Plan blanc express au CHU de Grenoble. Vingt-quatre heures après l'avoir déclenché, les autoritaires sanitaires ont levé le dispositif de crise.

Increasing ter­ro­rist attacks : Are the fire­figh­ters and EMS pre­pa­red in Isère ?

Increasing ter­ro­rist attacks : Are the fire­figh­ters and EMS pre­pa­red in Isère ?

FOCUS – The first to arrive at the scene of disas­ter ; the first people we can count on. You gues­sed it, we are tal­king about the EMS and the fire­figh­ters, but don’t for­get the chain of people in the hos­pi­tals, ready to save lives too. Are these pro­fes­sio­nals pre­pa­red for the risk of mul­tiple ter­ro­rist attacks in Isère ? Here are the ans­wers from these emer­gency specialists.

Colonel Doctor Christophe Roux. © Sdis 38

Colonel Doctor Christophe Roux. © Sdis 38

“I was in Paris on 7th January, 2015, for a mee­ting with the EMS at the fire sta­tion, 200 meters away from the pre­mises of Charlie Hebdo. 

Arriving first on the scene of the attack, I par­ti­ci­pa­ted in the medi­ca­li­za­tion of the first vic­tims, along­side Patrice Pelloux”, recalls Christophe Roux, colo­nel doc­tor, res­pon­sible for the health and medi­cal relief ser­vices for the depart­men­tal fire and rescue ser­vice in Isère (Sdis 38). He rea­li­zed, that day, that such acts could hap­pen again and again.

Feedback on the expe­rience in Paris expec­ted in January

Prevention is bet­ter than cure ! Isère fire­figh­ters and hos­pi­tals are the­re­fore, pre­pa­ring for the pos­si­bi­lity of mul­tiple ter­ro­rist attacks. To remedy any short­co­mings, “feed­back on the drama of the Paris attacks is expec­ted in January, to address the spe­ci­fi­ci­ties of dea­ling with nume­rous inju­ries, in near war-like condi­tions”, indi­cates Benjamin Garel, mana­ger of qua­lity and patient care in the tea­ching hos­pi­tal of Grenoble.

Benjamin Garel, directeur de la qualité et des usagers au CHU de Grenoble.  © CHU Grenoble

Benjamin Garel, mana­ger of qua­lity and patient care in the tea­ching hos­pi­tal of Grenoble. © CHU Grenoble

At least the Isère care and emer­gency ser­vices will not be caught off guard, accor­ding to Colonel Roux. “A high num­ber of vic­tims after a ter­ro­rist attack is one of the sce­na­rios we have envi­sa­ged for seve­ral years, when pre­pa­ring and trai­ning staff”, he says.

Focusing on the com­ple­men­ta­rity of the public ser­vices, he added : “we regu­larly work on this issue with the EMS.”

4000 volun­teer fire­figh­ters in Isère

In the event of an increase in the num­ber of ter­ro­rist attacks, an increase in the num­ber of relief wor­kers is essential.

“We are able to mobi­lize a large num­ber of fire­figh­ters in a very short time, mainly thanks to the Sdis – volun­teer fire­figh­ters”, explains the chief doc­tor. In total, over 4000 in Isère, in addi­tion to the pro­fes­sio­nal firefighters.

Many times, toge­ther, they have demons­tra­ted their mobi­li­za­tion capa­city, on occa­sions of large-scale inter­ven­tions, during floods for example.

In addi­tion, under the aus­pices of the defence of the south-east, the Isère fire­figh­ters share “resources and a com­mon doc­trine” with other depart­ments of the Auvergne and Rhône-Alpes regions ; the abi­lity to mobi­lize exter­nal rein­for­ce­ments in the case of a major crisis.

This has been in exis­tence for seve­ral years already, and is still fully ope­ra­tio­nal, accor­ding to the colo­nel. And for good rea­son : “We fairly regu­larly ask for assis­tance. For example, rein­for­ce­ment from the sou­thern region, in the case of large-scale forest fires.”

