Global & Disaster Medicine

Archive for the ‘Terrorism’ Category

French Disaster Plans: Dealing With the Paris Terror Attacks (Red, Yellow, and White Plans)


In the event of a disaster in France, two complementary plans are activated: the Red Plan and the White Plan.

The Red Plan concerns what is happening in the field. It is based on the principle of extracting and grouping the injured. The injured are grouped in the field hospital, the triage and care center where the treatment that is strictly necessary is given, to ensure survival, calm the pain, and be able to transport the victims without making their condition worse. The field hospital is placed under the authority of the medical response coordinating physician.

The Alpha Red Plan, such as that activated on the night of November 13, is designed to deal with multisite events.

The Yellow Plan is a variant of the Red Plan adapted to nuclear, radiological, biological, and chemical risks. At the same time, the hospitals must be prepared to deal with an influx of victims: this is the responsibility of the White Plan.

On November 13, the emergency services counted 479 victims: operations on chronic cases therefore had to be put on hold in order to deal with the urgent cases.

The White Plan includes setting up a unit tasked with communication with the media, informing families, programming the release of beds, calling in reinforcements, etc. In line with the Social Security Modernization Act of 2004, the White Plan was extended to cover all establishments around the hospital, including clinics

About the devastating series of attacks that struck Paris and Saint Denis on the evening of Friday, November 13, at six different locations, with 132 dead so far and more than 250 injured


“….The White Plan has been enshrined in law since 2004 and enables additional means and human resources to be mobilized, nonessential activities to be rescheduled, and additional beds to be opened.


“All the personnel are mobilized, in particular the [Service d’Aide Médicale Urgente] and A&E teams. The necessary staff are called in directly by the hospitals,” the AP-HP stated in a press release Friday evening. All the emergency services of the largest university hospital in France were mobilized. The victims of the attacks were mainly distributed among Saint-Louis Hospital, La Pitié Salpêtrière Hospital, Georges Pompidou European Hospital, Henri Mondor Hospital, Lariboisière Hospital, Saint-Antoine Hospital, Bichat Hospital, and Beaujon Hospital…..

On Saturday, November 14, at least 300 people were being treated in Paris hospitals, with 80 of them being considered absolute emergencies and 177 relative emergencies, plus 43 additional persons — either witnesses or family members.

AP-HP issued the somber warning that “most of the patients are in a state of shock and suffering from various and sometimes multiple injuries, which could require very long-term medical attention.” By late afternoon on Sunday, November 15, about 415 people, or about 100 more than the previous day, had been admitted to the hospitals for psychological shock. Of the 80 absolute emergency cases, 35 had been downgraded, but an additional three had died, raising the death toll from the attacks to 132. Of the 415 persons receiving treatment, 218 were discharged on Sunday evening.

In addition to the medical community, the residents of the Paris area as a whole made a commitment to the medical effort. Although blood reserves were announced by AP-HP as being sufficient on Friday evening, large numbers of the population nonetheless lined up to give blood. The French blood bank noted that “this mobilization needs to be a long-term one: 10,000 blood donations are required every day, and all blood groups are needed.” The Ministry for Health, for its part, stated that the ministry’s health emergency center had been immediately activated, along with the health emergencies preparation and response facility. “Medico-psychological emergency units…were set up on a number of Paris sites, in order to treat the victims and their families,” the ministry added……

Last Friday, in barely 1 hour, the staffing levels had been doubled. The triage system also enabled the injured to be evenly distributed, with the largest hospitals taking several dozens of the injured, which was not a strain on the hospitals. Even if treatment of the injured at the time went smoothly, Dr Prudhomme is concerned that the hospitals could be submerged by those suffering from the psychological shock: “We could see thousands of people suffering from psychological distress, and we do not necessarily have the resources.”…..”

Portrait of a Terrorist

NY Times

  • Adrian Russell Ajao = Khalid Masood after converting to Islam in his late 30s
  • 52-year-old husband and father.
  • Prone to violent outbursts as a younger man
  • Led a quiet life in recent years
  • Most afternoons he would pick up his two youngest children from primary school in a quiet suburban part of Birmingham, in the West Midlands of England.
  • “When he spoke about religion,” said a neighbor who did not want to be identified for fear of reprisals, “he suddenly was a different man,” describing in those moments a fierce and uncompromising anger about the treatment of Muslims.

Khalid Masood Credit Metropolitan Police, via Associated Press

Four people were killed, along with the assailant, and at least 50 people from 12 different countries were injured, of whom 31 needed hospital treatment. Two remain in a critical condition.


The Westminster attacker was British-born



22 March 2017

4 people killed

40 injured

  • 12 Britons in hospital
  • 3 French children injured
  • 9 other nationalities affected
  • 8 arrests made

London, Paris, Berlin, Madrid, Nice: Europe under Terror

LA Times

Northwestern Europe at Night


March 22, 2016: Two blasts ripped through the Brussels airport, turning a busy travel hub in the heart of Europe into a scene of carnage.

NY Times


A “sick and depraved terrorist attack”: 5 dead and 40 injured in London car-knife assault

Chicago Sun Times



The attack unfolded around 2:40 p.m., when the driver of a large vehicle mowed down pedestrians on Westminster Bridge, which leads to Parliament, killing 2 and injuring others, before crashing into a railing. After the crash, at least one man left the vehicle and approached Parliament, where he stabbed an armed police officer to death and was fatally shot by the police.

NY Times



Attack in London: Perhaps 4 dead and at least 20 injured outside the Houses of Parliament


  1. A police officer has died after being stabbed outside the Houses of Parliament
  2. Two other people have died and at least 20 others are injured after the attacker drove into them in a car on Westminster Bridge
  3. The alleged assailant was shot and killed by armed police
  4. Footage on social media shows people lying injured in the road
  5. Metropolitan Police say they are treating it as a terrorist incident and buildings are in lockdown


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