Emergency Medical Services in France - Organization

Organization

A law in 1986 defined SAMU missions as hospital based services providing permanent phone support, choosing and dispatching the proper response for a phone call request. The central component of SAMU is the dispatch centre where a medical regulation team of physicians and assistants has the task of:

• analysing calls to decide on the patient's need
• deciding the best solution for the patient's care
• dispatching the most appropriate mobile care resource (MICU, Ambulance, or Mobile care professional), or
• directing the patient to an alternative fixed resource such as primary care medical surgery or hospital service, or
• offering care advice over the telephone

Because of aggressive triage (called medical regulation), only about 65% of requests to SAMU actually receive an ambulance response. Current performance on emergency calls is arrival at scene within 10 minutes for 80% of responses, and within 15 minutes for 95% of responses.

This means that SAMU controls a variety of resources within a community from general practitioners to hospital intensive care services.

SAMU is organised at the 'Département' level, with each Department organising its own service, each of which is identified with a unique code, for instance SAMU 06 in Nice and SAMU 75 in Paris.

Additionally, two SAMU have specific tasks :

• The Paris SAMU is responsible for providing service to high-speed trains (TGV) and Air France aircraft, while in flight.
• The Toulouse SAMU is responsible for providing service to ships at sea.

In addition to the mainland French Departments, SAMU also operates in most of the offshore North and South American Departements, such as Guadeloupe (SAMU 971), Martinique, Guyane or Pacific and Indian French Islands (Tahiti Reunion).