French Public Health and SAMU "white Plans'

1. LECTURE N° 50 SAMU
MEDICAL REGULATION
FRENCH DISASTER PUBLIC
HEALTH WHITE PLANS
Miguel Martinez Almoyna MD MCUPH
SAMU of Paris
14/11/12 Reg50ENG M Martinez Almoyna SAMU of 1
Paris 2004

2. A Public Health Civil Defense white
plans for french hospitals and SAMU:
TOWARDS AN INTEGRATED
NATIONAL EMERGENCY MEDICAL
SYSTEM (IEMS) AND NETWORK
14/11/12 Reg50ENG M Martinez Almoyna SAMU of 2
Paris 2004

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. 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**)
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Almoyna SAMU of Paris

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. 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
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Almoyna SAMU of Paris

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-d'Oise 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 d'Armor
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-d'Or
(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-d'Azur
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
2A
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Corse-
du-Sud
Almoyna SAMU of Paris

8. THE SAMU SUB-SYSTEM SYSTEM
IMPLANTED IN EACH « DEPARTEMENT »
CAPITAL TOWN HOSPITALS
AS 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
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Almoyna SAMU of Paris

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 policy
It14/11/12
improoves not only quality of care but also equity of resource
Reg50ENG M Martinez 9
Almoyna SAMU of Paris
distribution!

10. The Hospital and SAMU
« Plan Blanc » emergency
care BIEMS sub-system
Four tiered
1 local Hospital « white plan »
2 « Departement network » SAMU + DDASS « white
plan blanc »
3 Civil Defense Zone regional network
« zonal white plan » ARH+DRASS+Regional SAMU
4 MOH + SAMU de Paris = national and
international disasters (+Foreign Office)
14/11/12 Reg50ENG M Martinez 10
Almoyna SAMU of Paris

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 …
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Almoyna SAMU of Paris

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 »
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Almoyna SAMU of Paris

13. 14/11/12 Reg50ENG M Martinez 13
Almoyna SAMU of Paris

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
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Almoyna SAMU of Paris

15. For More Informations on
Emergency Tele-medecine and
SAMU regulation
• mmartinezalmoyna.samu@invivo.edu
• www.uvp5.univ-paris5.fr/samu
(in different lenguages)
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Almoyna SAMU of Paris

16. French MOH and SAMU
documents on Public
Health Civil Defense
• WWW.sante.gouv.fr
• www.uvp5.univ-paris5.fr/samu
• www.samudeparis.org
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Almoyna SAMU of Paris

17. WWW.sante.gouv.fr/dossiers/planblanc2004.pdf
14/11/12 Reg50ENG M Martinez 17
Almoyna SAMU of Paris

18. Exporting SAMU , IEMS ,
Training in Emergency
Telemedecine and Medical
Regulation
• 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