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Terrorist attacks in Paris

managing mass casualties in a remote trauma center

Femy, Florenta; Follin, Arnaudb; Juvin, Philippea,,c; Feral-Pierssens, Anne-Laurea

European Journal of Emergency Medicine: August 2019 - Volume 26 - Issue 4 - p 289–294
doi: 10.1097/MEJ.0000000000000555
Original Articles

Objective On 13 November 2015, Paris was the target of multiple terrorist attacks responsible for a massive influx of casualties in emergency departments (EDs). Because of the activation of a local crisis plan and the arrival of extra staff, our capacities increased markedly. Our aim was to analyze whether our center, in this challenging context, efficiently managed this massive influx of patients.

Patients and methods We carried out a monocentric retrospective study. All patients received in the first 24 h were included (isolated psychological trauma with no physical injury excluded). Our main endpoint was to assess patient diversion through early secondary transfers ( ≤ 24 h) because of an overrun of our capacities.

Results A total of 53 victims were sent to our center in a 4 h timeframe; 12 patients were excluded (no physical injury). We analyzed 41 victims. Their median injury severity score was 4 (1;9). Three (7%) patients were transferred after ED management to a nearby hospital within the first 24 h for minor orthopedic surgery. There was a significant increase in medical/surgical staff (eight ED physicians instead of two; six intensivists vs. two; three orthopedic surgeons vs. one). Among the victims, 71% had firearms wounds and 30% had open fractures. Twenty surgeries were performed in the first 24 h. There were no in-hospital deaths.

Conclusion Faced with an unusual event and thanks to the increase in staff, our operating capacities increased. Our center took charge of almost all victims. Patient diversion concerned only three patients transferred to a nearby hospital for minor orthopedic surgery.

Departments of aEmergency

bIntensive Care Unit, Georges Pompidou European Hospital, Assistance Publique – Hôpitaux de Paris

cMedical School, Paris Descartes University, Paris, France

Received 8 November 2017 Accepted 1 May 2018

Correspondence to Anne-Laure Feral-Pierssens, MD, Emergency Department, Georges Pompidou European Hospital, 20 rue Leblanc, 75908 Paris Cedex 15, France Tel: + 33 660 836 580; fax: + 33 156 092 473; e-mail:

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