Traumatologists learn from the Paris and Quebec City bombings

Although not at all of the same magnitude, the Paris and Quebec City attacks represented essentially the same challenges for medical teams. These included lack of communication with the outside world, overloaded telephone lines in hospitals and the management of concerned relatives.

Dr. Carl Ogereau, an emergency physician and deputy head of the emergency department at the Hospital Saint-Louis in Paris, was at the heart of the action on the night of the Paris bombings. He was in the capital Thursday to share his experience at the 23 rd traumatology colloquium of the CHU de Quebec.

Hospital St. Louis is close to the Le Petit Cambodia and bar Le Carillon in the X th arrondissement of Paris. Around 21:25, armed men from Kalashnikov fired on the customers of the two establishments, killing 15 people.

“That night, it’s a classic evening, we have two doctors, three nurses …” says Dr. Ogereau. In the waiting room, people watch the football game. When they hear the first explosion near the Stade de France, at 21:20, they think it is a “domestic incident”, reports the doctor.

At 9:31 pm, a nurse who was coming out of her office called to the hospital to say that a shooting had just happened across the street. The staff does not immediately see the gravity of the situation as “it is a bar hilarious, a little shady,” says the speaker.

At 9:42 pm, a first wounded man presented with a wound that “pissed blood,” says the emergency room. Then, around 9:45 pm, a lady of 78 years, transported by a stretcher bearer and a hospital intern. In wanting to protect her grandson, with whom she dined in Little Cambodia, the septuagenarian had taken a bullet.

“You realize something has happened, but you do not necessarily realize you’re going to be overwhelmed by something,” says Dr. Ogereau. Staff quickly learned from early witnesses that there were “deaths everywhere” and that the situation was serious.

“The first organizational gestures are made […]. We release boxes, we call medical teams in reinforcement. The manager called me pretty quickly. He was watching the football game, heard the first explosion and later saw a headband scroll down the screen, “which announced the shooting at the Little Cambodia and the bar Le Carillon, the doctor said.

In total, Hospital Saint-Louis will receive 26 wounded, more than half of whom arrived in the first hour and a half, “the time that you are alone until your reinforcements arrive,” says Dr. Ogereau. No fewer than 19 patients would undergo an operation the same evening or the following days. The mobilization of medical teams was, he said, “quite exemplary”. “There was an awesome calm in the circumstances.”

Difficult communications

However, communications with the outside world were painful. “On the evolution of the situation, which informs us? The SAMU [Emergency Medical Services]? TV? That night, I called the SAMU and said to the guy, “Do you know about the shooting?” He said, “Yes, I know, it’s brothel everywhere, I remind you.” He never called me back, ” says Dr. Ogereau.

At the hospital, the telephone lines were saturated. “There were two medical lines on duty that were constantly ringing. People were calling to see if someone was present, if there was news of someone else. It was a real problem, especially since there was not necessarily any news to give to callers, and we also needed telephone lines to call our colleagues, “says Dr. Ogereau.

The Head of the Traumatology Program at the Hôpital de l’Enfant-Jesus, Dr. Julien Clement, experienced the same problems on the night of the attack on the Sainte-Foy mosque. “That evening I tried three times to contact the headmistress and tell her that I was in charge of the situation and that I would be updated. Three attempts, 15 minutes on the phone. It’s not quite optimal. And this is because there was a very intense demand for communications, but there were no more telephonists, “said the surgeon on the sidelines of the symposium.

Not an orange code, but …

D r Clement also believes that existing staff should have more leeway to be able to “take the most appropriate decisions.” “Even if we did not have enough casualties to start up all the orange code measures, there were things that would have been necessary, including a Crisis Staff that evening, mainly for the management of communications With families and other stakeholders. I do not think it was only for medical teams to do communications with families and to do crowd management, “said the surgeon.

D r Clement believes the rest that medical teams were not informed quickly enough to the scale of the event, although he is aware that “in a situation like that, you have to accept some degree Uncertainty and be able to manage it “.

Communication between the various institutions – police, civil security and hospital services – in this kind of tragedy are clearly to be reviewed, he said.

Dr. Carl Ogereau ‘s three “key messages” following the Paris bombings
When a crisis situation arises, do not hesitate to trigger an early warning so that you have all the right tools and resources
Imagine the worst possible scenarios and ensure that the simulation plans are functional
Provide repeated training to medical teams

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