Science

Hospital: emergency care after a summer on the verge – Sciences et Avenir

There is no fainting, but still a cold sweat: if the government is glad that it avoided the “declared catastrophe” in the emergency room, then in the field, “wrung out” educators are already afraid of a “very difficult” autumn.

The worst is never certain, but at the University Hospital of Rennes, the summer turned out to be “worse than the previous ones, as we expected.” The head of the emergency department of the main hospital in Île-et-Villaine, Professor Louis Soulat knows that he was close to having four services from one department “close simultaneously during the night”, a jump of 30% of Samu’s calls in July-August and ” twice as many” closed beds during staff leave.

Somehow, thanks to student reinforcements and the efforts of private clinics, “emergencies have survived,” he says.

But “we also can’t say that everything went well,” adds his colleague Vincent Bones, head of Samu de Haute-Garonne, where “for the first time we faced the closure of many establishments, sometimes for a whole week.”

Even the University Hospital of Toulouse was forced to accept “vital emergencies” only on certain evenings due to a strike of medical staff demanding more staff. Fortunately, the flow of patients dried up in mid-July, thanks in part to the seventh wave of Covid, which rose below the previous ones, he notes.

Then a little luck and a lot of cubit fat. Minister of Health François Brown, above all, remembers that “the declared catastrophe did not happen”, and wants the effect of his “operational mission” to be smoothly realized just before he enters the government at the very beginning of July.

Thus, the increase in calls to Samu “about 20%” at the national level indicates, he said, that the official instruction “to call at 15 before moving” has borne fruit and that “this message has passed.”

– “Endanger” –

“Among some patients there is a change in perception”, more aware of the “need for medical regulation”, confirms Professor Karim Tazarurte, head of Samu de Lyon, convinced that this point needs to be emphasized and “forget about what we should not hesitate to ask opinion before going to the emergency room.”

But on the other hand, “labor-intensive work has increased” for caregivers and “pickup” times are “much longer,” putting “at risk for people who cause emergencies,” denounces Gilbert Mouden, nurse anesthetist and elected Sud-Sante. at the University Hospital of Bordeaux, which reports a peak of 35 concurrent calls.

“There is a gap between the minister’s message and reality,” argues CGT-Santé, which notes that “15 centers are overwhelmed, staff is depleted” and “emergency services are closing unexpectedly (…) including in big cities. “.

The unions are preparing to take legal action: as in the case of Laval in mid-August, last week a report was sent to the prosecutor’s office of Bayonne about the “endangerment” of staff and patients. “If one of us ever gets involved, justice will be alerted to what’s going on,” explains Patrick Casalis, Unsa’s delegate from the Basque hospital.

“The drama was as it always was,” notes Marie-Pierre Martin, president of Collectif Inter-Urgences, who sees “patients always stay for 24, 48 hours or more, treated in a degraded regimen just because “there is no room in elsewhere.”

The situation remains unstable. “Teams are squeezed out” and “very fragile,” emphasizes Dr. Marc Noisette, head of emergency services in Mulhouse and Mr. Brown’s successor at the head of the Samu-Urgence de France association. Already predicting a “very challenging autumn,” he hopes for “strong signals this start of the school year” to prevent “some services from getting into even more trouble.”

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