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13/03/2012

Un hpital Kaboul

Jacques Monsgu

Dclaration de Relations Professionnelles


J'ai actuellement, ou j'ai eu au cours des deux dernires annes, une affiliation ou des intrts financiers ou intrts de tout ordre avec une socit commerciale ou je reois une rmunration ou des redevances ou des octrois de recherche d'une socit commerciale :

Affiliation/Relation
Subvention / soutien la recherche Frais de consultant / Honoraires Actionnaire majeur / Capitaux propres Revenu de redevances Proprit / Fondateur Droits de proprit intellectuelle Autre avantage financier

Socit
TERUMO

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LE DECOR

RC-N

RC - W MazarESharif RC-E

Bagram Herat Shank Kabul

RC-C

CampBastion

Kandahar

RC-S

RC-S/O

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Soutien mdical en Kapisa-Surobi Soutien mdical en Kapisa-Surobi


+
COP SHERKHEL
0/1/0

COP RED HILL


1/3/2

TAGAB
OMLT 2
GTIA RAPTOR

+
1/0/3 3/4/09

FOB NIJRAB (MORALES FRAZIER)


1/0/0 0/2/0 3/3/12 1/4/2 1/2/?

OMLT 2

OMLT 6

CONSANTE TFLF PECC (DRUIDE)


GTIA RAPTOR

+
OMLT 4

COP 51
0/1/0

OMLT 1

KAPISA +
(future FOB HUTNIK) 1/2/4 0/1/0

JEHOLS

COP 46

GTIA RAPTOR

GTIA 15.2

+
OMLT 2

COP BELDA
0/1/0

OMLT 4

+
OMLT 4

COP 42
1/2/2

+
OMLT 2

COP ALASAY
0/1/0

NAGHLU HAUT
1/1/1 1/1/3

OMLT 5 OMLT EM-6

SUROBI
GTIA 15.2

+
OMLT 2

COP SHEKUT
0/0/1

+ +

NAGHLU BAS
1/1/1

OMLT 3

FOB TORA
4/6/12

GTIA 15.2 + 2me REP

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Effectifs Franais soutenus: 3995

+
GTIA 15.2

ROCCO
1/1/5

Avril /2011

OMLT 3

6 0/3/0

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FOB NIJRAB

PS NIJRAB

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FOB TAGAB

PS TAGAB

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PS COP 51

COP SHEKUT

COP BELDA

PS COP 46

COP 42

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LAC de NAGHLU

NAGHLU BAS

FOB NAGHLU HAUT

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FOB TORA

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COP ROCCO

SUR LA ROUTE, CEST PAS TOUJOURS SIMPLE

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LHPITAL

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Rle 3 Medical Treatment Facilities (MTF)


built on KABOUL International Airport (KAIA) by OTAN between September 2008 and June 2009 NAMSA construction (cost = 18 M) opened in July 2009 leadership given to French Army reference document = Memorandum of understanding (MOU)

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MISSIONS
Medical support to ISAF population et Afghan (ANA/ANP) = priority task Medical support to KAIA camp (3800 persons) Medical support to civil casualities Medical support to embassies Specific missions: MASCAL plan / crash & rescue Mortuary toilets Visits Medical support to Afghan population

MEDICAL Rules of Eligibility


Role 3 NKAIA

9 LINES RECEIVED

ISAF ANA ANP


YES

NO

CIV CAS
YES

NO

Local National

YES

Acceptance
YES

Free ICU beds > 2


NO

Life Limb Eyesight

NO

Alert Commander Alert Emergency room

Commander notice for possible acceptance

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ROLE 3 MTF ORGANISATION


command support staff administration ops room Welcome cell ( bocal ) Consultations medecine /surgery/ ophtalmology dentist biology radiology Emergency room Intensive Care Unit and post-operating room Operating rooms Ward (hospitalization) Pharmacy Technical area

o o o o

Technical area

ICU Ward
SSPI

Operating rooms

Emergency room

Staff

Consultations

X-Ray

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4 ICU beds

3 Operating Rooms

3 POST OP beds Ste


Stock

2 damage controlled beds Emergency room

Hospitalization

Bio OPH 3 Dent

6 emergency beds

Command staff

Opsroom

bocal

Consultations

CT scan Rx

LA CONSULTATION

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Emergency room

Emergency Box 1 Emergency Box 2 Emergency Box 3 Emergency Box 4 Emergency Box 5 Emergency Box 6 Damage controlled bed 1

