Reg50 eng disasterfrenchwhiteplans

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French Public Health and SAMU "white Plans'

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Reg50 eng disasterfrenchwhiteplans

  1. 1. LECTURE N° 50 SAMU MEDICAL REGULATION FRENCH DISASTER PUBLIC HEALTH WHITE PLANSMiguel Martinez Almoyna MD MCUPH SAMU of Paris14/11/12 Reg50ENG M Martinez Almoyna SAMU of 1 Paris 2004
  2. 2. A Public Health Civil Defense whiteplans for french hospitals and SAMU: TOWARDS AN INTEGRATEDNATIONAL EMERGENCY MEDICAL SYSTEM (IEMS) AND NETWORK 14/11/12 Reg50ENG M Martinez Almoyna SAMU of 2 Paris 2004
  3. 3. 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 14/11/12 Reg50ENG M Martinez 3 Almoyna SAMU of Paris
  4. 4. THE NATIONAL EMERGENCY CAREPRE-HOSPITALSUB- SYSTEM NETWORK = Primary Care network for GP Emergencies+ = Emergency Ambulance fleet resources for emergency transporting patients (MICU*, Rescue Units*, Ambulances**) 14/11/12 Reg50ENG M Martinez 4 Almoyna SAMU of Paris
  5. 5. 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 14/11/12 Reg50ENG M Martinez 5 Almoyna SAMU of Paris
  6. 6. The French SAMU and SMURNetwork 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 14/11/12 Reg50ENG M Martinez 6 Almoyna SAMU of Paris
  7. 7. Calais Lille 62 Pas-de-Calais Nord-Pas-de-Calais Arras Nord 59 92 Hauts-de-Seine 93 Seine-St.Denis 94 Val-de-Marne 80 Somme 75 Paris 02 Charleville- Amiens Mézières 76 Aisne Seine-Maritime Picardie Ardennes Le Havre Laon Rouen Beauvais 08 Lorraine 50 Metz Manche Haute-Normandie 60 Oise 55 Châlons- Meuse Moselle Rhin (Bas) Caen 27 Eure Pontoise 95 sur-Marne 67 Val-dOise 57 Saint-Lo Calvados 14 93 Bar-le-Duc Nancy Évreux Yvelines 51 Marne Basse- Normandie 77 Strasbourg 78 92 94 Meurthe-et- 54 61 Orne Versailles Seine-et- Champagne-Ardenne Moselle Alsace Evry Marne Brest St-Brieuc Alencon Chartres 91 Essonne Melun Ile de-10 Aube Épinal 88 Vosges Colmar 29 Finistère 22 Côtes dArmor 35 Ille-et-Vilaine 53 72 Eure-et-Loire 28 France Troyes Chaumont 68 Rhin (Haut) Mayenne 89 Bretagne Sarthe 52 Marne Quimper Rennes Loiret 45 Yonne Laval (Haute) Mulhouse Le Mans Vesoul Belfort 56 Orléans Auxerre 70 Morbihan Saône Vannes Pays-de-la-Loire Blois 21 Côte-dOr (Haute) 44 41 Bèsançon Angers Loir-et-Cher Bourgogne Dijon Loire-Atlantique Tours 25 Doubs Nantes Maine-et- Centre Franche- Indre-et-Loire Niévre 58 49 Loire Bourges 37 Nevers Comté Jura 39 Chateauroux Cher 18 71 Saône-et-Loire Lons-le- La Roche-sur-Yon 79 Indre 36 Saunier Sevres Poitiers Moulins Vendée 85 (Deux) Macon 74 03 Allier Bourg-en- Savoit 86 Vienne Niort Bresse (Haute) La Rochelle Poitou- Gueret 69 Ain 01 Annecy Charente Creuse 23 Auvergne Rhône Charente- 42 Clermont- Maritime Charente Limoges Loire Lyon Chambery 87 Vienne Ferrand 17 16 Rhône-Alpes (Haute) Limousin Puy-de-Dôme Savoie Angoulême 63 St.Etienne 73 Isère 38 19 Corrèze Loire (Haute) Grenoble Périgueux Tulle Cantal 15 43 Valence Le Puy Alpes 05 Aurillac Dordogne 24 (Hautes) Bordeaux Privas 26 Drôme Gap 48 Mende Ardèche Lot 46 07 Gironde 33 Lozère 06 Alpes- Lot-et- 47 Cahors Rodez 84 Aquitaine Garonne 82 