Abstract
French Navy provides medical evacuations by helicopter (HME) on the Atlantic coast, up to 320 kilometers offshore, and under all weather conditions. The epidemiology of acute chest pain (ACP) on the high seas is little known. In this study, we aimed to assess the prevalence and constraints found in the management of these emergencies. This was a retrospective, descriptive, monocentric study performed from January 1, 2000, to April 30, 2009. The inclusion criteria was the occurrence of ACP while the patient was on the high seas, which required a HME From January 1, 2000, to April 30, 2009, 286 HME were performed - of which 132 were due to traumatologic and 154 due to medical emergencies. ACP with 36 missions was the leading cause of HME. All evacuated patients were men (professional sailors or ferry passengers). The average age was 48 years (range, 26–79). The most common prehospital diagnosis was acute coronary syndrome (ACS) in 23 patients (64%) including 11 patients with ACS with ST-segment elevation. 32 patients were airlifted by helicopter. All patients benefited from monitoring, ECG, peripheral venous catheter, and medical management as soon as the technical conditions allowed it. Our study shows a predominance of ACS with ST-segment elevation in the diagnosis of ACP. Even if the working conditions are extreme, the management of ACP on the high seas may be optimal. The limits of HME are not therapeutic, but diagnostic. Indeed, 42% of the initial diagnoses were rectified. A management flowchart has been proposed within the framework of the evaluation of professional practices, with a diagnostic reasoning based around the ECG and the patient's monitoring (fig1). The study has highlighted the high prevalence of ACP occurring in an offshore environment. The diagnosis is difficult in a dangerous context, which makes these medicalized evacuations singular. Figure – Abstract 319 – Flowchart of the management of ACP in the high sea
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