White plan run­ning well at the CHU

As for the hos­pi­tals, they have a cri­sis plan cal­led the White Plan*: “The white plan per­mits us to call in a lot of people, very qui­ckly, in order to treat seriously inju­red patients”, explains Benjamin Garel. The hos­pi­tals are open 24/7, the staff do not all work at the same time, which leaves an emer­gency reserve for the establishment.

Although the recall plan works well, “whe­ne­ver the white plan is trig­ge­red, we are sur­pri­sed by the reac­ti­vity of the staff, who often arrive without being cal­led in. In Paris, col­leagues repor­ted that pri­vate doc­tors retur­ned to the public hos­pi­tals to help”, stresses Benjamin Garel, and not without recognition.

© CHU de Grenoble - Service Communication

© CHU de Grenoble

Also, a spe­ci­fic orga­ni­za­tion is neces­sary, in times of cri­sis, to main­tain the conti­nuity of care and pre­serve the safety of the patients and staff, this includes the avai­la­bi­lity of beds.

“When there is an influx of woun­ded patients, we try to see patients who could go home ; we acce­le­rate some releases. We can also trans­fer some patients to other hos­pi­tals : exis­ting inpa­tients and those who are easily trans­por­table, or disas­ter vic­tims whose condi­tions are stable”, explains Benjamin Garel. To cla­rify, the Grenoble CHU regu­larly coope­rates with the CHU in Lyon, as well as hos­pi­tals in Chambéry and Annecy.

As for expe­rience of such excep­tio­nal situa­tions, the Grenoble CHU is not out­done : “Mini white plans are regu­larly acti­va­ted. This was the case, for example, after the bus acci­dent in Laffrey, in 2007, when we had to treat over twenty very serious inju­ries, very qui­ckly. In 2013 too, after ano­ther bus acci­dent in Alpe d’Huez.”

A large-scale exer­cise every year

In addi­tion to the expe­rience gai­ned in real-life situa­tions, cri­sis trai­ning takes place every year in Isère, the same as eve­ryw­here else in France.

With 87 high-thre­shold Seveso sites in the Rhone-Alpes region, many simu­la­tions involve NRBC risks (Nuclear, Radiological, Biological and Chemical). Like the fire­figh­ters, “the hos­pi­tals and ambu­lances are pre­pa­red for these risks, and the phar­macy stocks anti­dotes for cer­tain pos­sible attacks”, says Benjamin Garel.

Sites Seveso en France au 31 décembre 2014.  @ Ministère du développement durable

Seveso sites in France on 31st December, 2014 (in pink, high thre­shold ; in grey, low thre­shold). © Ministry of Sustainable Development

“This may involve tes­ting a decon­ta­mi­na­tion chain, lin­ked to a che­mi­cal attack, or dea­ling with a mul­tiple attack”, says Benjamin Garel.

In gene­ral, the exer­cises are plan­ned on a natio­nal, zonal or regio­nal scale, with large-scale exer­cises every year.

Concerning the spe­ci­fic pre­pa­ra­tion for the risk of mul­tiple attacks invol­ving heavy wea­ponry, Benjamin Garel, like Colonel Roux, wished to remain par­ti­cu­larly dis­creet on the sub­ject, citing defence secrecy.

Psychological sup­port of personnel

As some real-life inter­ven­tions can have a strong psy­cho­lo­gi­cal impact, and it is vital that the emer­gency ser­vices main­tain all staff ope­ra­tio­nal, so this aspect is now well integrated.

The hos­pi­tal in Isère also has an emer­gency para­psy­cho­lo­gist (CUMP38) both for vic­tims, and for staff. “At the Sdis, we also have a para­psy­cho­lo­gist, dedi­ca­ted to indi­vi­dual or group sup­port for fire­figh­ters, during or after cer­tain inter­ven­tions”, reveals Colonel Roux.

Véronique Magnin

* The white plan changes to dif­ferent colors, depen­ding on the hos­pi­tal ser­vices that need to be rein­for­ced : “If patients need sur­gery, the ‘red hos­pi­tal’ plan is trig­ge­red. The green plan is for medi­cine ; it is laun­ched, for example, in cases of mass poi­so­ning. Finally, we have the “yel­low hos­pi­tal” plan for pedia­trics”, says Benjamin Garel.

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