Date post: | 22-Dec-2014 |
Category: |
Health & Medicine |
Upload: | miguel-martinez-almoyna |
View: | 105 times |
Download: | 2 times |
REG900ENG 2004 SAMU IEMS Civil Defense 1
An actual exclusive Public Health Civil Defense
through a SAMU network ?
THE BACKBONE OF AN EXCLUSIVE MEDICOSANITARY INTEGRATED EMERGENCY MEDICAL SYSTEM
(IEMS)
Miguel MARTINEZ ALMOYNA (MD MCU)
REG900ENG 2004 SAMU IEMS Civil Defense 2
French IEMS (like deffined in Declaration of Jalisco)
MOH civil defense specific organisation
for disastrous sanitary crises
1. Pre hospital Emergency network sub-system
2. Hospital network Emergency sub-system
3. SAMU call centers for control and medical regulation sub-system
REG900ENG 2004 SAMU IEMS Civil Defense 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*, Basic transport Ambulances* )
REG900ENG 2004 SAMU IEMS Civil Defense 4
THE NATIONAL EMERGENCY CARE HOSPITALS SUB- SYSTEM NETWORK
= Secondary level of care hospitals ER and MICU (SMUR) resources are monitored by local SAMU
= Tertiary , Specialized emergency and ICU resources are monitored by local, neighbouring and regional SAMU
= Zonal area leading Reference Hospitals for NBC disasters
REG900ENG 2004 SAMU IEMS Civil Defense 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 remote islands!)
REG900ENG 2004 SAMU IEMS Civil Defense 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
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
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
REG900ENG 2004 SAMU IEMS Civil Defense 7
THE SAMU SUB-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 in the emergency phase of the crisis
REG900ENG 2004 SAMU IEMS Civil Defense 8
The French SAMU emergency tele-medecine system and network improoves not only quality of
care but also equity of resources Through 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
REG900ENG 2004 SAMU IEMS Civil Defense 9
The Hospitals and SAMUs french public Health disasters « Plans Blancs »
Four tiered1 local Hospital « white plan »2 « Departemental IEMS network » SAMU + DDASS « white plan»3 Public Health Regional and Zonal IEMS network« zonal white plans » ARH+DRASS+Regional Leader SAMU4 MOH + SAMU de Paris = national and international disasters
(Foreign Office)
REG900ENG 2004 SAMU IEMS Civil Defense 10
Exemples:
• A mega 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 …
REG900ENG 2004 SAMU IEMS Civil Defense 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 »
REG900ENG 2004 SAMU IEMS Civil Defense 12
REG900ENG 2004 SAMU IEMS Civil Defense 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
REG900ENG 2004 SAMU IEMS Civil Defense 14
For More Informations on Public Health Civil Defense
Emergency Tele-medecine and SAMU regulation
• [email protected]• SLIDESHARE Miguel Martinez
Almoyna
REG900ENG 2004 SAMU IEMS Civil Defense 15
French MOH and SAMU documents on Public Health Civil Defense
• WWW.sante.gouv.fr• www.samudeparis.org
REG900ENG 2004 SAMU IEMS Civil Defense 16
WWW.sante.gouv.fr/dossiers/planblanc2004.pdf
REG900ENG 2004 SAMU IEMS Civil Defense 17
The SAMU network is the key of a actual Public Health Integrated EMS is the nervous system of both day
to day and disaster medicosanitary emergencies