Medical support for SL jumps master procedures, combat techniques by dayor gt, Besides the personal medical equipment, according to the use of weapons,transmissions and the different the recommendations for combat rescue levels 2 means of deployment. The nurses and medics are tradi- (French TCCC) and 3 (medical level for frontline medi- tionally integrated within the combat groups. The doc- cine and prolonged field care)35, 36, some equipment tors are next to the ground commander, and to the trans- specifically devoted to drop support has been taken mitter. This makes communication and decision making along during recent operations in the Sahel region. It easier. was meant to be left behind with the parachutes after landing. This ‘immobilization kit’contained a spine After an MFF tacticalinfiltration, the scarcity of the immobilizing system (like KED® less cumbersome than equipment is a problem. More so than for SL jumps, as a spine board), a pelvic sling, a cervical collar and some dropping a collective drop bag cannot be done to date. splints (SAM SPLINT®), all included in a collective drop Today, MFF parachutes can carry 160kg.Once the bag.29 weight of the paratrooper (about 80kg) and of the parachute is removed, there remains only 40 to 50kg A 28kg collective box (figure 2) was also dropped for the material (ammunitions, ballistic protections, because of the tactical configuration and the fact that batteries, medical supply, water, food). If additional the Role 2 was quite far away. The equipment was car- material is needed for the mission, some pilots can ried during the infiltration and kept during the whole jump with “heavy load drop bag”. Those paratroopers mission. The box contained two 3-liter oxygen cylin- can carry a 100kg box or specific drop bag with a para- ders, a complete ventilator (MEDUMAT®), a mucus suc- chute usually used for tandem jump. This technic is tion pump with cannula, IV solution bag for fluid resus- often used in tandem jumps when a specialist (here the citation or IV rehydration (two liters), two water sprays doctor or the nurse) is not MFF qualified to take-out for faintness and heat strokes, one ankle splint, five the passenger material.The main drawback, for the malaria rapid diagnostic tests and their reagent bottles, doctor, is that it can take some time to recover his an IV treatment for scorpion envenomation37 material depending on the distance of landing bet- . Equipment is increasingly smaller which makes it possi- ween the operators. More and more health personnel ble to propose the best medical support with a good are trained to use tandem parachute with heavy load weight/volume ratio. Nevertheless, the quest for light- drop bag so as to carry more material. In future, the ness must continue, with, for example the acquisition acquisition of GPS guided aerialdelivery systems of light portable oxygen generator systems (Frontline (Microfly®) could provide a solution to the problem. Oxygen®)38, or ambient air ventilators39. All the time, the physical condition of the medicalteams must be Even if the choice of medical equipment can be influen- paramount. ced by its weight, parachuting is only the initial setting up of the operation. It is often followed by infiltrations Medical support for MFF jumps on foot. The equipment is then carried by men on their The medical supports of this missions is strongly related backs (figure 3). Again, physical fitness is paramount so to the concept of far-forward medical support, which is as not to hinder the progression of the missions. The specific to commando missions. equipment, albeit light and miniaturized, is necessarily reduced which implies thinking carefully what is nee- During those missions, doctors and nurses must be per- ded in view of the characteristics of the mission (means fectly integrated to the team; they are an integral part of and delays of evacuation to a Role 2, type of mission, the commando team. Their integration, based on trust, number of commandos…). depends on a solid knowledge of the military, which can only be achieved by training before the mission so as to It is possible to create « logistic slots » by burying mate- rial next to the dropping zone, to be used later. That Figure 2: Collective box used for static line jump way immobilisation material,oxygen cylinders and over Niger (2015). cumbersome material (ventilators, monitoring system, electric syringe pump, semi-automatic automated external defibrillators…) can be made available. After a careful study of all the possible scenarios, the ability to adapt is one of the most important qualities of paratroopers. It is essential in the conception of the medical support specific to each mission.40 Role 1: Medical post (MP) No MP was deployed for any of the jumps carried out by the French armed forces because it was not neces- sary for the type of mission or the number of personnel involved (except for Bonite operation in 1978, however the emergency of the situation and the lack of space in VOL. the aircrafts prevented to do so). The material has been 94/3 International Review of the Armed Forces Medical Services 13 Revue Internationale des Services de Santé des Forces Armées