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29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 1
SLIDES SET N° 9 ON SAMU MEDICAL REGULATION MARTINEZ ALMOYNA MD MCUPH
SAMU of Paris
PHYSICIAN MANNED MEDICAL REGULATION OF EMERGNECIES IN THE SAMU Deffinitions
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 2
Regulus
� The little King not the great REX
� The King delegates his autority to his vizir for rapid emergency decision taking when he sleeps…
To Regulate Regulator Regulation
� Keeping stability of the fluxe, the pressure, in SAMU Medical Regulation Room
� O Vizir , the SAMU Regulator Physician
� O King , the Public Health Minister
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 3
« Medical Regulation » can currently say
� A medico sanitary technical function of the SAMU service and of its Medical Regulation Team
� The Room were it works
� Be carefull by the ambiguation of the second english meaning of « regulation(s) » = Rules and Legislation !!!
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 4
IEMS = Integrated EMS (in Public Health System)
SIUM = Sistema Integrado de las Urgencias Médicas integrates all emergency medical care actors including the SAMU. This System is under Public Health Ministery regulations
The SAMU is a Service , it is the IEMS Medical Regulation center
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 5
Medical Regulation as a New medical diagnosis and treatment process
� An Exemple of this process in next slide
� Specific Slide Sets of the same objective will treat the specific « medical regulation syndroms ». Nosology Semiology are different of Clinical medical practice
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 6
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 7
" I l g i t "
p l u s d er é a c t i o n
p l u s d em o u v e m e n t sv e n t i l a t o i r e sa b d o m i n a u x
p l u s d ep o u l s
+ D E U I L
" D E C E D E "
" A R R E TC A R D I A Q U E "
p u l s a t i o n sr é a p p a r u e s
O U I
N O N
+ R C P
" A R R E TV E N T I L A T O I R E "
" C O M A "
o u i
r e p r e n d V '
p a s d e V > 1 0 M i n
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 8
I l g i t + i l c o n v u l s e
n o nr é p é t i t i o n
" H Y P O X I E "
" E T A T D E M A LE P I L E P T I Q U E "
E t i o l o g i e bO r g a n i q u e
n o n
é p i l e p s i e
a r r e t e
" C R I S ED ' E P I L E P S I E "
" C R I S E D EN E R F S "
" H Y P O G L Y C E M I E "
" H Y P E R T H E R M I E "
" I N T O X I C A T I O N "
" I N F E C T I O N "
" C O M P R E S S I O NC E R E B R A L E "
R E C H E R C H E S Y S T E M A T I Q U E
Medical Regulation colective shared tasks by SAMU Medical Regulation
team
� Tasks of first steps initializing the Medical File of the event and the patient
� See also the special Slide Sets for these processes in Normal and Critical SAMU activity
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 9
Ergonomy of SAMU Medical Régulation Room and Team
� One or more Regulator Physician(s) ?� One or more Medical Regulation Assistants ?
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 10
« ergonomy? » of Operators Working Place in the Regulation Room
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 11
Initial tasks for managing a Call / Affair/ File
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 12
Final Tasks in a SAMU Medical Regulation case management
� Being the IEMS , real Time Information center of all mobile fleets (Ambulances MICU) and fixed emergency caring resources (from primary to tertiary)
� The SAMU dispaches, assists and orients mobile effectors towards the fixed better medical choice resources
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 13
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 14
Tasks of contrôl and Regulation of IEMS mobile fleets by the SAMU
E n r e g i s t r el o c a l i s a t i o n ss u c c e s s i v e s
A s s i s t a n c e
N o nT r o u v e s o l u t i o n
O U I
B i l a n d é p a r t
B i l a n s d a n s l em o b i l e
D i s p o n i b l e
O U I
i n d i s p o n i b l e
N O N
N o u v e l l em i s s i o n
E N V O I D E M O B I L E
Medical Regulation of SAMU national network in case of Disaster
� The SAMU dispatches an Advanced Regulator Physicina in the Security Area for launching the SAMU White Plan
� Tle neighbouring SAMU and zonal SAMU de regulate together under national control and coodination of Public Health Minister
� See special slide sets
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 15
SAMU Advanced Medical Regulation
29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 16
TIME = minutes
Triage ICUArea
First Noria Avanced
SAMU Command and RegulationPost
DISASTER AREA
Implementation of the Medical Regulation Advanced Post on scene
POLICE CONTROLLED AREA29/04/13 REG9ENG Medical Regulation of SAMU M Martinez Almoyna 17