Organization in response to massive afflux of war victims in civilian practice – experimental feedback from the November 2015 Paris terrorist attacks - 08/12/17

Doi : 10.1016/j.jviscsurg.2017.07.007

M. Borel ^a, R. Rousseau ^b,^c, F. Le Saché ^a, D. Pariente ^d, S. Castro ^d, M. Delay ^d, P. Hausfater ^c,^d, M. Raux ^a,^c,^⁎ , F. Menegaux ^c,^e
^a Département d’anesthésie réanimation, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP–HP, 75013 Paris, France
^b Service d’orthopédie et traumatologie, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP–HP, 75013 Paris, France
^c Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
^d Service d’accueil des urgences, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP–HP, 75013 Paris, France
^e Service de chirurgie viscérale et endocrinienne, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP–HP, 75013 Paris, France

^⁎Corresponding author. Salle de surveillance post-interventionnelle et d’accueil des polytraumatisés, département d’anesthésie réanimation, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l’hôpital, 75651 Paris cedex 13, France.

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Summary

The arrival of a large number of war-weapon casualties at a civilian trauma center requires anticipation. A plan defining the management principles and the respective roles of the involved physicians and nurses and their interaction with each other is essential. Uni-directional patient flow associated with adequate numbers of staff physicians and nurses under the leadership of a medical director is essential to prevent the overwhelming of the trauma center. Routine and regular interaction between the pre-hospital medical flow control system and the medical director, on one hand, and between surgical teams and the medical director, on the other, are necessary to know when to apply “damage control” surgical techniques. Based on the feedback of a level 1 trauma center that received 53 victims of the November 13, 2015 terrorist attack in Paris, we present the factors of success, and the stumbling blocks.

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Keywords : Mass casualties, Penetrating trauma, Code