Perpignan hospital: "Summer was a demonic, the emergencies are not there to treat all the evils of the earth", alerts Doctor Laurent Ortega
Doctor LaurentToe, after a second summer under Covid in the emergency room of the hospital, how do you attack the start of the school year?
We are all there, tired at the end of this demonic summer where we have given a lot, and we will continue to improve the patient's journey in emergencies and inside the hospital.To this end, we keep reorganizing ourselves to assume in addition to real emergencies all this patient that overwhelms us and could be treated by city medicine or by medical houses.
Do your workforce follow?
We will never be enough in the face of the expression of emergencies, but we are about to welcome five new young emergency physicians who have been recruited and will come to strengthen the team.It is positive, it will not allow to be complete, but it is a breath of oxygen welcome after the summer of all the records that we have just suffered.
In particular a frequentation record?
Yes, the activity was violent, we held the shock difficult to.Summer started in mid-June during the deconfine.Everyone wanted to go on vacation and in the end coming to us.This is where we started breaking all the tributaries.Compared to 2019 the reference year, we did an average of twenty additional patients per day, or 11% more and this continues today.
How much do you quantify the passages at the time of the peaks?
On the highest levels, 600 more monthly patients were treated than in 2019.More than 600 in July and more than 500 in August for an overall volume of 6,600 patients per month with the fourth wave that was limited thanks to vaccination.That said, the situation was extremely tense in the public as in the private sector.We are all in the same problem and we try to work together.
Fewer leaves, more working hours and the reinforcement of 4 military doctors of special forces
Concretely how did you face?
We reorganized the emergencies in early July, by sectorizing and setting up dedicated COVVI and non-COVVID dedicated care teams.Then we shortened our vacation and we increased the number of our working hours.However, there has been a lot of expectations for patients, but vital emergencies, the most serious cases have been favored, this is our primary role.And it is for us immense satisfaction of having succeeded without reinforcement, with the exception of the three to four military doctors of the CNEC who work in the special forces and regularly came to help us on the guard.They were frankly welcome.
How many patients in everyday life represent?
About twenty on average.This inevitably increases the waiting time of the lambda patient which remains of the order of 4 to 5 hours.We are well aware that we must always optimize our structuring and it is also our will of everyday.But it must also be taken into account that the department welcomes 2,000 additional retirees each year and that in summer season we multiply by four the population of the Pyrénées-Orientales, by counting a city, Argelès, of 135,000 tourists where the permanence of care isnon -existent.In this context, it is obvious that emergencies are unable to receive everyone, to treat bobology, simple consultation...
The creation of seasonal medical houses would be the solution?
We have been asking their deployment for two years already.This new health network becomes completely essential over the most critical periods of the year, because it is imperative that these patients who need care have a response to their health problems without going through our services.Despite the incessant evolution of the emergency processes, it is impossible for us to be effective in the face of such an increase in attendance.And once again, I speak for all emergency services in the department, public and private.Everyone suffers.We must manage as soon as possible to set up a more coherent sanitary scheme.
Where does the project block where precisely?
One, for lack of doctors;two is a political will.For our part, we did the work but it is clear that the situation does not advance.It seems that ARS is working on adequate health coverage, I ask to see.
How many medical houses would be necessary?
Three.One either in Argelès or in Elne to also cover the Vermeille coast where from 8 p.m. there are no more doctors.Another towards Barcarès and finally one in the fenouillède, the other territories being covered.This device would allow patients to be examined on site, then returned to their home or oriented towards us in the event of real necessity.Without this health cordon, everyone falls back on the hospital and this work of sorting in the emergency.
"We have people sitting in the emergency room that we cannot extend because we do not have available hospitalization beds, we can't even put them on stretchers, we don't have any more"
Outside summer, is the health network of the territory suitable?
No, we have to work with general practitioners to strengthen the Hospital/City network.And that the hospital becomes a place where we can provide an adapted response to the real emergencies.Emergencies for emergencies.
How long have you had known for anytime?
Two to three years.At the moment we take the post-Covid with a lot of elderly people for whom short circuits should be assumed to be assumed.Is a 95-year-old person with an alteration of his general condition, is the emergency mission to deal with it?Wouldn't it be easier to have her hospitalized directly in consultation with her attending physician instead of spending 20 hours with us while waiting for a bed of geriatrics that we will not have?Emergencyists have only two arms and two legs and emergencies, I repeat, are not there to absorb all the evils of the earth.
The Covid epidemic necessarily aggravated the situation...
This covid finally turned out to be a formidable revealer of dysfunctions, he amplified all societal fractures with us, public and private emergencies at the crossroads.We have become the only place where people can come.
Is your emergency center allocated by suspensions of non-vaccinated personnel?
No, out of the 300 enrollment of the emergency center which includes pure reception of emergencies, the SAMU, the SMUR, hospitalization at home and the medico-judicial unit, we had some recalcitrant people at the start, but who finishedby being vaccinated.Otherwise, we had two resignations of nurses but for personal projects.Posts that will be replaced, management plays the game.
Do you fear the arrival of winter with its share of trauma and the risk of a new virulent variant of COVVID?
The traumato does not worry me.A new Covid flambé yes and no.We are barely starting to see the thinning of the point, it's not time to lower our guard.Let's not fall the mask, let's not give up the health pass and continue to vaccinate.The vaccine has changed everything since the first wave.
Despite this thinning, you continue to lack places, beds, stretchers?
This Tuesday afternoon in October, for example, it's fire.We have people sitting in the emergency room that we cannot extend because we do not have available hospitalization beds, we cannot even put them on stretchers, we no longer have.So we have to mix small trauma with lying down, people in the corridors...All this we want to change it, we will change it, I will not let go.
The project of a single emergency call number, 112, worries DR.Toe
Reconciliated with the critical firefighters this summer on the response time of the SAMU which they considered "too long", - since the SAMU has increased its capacity for responses to calls by the contribution of nine aids to regulation and by thePresence of an additional regulator during a vacation period -, the hospital emergency center is today faced with a new source of concern: the Matras law named LREM MP Fabien Matras, soon to be re -examined in the parliamentary room.The text proposes to establish a single emergency call number for all emergency services, European number 112.
"The contours of the reform are still blurred.Behind this 112, who will answer?A reception operator who will take the call for aid to regulation which will transmit it to a regulatory doctor?Result, the time for care may increase considerably.We fear a major destabilization of health emergency services ", reacts the boss of the emergency center, LaurentToe.
Fundamentally against this law, the practitioner sees a strictly interest in no interest."We work well together with the firefighters, we settled the technical difficulties that could generate tensions, we get along well, they are ended in the summer at the end of the roll, we totally agree forValue, not to break them, "concludes LaurentToe.
