Reg700 eng france iems and samu networks and public health disaster plans

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The french SAMU network and Public Heath Integrated EMS is the begining of a Sanitary Civil Defense

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Reg700 eng france iems and samu networks and public health disaster plans

  1. 1. M Martinez Almoyna 2004 French Public Health Intergrated EMS 1 A Public Health Civil Defense network for french hospitals and SAMU: TOWARDS AN INTEGRATED NATIONAL EMERGENCY MEDICAL SYSTEM (IEMS) AND NETWORK Miguel MARTINEZ ALMOYNA (MD MCU)
  2. 2. M Martinez Almoyna 2004 French Public Health Intergrated EMS 2 French IEMS (like deffined in Declaration of Jalisco) MOH civil defense specific organisation for disastrous sanitary events 1. Pre hospital network sub-system 2. Hospital network sub-system 3. SAMU control and medical regulation sub-system
  3. 3. M Martinez Almoyna 2004 French Public Health 3 THE NATIONAL EMERGENCY CARE PRE-HOSPITAL SUB- SYSTEM NETWORK = Primary Care network for GP Emergencies+ = Emergency Ambulance fleet resources for emergency transporting patients (MICU*, Rescue Units*, Ambulances**)
  4. 4. M Martinez Almoyna 2004 French Public Health 4 THE NATIONAL EMERGENCY CARE HOSPITAL SUB- SYSTEM NETWORK = Secondary hospital emergency and MICU (SMUR) resources are monitored by local (and neighbouring SAMU) = Tertiary , Specialized emergency and ICU resources are monitored by neighbouring and regional SAMU = Zonal leading Hospitals for NBC disasters
  5. 5. M Martinez Almoyna 2004 French Public Health 5 The French SAMU and SMUR Network for Emergency Care • In day to day medical individual emergencies • In collective public health mass emergencies • In France (continental and islands!) and even in foreign countries
  6. 6. M Martinez Almoyna 2004 French Public Health Intergrated EMS 6 Toulon Angoulême Périgueux Bordeaux Mont-de-Marsan Agen Auch Tarbes Pau Foix Toulouse Montauban Cahors Aurillac Niort La Rochelle Rodez Albi Carcassone Montpellier Mende Privas Le Puy Lyon Bourg-en- Bresse Annecy Chambery Grenoble Valence Gap Avignon Marseille Perpignan Digne Lons-le- Saunier MaconMoulins Dijon Bèsançon Vesoul Épinal Colmar Strasbourg Nancy Metz Bar-le-Duc ChaumontTroyes Auxerre Bourges Nevers Chateauroux Poitiers Angers Le Mans Alencon Chartres Orléans Blois La Roche-sur-Yon Nantes Vannes Quimper St-Brieuc Rennes Laval Saint-Lo Caen Évreux Rouen Amiens Arras Lille Laon Charleville- Mézières Châlons- sur-Marne Versailles Beauvais Gueret Limoges Tulle Bastia Ajaccio Nice St.Etienne Clermont- Ferrand Tours Evry Mulhouse Nîmes Bayonne Brest Le Havre Calais 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 1617 18 19 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 76 78 79 80 89 2A 2B 95 91 87 88 81 82 85 86 84 83 Aveyron Lot Ariège Gers Garonne (Haute) Pyrénées (Hautes) Tarn Tarn-et- Garonne Pas-de-Calais Nord Vendée Sarthe Maine-et- Loire Loire-Atlantique Mayenne Aisne Oise Somme Charente Charente- Maritime Vienne Sevres (Deux) Alpes (Hautes) Alpes de Haute- Provence Alpes- Maritimes Bouches-du- Rhône Var Vaucluse Ain Savoit (Haute) Savoie Isère Loire Rhône Ardèche Drôme Corse- du-Sud Haute-Corse Rhin (Haut) Rhin (Bas) Gironde Dordogne Lot-et- Garonne Landes Pyrénées- Atlantique Puy-de-Dôme Loire (Haute) Cantal Allier Manche Orne Calvados Côte-d'Or Niévre Saône-et-Loire Yonne Eure-et-Loire Cher Loir-et-Cher Indre Indre-et-Loire Loiret Marne Marne (Haute) Aube Ardennes Saône (Haute) Doubs Jura Belfort Eure Seine-Maritime Val-d'Oise Yvelines Seine-et- Marne