Via The Guardian, a reminder that cutting the "fat" out of healthcare budgets is a fool's economy. If you lack surge capacity, you have very little at all: 'Surgery of war': Paris hospital doctors reflect on 12 hours of mayhem. Excerpt:
Fifty-seven of those injured in the Paris attacks remain in intensive care on Thursday, three of them in a critical state, following an unprecedented medical emergency for French hospital staff and what one stunned doctor called “the surgery of war”.
About 221 people are still in hospital, the association of Paris hospitals said, from a total of 433 injured in last Friday’s multiple shootings. Some can be expected to be discharged within days, while others will undergo long-term rehabilitation for severe life-changing injuries. All are being offered treatment from specialists for psychological trauma.
The injured were spread across the French capital, with the gravely hurt treated in 35 different operating theatres. According to doctors, the situation has now normalised following an extraordinary 12 hours which saw French medical staff grapple with the highest number of gunshot wounds since the second world war.
One surgeon, Rémy Nizard, said staff who turned up voluntarily late on Friday and in the early hours of Saturday were faced with a range of traumatic injuries. They included numerous fractures to the leg, femur, foot and humerus.
“It was the surgery of war,” he told Le Monde, adding: “Some people arrived with a shot in the head or neck. They presented with burst eye sockets. There was a significant risk of losing the eye.”
At the Georges Pompidou European hospital the 49 unconscious patients who arrived overwhelmed the facility and its usual procedures.
“Doctors didn’t know who they were. They wrote numbers on the foreheads and hands of the wounded,” Morgane, a 26-year-old nurse, whose colleague works in the critical care unit said. She added: “It was horrible. She was absolutely shocked.”
“These people had injuries from war weapons. It’s the sort of thing you might expect from the battlefield,” said Philippe Juvin, the hospital’s head of casualty. Of his staff he added: “Nobody has come out of this untouched. Everybody has been affected. They are all very tired, physically and psychologically. There’s such sadness.”
He added: “We have a psychiatrist at their disposal. To be frank I don’t know why they’ve been affected in this way. We are used to dealing with injuries of this nature. We get shootings. But not in such huge numbers. Not 50 in one go.”
The Georges Pompidou, where some of the most severely injured were treated, is a sprawling glass building close to France’s defence ministry. Its flags were at half mast on Thursday; patients with ordinary injuries hobbled in and out; the first-floor accident and emergency ward again a place of calm.
In an eerie coincidence, last Friday morning Paris’s ambulance, fire services and hospitals had rehearsed a scenario based on a Charlie Hebdo-style attack, with more than 100 casualties from shooting. Hours later this scenario happened for real. The wounded were distributed smoothly across at least five city hospitals, with an emergency plan activated.
According to Jacques Duranteau , an anaesthetist at the Bicete hospital, medical teams have come out of the acute phase. The situation was now returning to normal, he said.“There may be a few adjustments, but today patients are where they should be.
“Some of the victims will be starting long months of treatment and rehabilitation. Those who are seriously injured will have to have specific treatment. For them care will be physical and psychological. The stress they have gone through is of an unimaginable level.”