[Organisation of emergency medicine in France]. / Organisation de la médecine d'urgence en France.

The French emergency medicine infrastructure (structures de médecine d'urgence) ensures patients care from the very location of the distress to the appropriate hospital department: medical care in the field, by hospital clinical teams (the services mobiles d'urgence et de réanimation [SMUR]), is a key characteristic of our medical emergency response system. Response to medical distress revolves around information about not only the location and characteristics of the medical need, but also the availability of adapted hospital services. Gathering and transmitting this information is the prerogative of the service d'aide médicale d'urgence (SAMU) and its telephone dispatch center (Centre 15). For patients coming directly to the hospital, the emergency room (ER), a former underfunded and neglected hospital service, has become a key point of access. The ER is now responsible, after providing immediate first line care, to guide the patient through the care system. As such they are equipped with short term hospitalization units designed to enable up to 24h patient observation before orientation. This ensemble, networked at the level of a health territory, ensures the quality, safety, and efficacy that the population is entitled to demand.

Electrocardiogram on a chip: overview and first experiences of an electrocardiogram manufacturer of medium size.

The integration of an electrocardiogram (ECG) device into a chip is already well known in the field of implanted devices, such as pacemakers. For noninvasive electrocardiology, this approach has not been used on a broad scale commercially. The extension of electrocardiology to telemetry, home care, and special applications as in magnetic resonance imaging has spawned a new interest in highly miniaturized ECG devices. In our company, we are aiming for using highly integrated devices exactly in these fields. On one hand, the home monitoring market ("eHealth," "pHealth") requires small and lightweight devices ("ECG in an electrode"); on the other hand, the use of an ECG device within a hostile environment as in an magnetic resonance imaging machine with strong electromagnetic fields requires small dimensions of the device. Of these 2 fields, the one of home monitoring is the most promising. There is a large population in need of such monitoring (eg, patients with congestive heart failure), and the cost issue in medical care drives the market in this direction. Projects in both fields will be presented as well as the first experiences as a middle-sized manufacturer in trying to produce an integrated ECG "device."