Essonne 94 93 Seine-St.Denis 94 Val-de-Marne 92 Hauts-de-Seine 75 Paris Lozère Gard Aude Pyrénées- Orientales Hérault Creuse Corrèze Vienne (Haute) Meuse Meurthe-et- Moselle Moselle Vosges Finistère Côtes d'Armor Ille-et-Vilaine Morbihan Alsace Lorraine Aquitaine Basse- Normandie Bretagne Auvergne Bourgogne Centre Champagne-Ardenne Franche- Comté Haute-Normandie Ile de- Languedoc- Roussillon Limousin Midi-Pyrénées Pays-de-la-Loire Nord-Pas-de-Calais Picardie Provence-Alpes- Côte-d'Azur Poitou- Charente Rhône-Alpes Corse France 92 Pontoise Melun 93 77
  7. 7. M Martinez Almoyna 2004 French Public Health Intergrated EMS 7 THE SAMU SUB-SYSTEM SYSTEM IMPLANTED IN EACH « DEPARTEMENT » CAPITAL TOWN HOSPITALS AS TWO ROLES IN CASE OF EMERGENCY The responsible physician (SAMU medical regulator physician) as the two roles A technical medical role for deciding and organizing the initial medical emergency care An Administrative Authority emergency Delegated Role for deciding alerting and initiating « plans blancs » and « plan rouge » Public Health emergency resources involvment
  8. 8. M Martinez Almoyna 2004 French Public Health 8 The French SAMU emergency tele-medecine system and network improoves not only quality of care but also equity of resources distribution! A national medical emergencies specific and protected exclusive hotline (15) Plus a health care tele-communication network beetween emergency regional integrated medical emergency hospital (ER OR ICU) and out of hospital resources (MICU Ambulances) Plus a MOH national civil defense policy
  9. 9. M Martinez Almoyna 2004 French Public Health 9 The Hospital and SAMU « Plan Blanc » emergency care IEMS sub-system Four tiered 1 local Hospital « white plan » 2 « Departement network » SAMU + DDASS « white plan blanc » 3 Civil Defense Zone regional network « zonal white plan » ARH+DRASS+Regional SAMU 4 MOH + SAMU de Paris = national and international disasters (+Foreign Office)
  10. 10. M Martinez Almoyna 2004 French Public Health Intergrated EMS 10 Exemples: • An explosion in Toulouse • A mass casualty in a Corsica Island Stadium or Charles de Gaule Airport • An Paris subway attentate • A disaster in Latin America or an Air France aircraft terrorist attack …
  11. 11. M Martinez Almoyna 2004 French Public Health Intergrated EMS 11 A NATIONAL SAMU NETWORK BUT WITH 3 LEVELS 1. « Départements » SAMU (and neighbouring « departements ») 2. « Public Health Civil Defense Zones » regional SAMU 3. « BMOH + SAMU of Paris »
  12. 12. M Martinez Almoyna 2004 French Public Health Intergrated EMS 12
  13. 13. M Martinez Almoyna 2004 French Public Health 13 A NATIONAL COORDINATED (?) AN EMERGENCY CARE PUBLIC HEALTH SYSTEM? A REAL INTEGRATED EMS (IEMS) Ministery of Health + Military Defense Civil Defense Fire Men Rescue (plan Rouge) Private, ONG Foreign Office
  14. 14. M Martinez Almoyna 2004 French Public Health Intergrated EMS 14 For More Informations on Public Health Civil Defense Emergency Tele-medecine and SAMU regulation • migmigmig@orange.fr • SLIDESHARE Miguel Martinez Almoyna
  15. 15. M Martinez Almoyna 2004 French Public Health 15 French MOH and SAMU documents on Public Health Civil Defense • WWW.sante.gouv.fr • www.samudeparis.org
  16. 16. M Martinez Almoyna 2004 French Public Health 16 WWW.sante.gouv.fr/dossiers/planblanc2004.pdf
  17. 17. M Martinez Almoyna 2004 French Public Health Intergrated EMS 17 SAMU network in a real Public Health Integrated EMS is the nervous system of both day to day and disaster medicosanitary emergencies

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