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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

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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

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« 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 !!!

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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

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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

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" 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

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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

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Ergonomy of SAMU Medical Régulation Room and Team

� One or more Regulator Physician(s) ?� One or more Medical Regulation Assistants ?

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« ergonomy? » of  Operators Working Place  in the Regulation Room

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Initial tasks for managing a Call / Affair/ File  

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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

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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

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SAMU Advanced Medical Regulation

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TIME = minutes

Triage ICUArea

First Noria Avanced

SAMU Command and RegulationPost

DISASTER AREA

Implementation of the Medical Regulation Advanced Post on scene

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