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Updated: Feb 20, 2026

Integrated Compensatory Responses in a Human Model of Hemorrhage
Published on: November 20, 2016
Organization in response to massive afflux of war victims in civilian practice - experimental feedback from the
M Borel1, R Rousseau2, F Le Saché1
1Département d'anesthésie réanimation, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP-HP, 75013 Paris, France.
Abstract:
The arrival of a large number of war-weapon casualties at a civilian trauma center requires anticipation. A plan defining the management principles and the respective roles of the involved physicians and nurses and their interaction with each other is essential. Uni-directional patient flow associated with adequate numbers of staff physicians and nurses under the leadership of a medical director is essential to prevent the overwhelming of the trauma center. Routine and regular interaction between the pre-hospital medical flow control system and the medical director, on one hand, and between surgical teams and the medical director, on the other, are necessary to know when to apply "damage control" surgical techniques. Based on the feedback of a level 1 trauma center that received 53 victims of the November 13, 2015 terrorist attack in Paris, we present the factors of success, and the stumbling blocks.
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