July 14, 2016, Terror Attack in Nice, France

Abstract

On July 14, 2016, a terrorist attack by truck occurred in Nice, France, during the traditional fireworks for Bastille Day. The authors present the point of view of the doctors from Lenval University Children's Hospital, which is located near the attack place and which had to manage 47 casualties, including 12 adults.

Five Challenges When Managing Mass Casualty or Disaster Situations: A Review Study

“…Dealing with uncertainty, unpredictability and unexpected consequences was a significant challenge in many of the described events [12,15,16,22,25,26]. Unconfirmed information, a lack of information and contradictory information cause blurred pictures that made decision-making more difficult than in normal situations.…”

“…Combined with obvious difficulties in determining the numbers, this led to significant frustration and made it difficult to assess whether the situation was, in fact, a mass casualty or disaster [12,26]. Sometimes, the contingency plan or disaster mode was not activated until long after the first patients were already in the emergency departments [10,15,24,25].…”

“…In some cases, the plan did not cover the right things, or it was not applicable to the situation because the public did not behave as the plan presumed or the event developed in an unexpected direction [10,21,24]. One example of this was that spontaneous evacuation-injured people not awaiting prehospital medical care, but leaving the disaster site on their own or with the help of bystanders to go to the hospital-was not mentioned in any plan but occurred in many of the studied events [10,12,15,25,27]. This, combined with strained prehospital medical care, resulted in victims not being 'prepared' (i.e., pre-treated) as expected by the contingency plans.…”

“…This, combined with strained prehospital medical care, resulted in victims not being 'prepared' (i.e., pre-treated) as expected by the contingency plans. This caused a mismatch between the contingency plans and the need for improvisation in emergency departments [25]. The disaster contingency plans, in general, mainly focused on severely injured patients.…”

“…The disaster contingency plans, in general, mainly focused on severely injured patients. However, in many of the studied events, most patients needed basic medical care and/or psychosocial support [10,12,25,26]. The patients arriving at the hospital required, not only surgical care, but also internal medicine care [10,21,28].…”