Languedoc- 04 Digne Maritimes Vaucluse Agen Midi-Pyrénées Tarn-et- Roussillon Alpes de Haute- Aveyron Landes 40 Garonne 30 Gard Avignon Provence Nice 12 Montauban Albi Nîmes Provence-Alpes- Mont-de-Marsan 32 Gers 81 Tarn Bouches-du- Côte-dAzur Montpellier Rhône 13 Var Auch Toulouse 34 Hérault Marseille 83 Garonne Bayonne Toulon Pau 31 (Haute) Pyrénées- Carcassone Tarbes Atlantique 11 Aude 64 Pyrénées Foix (Hautes) 09 Ariège 65 Perpignan Pyrénées- 66 Orientales Bastia Haute-Corse 2B Corse Ajaccio 2A14/11/12 Reg50ENG M Martinez 7 Corse- du-Sud Almoyna SAMU of Paris
  8. 8. THE SAMU SUB-SYSTEM SYSTEM IMPLANTED IN EACH « DEPARTEMENT » CAPITAL TOWN HOSPITALS AS TWO ROLES IN CASE OF EMERGENCYThe responsible physician (SAMU medical regulator physician) as the two rolesA technical medical role for deciding and organizing the initial medical emergency careAn Administrative Authority emergency Delegated Role for deciding alerting and initiating « plans blancs » and « plan rouge » Public Health emergency resources involvment 14/11/12 Reg50ENG M Martinez 8 Almoyna SAMU of Paris
  9. 9. The French SAMU emergency tele- medecine system and network: 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 policyIt14/11/12 improoves not only quality of care but also equity of resource Reg50ENG M Martinez 9 Almoyna SAMU of Paris distribution!
  10. 10. The Hospital and SAMU « Plan Blanc » emergency care BIEMS sub-systemFour tiered1 local Hospital « white plan »2 « Departement network » SAMU + DDASS « white plan blanc »3 Civil Defense Zone regional network« zonal white plan » ARH+DRASS+Regional SAMU4 MOH + SAMU de Paris = national and international disasters (+Foreign Office) 14/11/12 Reg50ENG M Martinez 10 Almoyna SAMU of Paris
  11. 11. 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 …14/11/12 Reg50ENG M Martinez 11 Almoyna SAMU of Paris
  12. 12. 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 » 14/11/12 Reg50ENG M Martinez 12 Almoyna SAMU of Paris
  13. 13. 14/11/12 Reg50ENG M Martinez 13 Almoyna SAMU of Paris
  14. 14. A NATIONAL COORDINATED (?) AND EMERGENCY CARE PUBLIC HEALTH SYSTEM? Ministery of Health + Military Defense Civil Defense Fire Men +Rescue (plan Rouge) Private, ONG Foreign Office 14/11/12 Reg50ENG M Martinez 14 Almoyna SAMU of Paris
  15. 15. For More Informations onEmergency Tele-medecine and SAMU regulation • mmartinezalmoyna.samu@invivo.edu • www.uvp5.univ-paris5.fr/samu (in different lenguages) 14/11/12 Reg50ENG M Martinez 15 Almoyna SAMU of Paris
  16. 16. French MOH and SAMUdocuments on PublicHealth Civil Defense • WWW.sante.gouv.fr • www.uvp5.univ-paris5.fr/samu • www.samudeparis.org 14/11/12 Reg50ENG M Martinez 16 Almoyna SAMU of Paris
  17. 17. WWW.sante.gouv.fr/dossiers/planblanc2004.pdf14/11/12 Reg50ENG M Martinez 17 Almoyna SAMU of Paris
  18. 18. Exporting SAMU , IEMS ,Training in EmergencyTelemedecine and MedicalRegulation• From Chile to Mexico through Andean poor countries• From Algeria to Barhein through Nigeria• From Brazil to Japan through Iran 14/11/12 Reg50ENG M Martinez 18 Almoyna SAMU of Paris

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