Blessure psychique de guerre et blessure psychique lors d’attentats : quel parcours de soins ?

Abstract

When we listen to the testimonies of recent victims of attacks that have taken place in France in recent years, it is difficult not to draw parallels with war medicine. Since the initial exposure, which is characterized by its effect of surprise and stupefaction, the use of injurious and devastating weapons which leave painful and functional sequelae, the number of victims which increases the horror of the situation, it is of a battlefield that this description seems to come from. However, what characterizes the latter is the preparation of combatants to manage this type of eventuality and the operationality of a health service seasoned in crisis management. From the initial care in the theater, as close as possible to the fighting, to the conditioning of the wounded before their eventual evacuation, we will present to you in this work the care structures set up in the theaters of operation to provide assistance to the injured. We will see there that the psychological support of the combatants is integrated into this support and this from the battlefield. At the field hospital, brief management can be carried out associated with a few days of observation according to the principles of Salmon (immediacy, proximity, simplicity, expectation, centrality). From a distance, we will see how the accompaniment of the injured is thought out over time, not only in terms of care, but also in terms of administrative support in the steps aimed at recognizing and repairing the condition. Finally, we will present the first findings from the implementation of psychosocial rehabilitation tools. We hope that the course of care that emerges through this communication can inspire practitioners who accompany civilian victims of attacks.