Medical Services Chaos and Surgeons Contributions During Arab Spring
Abdelhakim T. Elkholy MBBCH,FACS
ATLS CHAIRPERSON EGYPT
National coordinator and Instructor ATLS-
General Surgery Resident, Ahmed Maher
Visitor Resident, KasrAlainy Hospital – Cairo
All pictures and cases are real and taken
from the scene of events .
Police officers were attending in the
All pictures were taken secretly by
mobile phone camera !
28 January 2011
Fatal injuries (shooting to kill !).
Mass casualty incidents.
No disaster management plan was present or
All doctors from all specialties worked in the
casualty reception and all on-call consultants
came to the hospital
All elective surgeries stopped.
Collapse of medical service, communication
- Cairo University Hospital.
- The biggest hospital with a 5200-beds
- It is tertiary ,referral center for all hospitals
in Egypt .
- It is the closest hospital to Tahrir Square.
Evidence of an Emerging Pattern of Regime’s
Organized Escalating Violence
During 10 Hours on the Night of January
Published Article in Annals of Surgery, 2012
Mohamed D. Sarhan, MD, MRCS, Ashraf A.
Dahaba, MD, MSc, PhD, Michael Marco, MD, MSc, and Ayman
Published Article in Annals of
Of 3012 casualties, 453 were triaged as “immediate
On arrival, 339 of 453 patients (74.8%) needed
surgical intervention within 6 hours of arrival
whereas 74 of 453 patients (16.3%) were managed
Forty of 453 (8.8%) of patients did not survive their
injuries. Most of the inpatients (302/453, 66.6%)
were admitted within 10 hours on January
28, 2011, during which evidence of a pattern of
regime’s organized escalating violence emerged.
Patterns of injuries
Firearms resulted in the majority of injuries (93.1%)
Stab wounds (3.5%)
Blunt trauma from stone throwing (2.6%)
Tear gas inhalation (0.4%)
Sites of injuries
The most common sites of injury were the head and neck
the upper and lower extremities (18.1%).
abdominal area (13.6%).
multiple firearm injuries (6.1%)
Some Cases presented during the revolution.
Gunshot: entrance Rt. Lower chest and
exitLt. neck .
Presented hemodynamically unstable and
unfortunately died due to extension of the
vascular injury to major vessels.
Shotgun left hemi-thorax and left upper
quadrant of the abdomen.
Patient presented hemodynamicaly unstable
and Splenectomy was done but patient died
due to extensive hematemesis.
Shotgun to the back.
Patient presented with hematuria.
Admitted under observation.
Shotgun to the back.
Presented with right pneumothorax and
Shotgun umbilical region presented 24 hours
after the injury.
Multiple small bowel perforation.
Patient died after 2 weeks due to septicemia.
It was noticed that the effect of small pellet
may be delayed and this issue is under
Patient presented to‘Ahmed Maher Teaching
Hospital’ without cardiothoracic surgeons !!
Hemodinamicaly stable middle-aged male
Gunshot to the chest.
no communication method as the government
cut all methods of communication.
You can not transfer patients as there is no way
Conflict between people and police increased the
problem of security.