Mass Air Medical Evacuations in a French Overseas Territory in Exceptional Situation

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OBJECTIVES On November 28, 2017, the fire at the Guadeloupe University Hospital created an exceptional healthcare crisis, due to the loss of critical care units, operating rooms, and emergency department at the island’s main hospital. Large-scale air medical evacuations were organized to the University Hospital of Martinique, another nearby French island. This unprecedented event posed unique challenges in terms of feasibility and risks inherent to these emergency medical evacuations of critically ill patients.METHODS It was a retrospective, observational, monocentric study, including all patients with initial medical care provided in Guadeloupe archipelago, Saint-Martin and Saint-Barthelemy islands and which required medical evacuation to the Martinique University Hospital during the following 6 weeks after fire at the Guadeloupe University Hospital.RESULTS During the study period, 93 patients were included which corresponds to 2.2 patients transferred per day, with a highest transfers occurred during the first week (n = 30). Median age was 52 [22 - 64] years-old, and 54 were male (58.1%). All transfers were conducted by air 58 patients were admitted in ICU (62.3%) and diseases were mainly cardiovascular (n = 18, 19.4%), neurosurgery (n = 16, 17.2%) and paediatric (n = 15, 16.1%). Nine patients (9.7%) experienced complications or clinical deterioration during air transfer. Median length of hospital stay was 11 [7 - 17] days. Seven patients died during hospitalization (7.5%) and 81 patients (87.1%) returned in home territories after care in Martinique.CONCLUSIONS This event demonstrates the feasibility of conducting multiple air medical evacuations during a health crisis in a French overseas territory, with the appropriate medical and logistical resources for the safety and quality of care for evacuated patients.

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