In Paris, hospital emergencies already saturated, deprogramming has begun

The ninth wave of Covid is barely starting, the flu has not yet arrived, and yet Parisian hospitals are already overwhelmed. Nicolas Revel, the new director general of Assistance Publique – Hôpitaux de Paris, and Professor Rémi Salomon, president of the Establishment Medical Commission, a sort of parliament of doctors, sounded the tocsin on Monday, November 21 in an email addressed to the heads of departments of the main Parisian establishments, of which the Express was able to learn.

While pediatric establishments are already saturated with children with bronchiolitis, the two hospital officials indicate that, Monday morning, “the number of stretcher beds reached an unprecedented peak (188) in adult emergency services”. In other words, 188 patients were cared for in the emergency room corridors… Difficulties which started several days ago, and which would be linked to both “greater hospitalization needs, particularly among those over 75 years”, and “difficulties in finding downstream solutions (…) in a general context of declining capacity”.

The causes of these difficulties are known: a probably excessive number of bed closures in recent years, coupled with a crisis in the recruitment of caregivers, nurses and nursing assistants, which forces them to close more more beds. Faced with this situation, a crisis cell was organized on Monday in the middle of the day, to take stock of the capacities of the various sites, and the actions already undertaken. The director of the AH-HP calls on hospital officials to trigger the “hospital in tension” plan, the last step before the white plan, and hold regular crisis meetings.

In view of the number of patients still awaiting hospitalization at the end of the day on Monday, Nicolas Revel and Rémi Salomon are calling for medical deprogramming, in order to be able to absorb the flow of patients. “We are aware of the difficulty of this exercise and the tensions that it can generate within the medical community, in a context where the supply of care is chronically reduced”, they indicate to the teams. If the Regional Health Agency has been warned of these difficulties, transfers to other hospitals in the region (outside AP-HP) seem difficult to envisage, because many of them also see their emergency services already saturated.

This renewed tension comes as the Minister of Health François Braun announced on Monday an extension of 543 million euros for the hospital for 2022, which comes “in addition to the 570 million already announced to deal with the epidemic. of bronchiolitis”. Will these emergency measures allow hospitals to quickly recruit the staff needed to reopen beds and avoid worsening difficulties? Have. This morning, on Twitter, Professor Rémi Salomon called on people at risk to get vaccinated against the flu and Covid, as well as to wear a mask and ventilate to reduce the transmission of these viruses. “If you can avoid going to the emergency services these days…”, he concluded his message. We understand better why.

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