Damage controlled bed 2

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Prise en charge du polytraumatis

Management of severe trauma

Blesss de guerre = Traumatiss graves


Risques
Hmorragie Hypoxie Tr. Conscience Douleur Hypothermie

Piges :
Lsions mconnues Faussement stables

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Qualit de la prise en charge


Reconnatre et traiter rapidement les dtresses vitales Hirarchie du conditionnement Hirarchie des traitements Chirurgie / radiologie Rapidit +++++

Procdure de prise en charge

Chef Une personne = une fonction Communication Un scribe Adaptation

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1re tape
Placersurle brancard Monitorer Dshabiller Rchauffer Examiner

/ 2me tape / 3me tape


Chirurgiedemble OU Radiopuis chirurgie RP/Bassin TDM

Abordvasculaire: IVetIO(2) Hemocue Bilansanguin: ABORh NFSPlTP TCAFib Recherchedes Remplissage dtressesvitales Transfusion/ Dballerles pansements collectesangtotal FASTcho Sdation/ Regarderpartout! Analgsie (dos)

Prparation du dchocage

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Positionnement / positions

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Positionnement / positions

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ICU and Recovery-room

Bed 1 Bed 2 Post op 1

Post - op 2 Bed 3 Bed 4 Post op 3

LA SSPI

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Operating theatre
Sterilization Operating room 1 (Orthop / opht)

Operating room 2 (visc)

Septic operating room Stock

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Ward

ROOM AFGHAN FEMALE ET CHILDREN (9)

ROOM AFGHAN MEN (9)

ROOM ISAF (8)

ISOLATION ROOM OR VIP ROOM (3)

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PHARMACY

ENGEENERING

BIOLOGY

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RADIOLOGY

Interprtation des images Multidisciplinaire et multiculturelle !!!

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MEANS OF TRANSPORT

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Organisation of the Medical Treatment Facility Role 3


99 french persons 65 from Military Hospital (Paris & Lyon) (3 months) 34 from the 1st Medical Regiment (6 months) 32 persons from other nationalities 11 Czech : 2 Surgeons and 1 anaesthesist 2 anesthesist nurse 2 nurses of operative room 3 nurses ER 5 Bulgarians : 2 Surgeons and 1 anaesthesist 1 nurse of operative room 1 anesthesist nurse 1 Hungarian nurse 5 US 10 belges

Crew : 130

Rle 1 US Rle 1 BEL OFF ADJOINT

MEDECIN CHEF DE L'HMC

GESTIONNAIRE Convoyeuse de l'air

ADJOINT GEST.

ADU

OPS ROOM PSY

MEDEVAC VR

CADRE DE SANTE

KINE.

CONSULTATION

REANIMATION

URGENCE

Hospitalisation

RADIO

LABORATOIRE

BLOC OPERATOIRE

PHARMACIE

DENTISTE OPHTALMO

NEUROCHIR

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MEDICAL TEAM 3 surgery teams : 1 ophtalmologist 1 neurosurgeon 2 emergency physicians 1 ward physician 2 office physicians 1 psychiatrist 1 pharmacist 1 dentist
orthopedist visceralist anesthesiologist

+ rles 1 US & belge

STRATEVAC

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MORPHEE

Few datas
Role 3 opened in July 2009 Consultations :
1000 per month
50% ISAF 40% afghan population

Hospitalization (surgery, intensive care, medicine)


155 per month
40% ISAF 50% afghan population

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(5 avril-7 juillet 2011)


Prs de 1000 passages SAU
63 dchocages

8me Mandat

1400 journes hospitalisation 316 blocs opratoires 12 collectes sang total 60 RAPASAN / 3 STRATEVAC / 1 MORPHEE 20 toilettes mortuaires Mais aussi:
2 phases aigus dIDM 2 ACR 2 EP graves 2 hmorragies mninges chirurgicales /

LA VIE SUR LE CAMP

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LOGEMENT

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LE DFAC

LE DFAC

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LE SPORT

MERCI

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