The French <i>Syrette</i> of morphine for administration to combat casualties

Pasquier, Pierre; Bazin, Sébastien; Petit, Ludovic

doi:10.1177/2049463715622958

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…Finally, a ketamine pulverization device for IN analgesia is being developed currently by the FMHS Central Pharmacy and this could soon be made available as a means of auto-administration for all servicemen and women. The idea is to include this device in the personal kit of each soldier, actually this kit is composed of a morphine syrette (a 10 mg subcutaneous dose) for analgesia (31). It would be interesting to carry out a new study in a few year to assess the impact of introducing both these standardized guidelines and the new injection device on the level of knowledge and application of this method of analgesia.…”

Section: Discussionmentioning

confidence: 99%

Use of Intranasal Analgesia in Military Setting: a French Cross Sectional Survey

Montagnon¹,

Cungi²,

Morand³

et al. 2021

Preprint

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Background For military physicians, practice in tactical and austere environments, particularly during deployments, requires optimized pain management. Several recent studies have shown a definite interest in the intranasal (IN) route for analgesia. Few published series show efficacy and variable times of action depending on the drug used (ketamine, sufentanil and fentanyl), with exceptional side effects. The aim of this study is to evaluate the medical practice of the French Military Health Service (FMHS) physicians.Methods We carried out a declarative and multicentric survey from January 15, 2020, to April 14, 2020. The surveyed population was the physicians of the FMHS, 727 working in medical units and 55 in emergency departments (EDs) in France and overseas. Results In all, 259 responses were collected, giving a 33% return rate; 77.6% of physicians reported being familiar with the IN route for analgesia. However, only 18.4% had already used it. Physicians trained in emergency medicine and assigned to highly operational units were more familiar with this route and used it more frequently. The most common drug used was ketamine (51%). Finally, 90% of respondents expressed an interest in training and use of intranasal analgesia. ConclusionsIf a majority of physicians from the FMHS are familiar with IN analgesia, only few use it in practice. Therefore, specific training is suitable to improve this knowledge and homogenize guidelines. Having been the subject of numerous studies in progress in civilian and military medicine, the IN route seems to be a promising solution for remote and austere environments.

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Section: Discussionmentioning

confidence: 99%

Use of Intranasal Analgesia in Military Setting: a French Cross Sectional Survey

Montagnon¹,

Cungi²,

Morand³

et al. 2021

Preprint

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“…Field analgesia or wound management has also become challenging as the time frame to definitive care lengthens . Multimodal analgesia combining subcutaneous then intravenous morphine, ketamine, and midazolam were used during our study according to the current French guidelines (Table ). Intranasal administration of analgesics (fentanyl, ketamine) is also increasingly used in the field.…”

Section: Discussionmentioning

confidence: 99%

Five years of prolonged field care: prehospital challenges during recent French military operations

et al. 2019

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BACKGROUND French military operations in the Sahel conducted since 2013 over more than 5 million square kilometers have challenged the French Military Health Service with specific problems in prolonged field care. STUDY DESIGN AND METHODS To describe these challenges, we retrospectively analyzed the prehospital data from the first 5 years of these operations within a delimited area. RESULTS One hundred eighty‐three servicemen of different nationalities were evacuated, mainly as a result of explosions (73.2%) or gunshots (21.9%). Their mean number evacuation was 2.2 (minimum, 1; maximum, 8) per medical evacuation with a direct evacuation from the field to a Role 2 medical treatment facility (MTF) for 62% of them. For the highest‐priority casualties (N = 46), the median time [interquartile range] from injury to a Role 2 MTF was 130 minutes [70 minutes to 252 minutes], exceeding 120 minutes in 57% of cases and 240 minutes in 26%. The most frequent out‐of‐hospital medical interventions were external hemostasis, airway and hemopneumothorax management, hypotensive resuscitation, analgesia, immobilization, and antibiotic administration. Prehospital transfusion (RBCs and/or lyophilized plasma) was started three times in the field, two times during helicopter medical evacuation, and five times in tactical fixed wing medical aircraft. Lyophilized plasma was confirmed to be particularly suitable in these settings. One of the specific issues involved in lengthy prehospital time was the importance to reassess and convert tourniquets prior to Role 2 MTF admission. CONCLUSION Main challenges identified include reducing evacuation times as much as possible, preserving ground deployment of sufficiently trained medics and medical teams, optimization of transfusion strategies, and strengthening specific prolonged field care equipment and training.

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“…In addition, falls correlated with a greater age of participants and the number of broken ribs. Choi et al 5 conducted a similar study investigating the use of lidocaine in TRF management. Within this study, the severity of endured injuries was quantified using the Injury Severity Score, and the Injury Severity Score in addition to the length of stay was adjusted for in statistical analyses.…”

Section: "Intravenous Lidocaine For the Management Of Traumatic Rib F...mentioning

confidence: 99%

“…Finally, the French Military Central Pharmacy is currently developing a ketamine pulverization device for intranasal analgesia at the point of injury. This device could soon be available as a means of autoadministration for all servicemen and women, in addition to the French syrette of morphine, a 10-mg subcutaneous morphine dose provided in the combat first aid kit 5 …”

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confidence: 99%

The intranasal route for ketamine administration may be a simple way to improve battlefield analgesia

Montagnon

Dubecq

2023

J Trauma Acute Care Surg

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The French Syrette of morphine for administration to combat casualties

Cited by 4 publications

References 2 publications

Use of Intranasal Analgesia in Military Setting: a French Cross Sectional Survey

Use of Intranasal Analgesia in Military Setting: a French Cross Sectional Survey

Five years of prolonged field care: prehospital challenges during recent French military operations

The intranasal route for ketamine administration may be a simple way to improve battlefield analgesia

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