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Intensive Care Med. 2019 Sep;45(9):1231-1240. doi: 10.1007/s00134-019-05724-9. Epub 2019 Aug 15.

Analysis of the medical response to November 2015 Paris terrorist attacks: resource utilization according to the cause of injury.

Author information

1
Sorbonne Université, INSERM, UMRS1158, Paris, France. mathieu.raux@aphp.fr.
2
Assistance Publique Hôpitaux de Paris (APHP), Department of Anaesthesiology and Critical Care Medicine, Groupe Hospitalier Pitié Salpêtrière, Paris, France. mathieu.raux@aphp.fr.
3
Université Paris Descartes, Paris, France.
4
APHP, SAMU 75, Hôpital Necker-Enfants Malades, Paris, France.
5
Université Paris 13, Bobigny, France.
6
APHP, SAMU 93, Bobigny, France.
7
Service Médical du RAID, Bièvres, France.
8
Sorbonne Université, INSERM, UMRS1136, Paris, France.
9
APHP, Department of Emergency Medicine, Hôpital Saint Antoine, Paris, France.
10
APHP, Department of Emergency, Hôpital Européen Georges Pompidou, Paris, France.
11
Department of Emergency, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, Paris, France.
12
APHP, Department of Emergency, Hôpital Saint-Louis, Paris, France.
13
Université Paris Diderot, Paris, France.
14
APHP, Department of Anesthesiology and Critical Care, Hôpital Lariboisière, Paris, France.
15
APHP, Department of Anaesthesiology and Critical Care Medicine, Hôpital Henri Mondor, Créteil, France.
16
APHP, Division of Vascular Surgery, Hôpital Bichat, Paris, France.
17
Etablissement Français du Sang, Paris, France.
18
Institut Médico-légal de Paris, Paris, France.
19
Assistance Publique Hôpitaux de Paris (APHP), Department of Anaesthesiology and Critical Care Medicine, Groupe Hospitalier Pitié Salpêtrière, Paris, France.
20
Brigade des Sapeurs-Pompiers de Paris, Paris, France.
21
Sorbonne Université, INSERM, UMRS1166, IHU ICAN, Paris, France.
22
APHP, Department of Emergency, Groupe Hospitalier Pitié Salpêtrière, Paris, France.

Abstract

PURPOSE:

The majority of terrorist acts are carried out by explosion or shooting. The objective of this study was first, to describe the management implemented to treat a large number of casualties and their flow together with the injuries observed, and second, to compare these resources according to the mechanism of trauma.

METHODS:

This retrospective cohort study collected medical data from all casualties of the attacks on November 13th 2015 in Paris, France, with physical injuries, who arrived alive at any hospital within the first 24 h after the events. Casualties were divided into two groups: explosion injuries and gunshot wounds.

RESULTS:

337 casualties were admitted to hospital, 286 (85%) from gunshot wounds and 51 (15%) from explosions. Gunshot casualties had more severe injuries and required more in-hospital resources than explosion casualties. Emergency surgery was required in 181 (54%) casualties and was more frequent for gunshot wounds than explosion injuries (57% vs. 35%, p < 0·01). The types of main surgery needed and their delay following hospital admission were as follows: orthopedic [n = 107 (57%); median 744 min]; general [n = 27 (15%); 90 min]; vascular [n = 19 (10%); median 53 min]; thoracic [n = 19 (10%); 646 min]; and neurosurgery [n = 4 (2%); 198 min].

CONCLUSION:

The resources required to deal with a terrorist attack vary according to the mechanism of trauma. Our study provides a template to estimate the proportion of various types of surgical resources needed overall, as well as their time frame in a terrorist multisite and multitype attack.

FUNDING:

Assistance Publique-Hôpitaux de Paris.

KEYWORDS:

Bombing; Disaster medicine; Emergency Surgery; Gunshot wound; Mass casualty; Terrorism

PMID:
31418059
DOI:
10.1007/s00134-019-05724-9
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