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aboard a TGV train transformed into a mobile resuscitation service

Operation Thistle. April 10, 2020. In all, 45 victims of Covid_19 from all over the Ile de France, are transferred by two TGVs to Bordeaux and Poitiers. The objective is to unclog hospitals in Ile de France saturated with shoppers because of covid-19. The operation is coordinated by the SAMU. (And the SNCF). On the train to Bordeaux: patients are placed on the ground floor of the train. To enter it, you have to equip yourself. They are 4 per train. All are intubated. The electricity in a train is discontinuous. They are all connected to a generator which takes over when the electricity goes out.

LAURENCE GEAI FOR “THE WORLD”

By Gabriel Coutagne

Posted today at 2:07 am

It is 7:30 a.m. on Friday April 10 at Austerlitz station in Paris. Usually, we could have seen the passengers massing on the platforms, on the eve of Easter weekend.

But that morning, a ballet of ambulances, stretchers and medical personnel marched. Two TGVs, Chardon 9 and 10 (named after the rail transfer operation), were made available to health services to evacuate 45 patients from Ile-de-France in order to free up intensive care beds. Photojournalist Laurence Geai, on board Chardon 9, set sail for Bordeaux. Chardon 10 goes to Poitiers.

Each convoy is made up of a standard train set at the head to absorb the shock in the event of an obstacle, and a second sanitary train. Inside, each duplex car was literally turned into a field hospital to accommodate four patients. In all, this TGV carries 24 patients.

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Downstairs, in the Covid area, the patients and their stretchers are installed in place of the usual armchairs. Infusions, portable respirators and other machines are placed above where a coat or bag is normally placed.

Patients are sedated, intubated and on artificial respiration. “We do everything as if we were on resuscitation service”, notes Doctor Lionel Lamhaut, anesthesiologist-resuscitator and transport coordinator.

The bar car, command space

Upstairs is the space for caregivers: two doctors, four nurses and a logistician per car, not counting the volunteer rescuers. The bar car is converted into a command center. In each car transporting patients, contact between the two spaces is as rare as possible, in order to avoid contamination. Near the stairs, an airlock allows staff to equip themselves in sterile clothing.

On the SNCF side, all positions are doubled: drivers, chiefs, convenience stores, security agents, etc. All volunteers.

Around 1 p.m., the ballet resumed on the platforms of Bordeaux train station. Medical ambulance vehicles, firefighters and the Red Cross distribute the sick to hospitals and private clinics in the city.

The caregivers and rescuers who were on board, set out for Paris.

“It’s a unique organization in Europe, if not in the world”, exclaims Dr. Agnès Ricard-Hibon, president of the French Society of Emergency Medicine. “We have a relatively strong hospital system to be able to respond to this crisis”, says Lionel Lamhaut. “But this system is clearly damaged, he regrets. Will we have more resources after the crisis? This is a real question. “

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