“Alerts are coming from everywhere”: in the heart of summer, hospital emergencies in a crisis “worse” than last year
2023-08-18 15:11:00
“We have never experienced such a scale of emergency structure closures”, says Agnès Ricard-Hibon, spokesperson for the French Society of Emergency Medicine (SFMU).
Very present in recent days in the media, the main representatives of emergency physicians, from Amuf (Association of emergency physicians of France) to SUdf (Samu-Urgences de France), have also judged the situation “more serious than last summer”, touching according to the president of SUdf Marc Noizet “all departments”from small to large services, to “extremely touristic areas”.
Emblematic case, the emergency reception of Saint-Tropez (Var), star seaside resort of the Côte d’Azur, remained closed for three nights in August, the hospital ensuring by press release that it had “All” tried to avoid this “extreme situation”.
Shortage of emergency physicians, temporary workers, paramedics, downstream beds… “Alerts are coming up from everywhere”, from Brittany to the Atlantic coast, laments Dr Ricard-Hibon. Head of the Val-d’Oise Samu, she has “learned on Tuesday of the night closure, for fifteen days, of a service in Ile-de-France”.
“Maintaining the essentials”
A Smur (mobile emergency and resuscitation service) from Hauts-de-Seine also transferred an infant with bronchiolitis to Rouen on Sunday, for lack of a pediatric intensive care bed in Ile-de-France. The situation has been since “back to normal”according to the Regional Health Agency (ARS).
“The worst days were the bridge of August 15”, says Dominique Savary, head of emergencies at the Angers University Hospital and SUdf representative: in the Pays-de-la-Loire, “four services were closed”in addition to “six lines of Smur at a standstill” and a helicopter “not functional” In Nantes.
“The pressure falls on the services that resist, at the cost of major overtime”, the Smur having to move “much further” and parry “at most serious”. In an area where psychiatry “collapses”, the emergency doctors also saw psychiatric patients “in serious condition arriving from Sarthe, 100 km away”says Mr. Savary.
The Minister of Health Aurélien Rousseau (d) visits the reception and call regulation center (CRRA) of SAMU (emergency services) in Toulouse, August 14, 2023AFP / Valentine CHAPUIS.
“I would not say that the situation is more serious” that in 2022, judged on France info the Minister of Health Aurélien Rousseau. “She is still tense, and she will be tense after the summer too” because caregivers are lacking, he warned.
“We anticipate better” tensions this year, he said. The biggest hospitals “support” the smallest, and night closures allow “to maintain a care offer” during the day where “we could no longer”.
To maintain “the essentials”, vital emergencies, the authorities enjoin the population to “always call” the city offices or the 15 before moving.
“Rejected patients”
If the figures vary, the minister delegate in charge of the health professions, Agnès Firmin Le Bodo, indicated on August 3 that the services “really closed” remained rare, “18%” working “with regulation“, or the obligation to call 15 to be taken care of.
Filtering has become the rule in all hospitals in Mayenne, Manche, in several Breton towns such as Carhaix (Finistère), or at night in Dax, Pau or Niort.
A SAMU dispatcher speaks on the phone with a patient at the Pellegrin hospital in Bordeaux, May 20, 2022AFP/Archives / ROMAIN PERROCHEAU.
At the CHU Pellegrin in Bordeaux, it is applied 24 hours a day and patients presenting spontaneously are turned away, notes Julien Dulou, caregiver and representative of Sud-Santé Sociaux. Amid severe cases, some patients “overplay” to enter.
By triaging patients, “we are not immune to error”, regrets on condition of anonymity an emergency doctor from the CHU.
The hospital is not “more attractive”, have long claimed emergency workers, pleading to bring about the revaluation of night and weekend guards, promised by Emmanuel Macron.
For Jean-François Cibien, president of the inter-union Action Practitioner Hospital (APH), regulation “is a solution”provided that its “forces vives”medical regulation assistants (ARM) – the first to drop out of Samu – on strike in three quarters of the territory.
Understaffed, they have in places “+45% activity, without any valuation”, he laments, calling on the ministry to give them the “risk premium” that they claim.
Faced with the heat wave which could suffocate the services even more, Aurélien Rousseau remains confident: “the hospital will cope”, he promises.