EMERGENCY MEDICAL RESPONSE TO THE MULTISITE TERRORIST ATTACKS IN PARIS IN 2015

Abstract

　　Based on the report by Assistance Publique-Hôpitaux de Paris (APHP) and Service d'Aide Medicale Urgente (SAMU), the emergency medical response to the multisite terrorist attacks by shooting and bombing in Paris in November, 2015 was demonstrated. France has the pre-, in-, and inter-hospital response plan for mass casualty incident. Aggressive use of tourniquet and gauze containing hemostatic agent, restricted fluid resuscitation with vasoconstrictor and tranexamic acid, and avoid hypothermia are the key elements of prehospital treatment in multiple shooting or bombing. Additionally direct transfer system for victims from scene to operating room has been planned. In this incident, there were 129 dead on scene. The 356 victims with "isolated chest injury" or "abdominal and/or limb wound" were categorized as "Absolute Emergency" and transferred to 18 pre-planned hospitals in the form as a package with 5-8 patients to one hospital at one time. In Pitié Salpêtrière University Hospital, 23 of 53 victims were received damage control surgery in 10 of 13 operating rooms (OR) at most without saturation. The mortality at the 7th day of 16 APHP hospitals was 1.3%. This information emphasizes the importance of rapid and adequate prehospital treatment, pre-planned referral hospital network, and sequential group transfer system and surge capacity of OR.