How Paris hospitals responded to last weekend's terrorist attacks

Within minutes of the terrorist attacks in Paris Nov. 13, city hospitals activated a coordinated response to treat the gunshot and bombing victims, according to Stat News.

Healthcare workers operated amid heightened emergency activity, with medical workers mobilized to the various scenes of the attacks. This local response, called "Plan Blanc," is part of France's national emergency response plan. 

Here are five things to know about Paris' coordinated response to treat the victims of the shootings and bombings, according to Stat News.

1. Paris' hospital authority announced its Plan Blanc at approximately 10:30 p.m. on Friday, about an hour after the attacks began. This entailed calling medical personnel to report to hospitals, disbanding ambulances and preparing hospital beds ahead of the hundreds of wounded patients pouring into Paris' hospitals. The state of emergency in the city's hospitals lasted through the afternoon on Saturday. At that point, 129 people had died.

2. Friday's attacks occurred during a planned strike by union-organized physicians and nurses against healthcare payment legislation, according to The Connexion, an English newspaper in France. However, those healthcare workers on strike ended it early in "solidarity" with victims of the attack.

3. By Saturday afternoon, Paris hospitals had discharged 53 patients, but seven hospitals were still treating 300 people injured in the attacks. Of those people, 80 were in "absolute" critical condition and 177 were in "relatively" critical condition.

4. How does France's response plan compare to the U.S.? American hospitals have similar emergency response plans to Plan Blanc. U.S. hospitals' plans operate relatively independently, whereas France's local Plan Blanc plan is part of a more coordinated national strategy for dealing with emergencies, known as the Orsan plan. Other European countries have similar strategies to France.

However, the same elements are essential for an effective response plan, according to Paul Biddinger, MD, who led the emergency department response at Massachusetts General Hospital in Boston after the Boston Marathon bombings in 2013. These elements include "a staggered mobilization of staff, an efficient means of command and control and the ability to detect patients most in need of immediate care, especially when they have life-threatening internal injuries that might not be readily apparent," according to the report.

5. There are two main approaches for treating injured people in situations like the mass attacks in Paris. One is a "forward-leaning" response which emphasizes immediate treatment at the scene to avoid overburdening hospitals, while an opposing model calls for stabilizing injured patients at the scene and then transporting them to the hospital for more acute care.

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