology, diagnostic tools and choice of adequate treatment ▸ Compartment syndrome: therapeutic and preventive indications
| Practical sessions on cadavers
▸ Wound debridement, skin grafting (manually operated dermatome), negative pressure wound therapy dressings, basic pedicle flap transfers and limb amputation ▸ Upper and lower extremity external fixation with PercyFx ▸ Upper and lower limb arteries approach (axillary, humeral, iliac, femoral and popliteal arteries) ▸ Fasciotomy (leg 4 compartments, forearm and hand)
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Module 3 | Management of head, neck, cervical spine and thoracic injuries
▸ Craniocerebral wounds and cranial trauma ▸ Spinal cord, ocular, face and neck injuries ▸ Wounds of the neck, larynx, trachea and oesophagus ▸ Open and closed thoracic injuries: indications and management of chest drainage and emergency thoracotomy
| Practical sessions on cadavers
▸ Skull and face: burr hole trepanation, craniotomy, nasal packing for epistaxis and intermaxillary blocking ▸ Neck: cricothyrotomy, tracheotomy, subclavian and carotid arteries approach ▸ Thorax: anterolateral and clamshell thoracotomies, sternotomy, vascular control of descending thoracic aorta and cross-clamping, vascular control of major branches of the aortic arch and subxiphoid pericardial window ▸ Enucleation of the eye
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Module 4 | Management of abdominal and pelvic injuries, eFAST
▸ Thoracoabdominal injuries: penetrating and closed injuries, haemorrhagic shock, damage-control resuscitation and liver, spleen, kidney, duodenum, pancreas and digestive injuries ▸ Pelvic injuries: abdomino-pelvic-gluteal injuries, bladder, ureteral and urethral injuries and closed pelvic fracture ▸ Basis of eFAST
| Practical sessions on cadavers
▸ Abdomen: organs approach, mobilisation and fascia separation, Pringle manoeuvre, perihepatic packing, vascular control of aorta and inferior vena cava, splenectomy, colostomy and laparotomy with negative pressure wound therapy dressings ▸ Pelvis: suprapubic cystostomy, ureteral double-J stent set up, pelvic external fixation, pelvic packing and internal iliac artery ligation ▸ eFAST: hands-on sessions between students
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Module 5 | Medical support to populations and management of major haemorrhage
▸ Reminder of severe abdominal (module 4), thoracic (module 3) and vascular (module 2) haemorrhage management ▸ Medical support to populations in austere environment: principles, ethics and specificity of care
| Practical sessions on swine
▸ Temporary repair of haemorrhagic injuries: direct pressure, packing, vascular control and temporary shunt ▸ Definitive repair of haemorrhagic injuries: vascular repair and end-to-end anastomosis, venous bypass graft, suture of a lesion of inferior vena cava or portal vein and suture of a wound to the heart ▸ Laparotomy with negative pressure wound therapy dressing at the end of procedure
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