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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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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)
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-system2. Hospital network sub-system3. SAMU control and medical regulation
sub-system
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
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**)
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
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
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
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
M Martinez Almoyna 2004 French Public Health Intergrated EMS 6
Toulon
Angoulême
Périgueux
Bordeaux
Mont-de-Marsan
Agen
Auch
TarbesPau
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
DijonBèsançon
Vesoul
Épinal Colmar
StrasbourgNancy
Metz
Bar-le-Duc
ChaumontTroyes
Auxerre
BourgesNevers
Chateauroux
Poitiers
Angers
Le Mans
Alencon Chartres
Orléans
Blois
La Roche-sur-Yon
Nantes
Vannes
Quimper
St-Brieuc
RennesLaval
Saint-LoCaen
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
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04
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10
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89
2A
2B
95
91
87
88
81
82
8586
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.Denis94 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
FinistèreCôtes d'Armor
Ille-et-Vilaine
Morbihan
Alsace
Lorraine
Aquitaine
Basse- Normandie
Bretagne
Auvergne
BourgogneCentre
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
9377
M Martinez Almoyna 2004 French Public Health Intergrated EMS 7
THE SAMU SUB-SYSTEM SYSTEM IMPLANTED IN EACH « DEPARTEMENT » CAPITAL TOWN HOSPITALSAS 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
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
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
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
9
The Hospital and SAMU « Plan Blanc » emergency care IEMS sub-system
Four 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)
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 …
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 SAMU3. « BMOH + SAMU of Paris »
M Martinez Almoyna 2004 French Public Health Intergrated EMS 12
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
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
M Martinez Almoyna 2004 French Public Health Intergrated EMS 14
For More Informations on Public Health Civil Defense
Emergency Tele-medecine and SAMU regulation
• [email protected]• SLIDESHARE Miguel Martinez
Almoyna
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
15
French MOH and SAMU documents on Public Health Civil Defense
• WWW.sante.gouv.fr• www.samudeparis.org
M Martinez Almoyna 2004 French Public Health
Intergrated EMS
16
WWW.sante.gouv.fr/dossiers/planblanc2004.pdf
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