ABSTRACT
The teaching of disaster medicine began in France in the 1980s. Many emergency physicians register each year for the disaster medicine "capacity", which is the most representative training program in this field. This capability includes theoretical courses, workshop and a disaster drill. Large-scale interdepartmental drills such as those carried out within the framework of the capacity of the UFR of Medicine of the University of Paris Cite, allow a situation close to reality. However, disaster medicine only covers a part of exceptional health situations (SSE). Recent examples have shown that it is necessary to extend the area of the capacity to this new domain. It is also necessary to develop training adapted for medical students in the second and third cycles and for paramedical personnel so that all of them has a basic knowledge of the subject. Copyright © 2022 Elsevier Masson SAS
ABSTRACT
During the third wave of the COVID-19 crisis in the Île-de-France region, the prolonged tension on critical care beds led to the development of the concept of a CMTE (Medical Center for Transit and Evacuation). This unit based in a hospital, near the technical resuscitation platform, aims to accommodate for a few hours, sort, condition and then transfer serious COVID-19 patients for whom the medical regulation of the departmental SAMU initially failed to find a place in critical care. It therefore makes it possible to secure pre-hospital care and optimize the management of a flow of serious patients linked to the pandemic. This article describes this structure, its components, its operation and its relationship with the SAMU. It is considering its application to contexts other than the pandemic.
ABSTRACT
Au cours de la troisième vague de la crise COVID-19 en région Île-de-France, la tension prolongée, sur les lits de soins critiques, a conduit à développer le concept d’un CMTE (Centre medical de transit et d’évacuation). Cette unité, basée dans un hôpital, à proximité du plateau technique de réanimation, a pour objectif d’accueillir, pendant quelques heures, de trier, de mettre en condition puis de transférer les patients COVID-19 graves pour lesquels la régulation médicale du SAMU départemental n’a pas réussi initialement à trouver une place en soins critiques. Elle permet donc de sécuriser la prise en charge pré-hospitalière et d’optimiser la gestion d’un flux de patients graves lié à la pandémie. Cet article décrit cette structure, ses composantes, son fonctionnement et ses relations avec le SAMU. Elle envisage son application à d’autres contextes que la pandémie.
ABSTRACT
In Île-de-France (IDF), the SAMU Zonal in accordance with the ORSAN plan, ensures the coordination and in particular the reciprocal reinforcement of the 8 SAMU of the region which is also the Defense Zone. As such, it has been mobilized during several exceptional health situations since 2014 such as the 2015 terrorist attacks and the COVID. Its objective was to harmonize the medical response and optimize the use of existing resources within the SAMU of IDF. It has established the means of communication and the organizations needed to manage the crisis, in particular temporary and dedicated structures for medical regulation.
ABSTRACT
Résumé En Île-de-France, le SAMU Zonal conformément au dispositif ORSAN assure la coordination et notamment le renfort réciproque des 8 SAMU de la région qui est aussi la Zone de Défense. À ce titre, il a été mobilisé au cours de plusieurs situations sanitaires exceptionnelles (SSE) depuis 2014 telles que les attentats terroristes de 2015 et la crise COVID. Son objectif était d’harmoniser la réponse médicale et d’optimiser l’utilisation des ressources existantes au sein des SAMU d’IDF. Il a établi les moyens de communication et les organisations nécessaires à la gestion de la crise notamment la mise en place des structures transitoires et dédiées de régulation médicale. Summary In Île-de-France (IDF), the SAMU Zonal in accordance with the ORSAN plan, ensures the coordination and in particular the reciprocal reinforcement of the 8 SAMU of the region which is also the Defense Zone. As such, it has been mobilized during several exceptional health situations since 2014 such as the 2015 terrorist attacks and the COVID. Its objective was to harmonize the medical response and optimize the use of existing resources within the SAMU of IDF. It has established the means of communication and the organizations needed to manage the crisis, in particular temporary and dedicated structures for medical regulation.
ABSTRACT
The COVID-19 epidemic required reinforcement of technical resources and personnel within the framework of medical regulation activities but also for EMS and MICU interventions. This reinforcement has been adapted to the evolution of the activity. In the SAMU of Paris, the activity imposed the doubling of medical regulation work posts from the second week of March in order to respond to both the usual calls but also to the demand related to COVID. Only the 2nd cycle medical students were therefore integrated into this organization, they benefited on their arrival from a training adapted to their level of study and to the functions to be performed within the medical regulation and also throughout their activity of supervision by a senior doctor of Emergency physician or GP of the EMS system. This activity was therefore secured by senior doctors as in any hospital internship. This organization contributed, particularly in Paris, to the management of the surge of EMS calls. This reinforcement was then maintained, both in the context of the crisis and in daily activity in the deployment of the Access to Care Service.
ABSTRACT
We portray the evolution of the Covid-19 epidemic during the crisis of March–April 2020 in the Paris area, by analyzing the medical emergency calls received by the EMS of the four central departments of this area (Centre 15 of SAMU 75, 92, 93 and 94). Our study reveals strong dissimilarities between these departments. We show that the logarithm of each epidemic observable can be approximated by a piecewise linear function of time. This allows us to distinguish the different phases of the epidemic, and to identify the delay between sanitary measures and their influence on the load of EMS. This also leads to an algorithm, allowing one to detect epidemic resurgences. We rely on a transport PDE epidemiological model, and we use methods from Perron–Frobenius theory and tropical geometry. © Académie des sciences, Paris and the authors, 2020. Some rights reserved.