Lhe winter season has not yet started and the number of stretcher beds in Parisian emergency departments reached an unprecedented number at the start of the week. This situation is not new, but is aggravated in the current context of non-opening of 15% to 20% of downstream beds in hospitals, due to an inability to recruit paramedical staff to operate them.
Stretcher bed: what are we talking about? This watered-down term refers to patients who have consulted in the emergency department, whose medical care in the emergency room has ended, ending with the decision to admit them to hospital, but who, due to the saturation of hospital beds downstream, begin their first night of hospitalization on a stretcher while waiting for a bed to become available. In the current context, this admission decision taken by emergency physicians is carefully considered, most often because the diagnosis made requires hospital treatment or the degree of autonomy makes a return home perilous.
Stretcher beds are a huge daily stress for emergency departments and hospitals, but are mainly accompanied by increased morbidity, and unfortunately often mistreatment, because the care is not optimal (staff emergencies continuing, in parallel, to manage the flow of incoming patients). They are not worthy of the level of development of our health system in France. From a sociological point of view, the vision and current management of these stretcher beds have many similarities with the migrant crisis, including the epic of the ship Ocean-Viking was the recent illustration.
Support at an impasse
Like these migrants taking the heavy decision to leave their country of origin to go to sea, these patients were forced by illness or trauma to join the notoriously unfriendly environment of an emergency department. With, in both cases, a request for legitimate aid: humanitarian for some, medical for others. In both cases, this aid was provided to them effectively in a context of emergency and distress: rescued by the patrol of a humanitarian ship for some, supported, diagnosed and treated by an emergency unit for others.
And, in both cases, the rest of the downstream management is at an impasse: no port allowing docking for some, no downstream bed for others. Long days of waiting for some, long hours for others, in extremely precarious conditions of comfort and respect for privacy. We are little or badly nourished on a humanitarian boat or in an SU, we sleep badly there, basic hygiene must be done in degraded conditions. It is shocking for everyone; but even more at 92 years old in an emergency department, sometimes to end his life there.
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