The medical and operational impact of the deployment of a scanner within Role 2 in Mali for the French army

Introduction: According to the NATO classification, the difference between Role 2 and Role 2+ is the presence of extra diagnostic and therapeutic means, including the deployment of a scanner. The aim of this study is to analyze the impact of this deployment at the front, in the Gao French Role 2 (Mali). Our main hypothesis is that the presence of a scanner at the front improves the servicemen's diagnostic and therapeutic management abilities. Secondly that scanner holds strategic relevance by limiting the repatriation of servicemen on medical grounds.

Materials and methods: A prospective analytical observational study was conducted over 6 months within Gao's Role 2. All the French military patients who received a scanner were involved. The collected data was epidemiological, clinical and radiological in nature, and included the results from the scanner and data regarding the operational impact (repatriation). The principal judgment criterion was the rate of modification of the therapeutic decision. The secondary criterion was the modification of the repatriation decision on medical grounds.

Results: Of the 45 patients examined, in 14 cases (31.1%), performing a scanner changed patients' therapeutic management in relation to the management, which would have been conducted in the scanner's absence. For 12 of these patients (85.7%), the indication of the scanner concerned visceral or cranium-spine pathologies. For 33 patients (73.3%), the scanner enabled diagnosis via the elimination of an organic injury or a severity criterion. The repatriation decision remained unchanged for many patients.

Discussion: The scanner appears to be a significant factor in the initial therapeutic decision. Scanning made it possible to clarify the diagnosis and to better adapt the initial therapeutic decision. In contrast, the operational impact was null. The literature highlights the relevance of scanner in surgical abstention (limiting unnecessary operative procedures), and for the visceral, cranium-cerebral and spine pathologies in an emergency.

Conclusion: The scanner, a heavy logistic unit deployed within a forward surgical unit, holds therapeutic relevance for French servicemen's management with an important medical service provided for the therapeutic choices, although its operational impact has yet to be demonstrated.