SAMU

For other uses, see Samu.

The International SAMU Logo marking each IEMS Ambulance

File:Ambulância-urgência.jpg

A Brazilian MICU with a SAMU 192 marking

Service d'Aide Médicale d'Urgence, Servicio de Atencion Medica a las Urgencias, Servicio de Atendimento Medico as Urgencias could be traduced in English as (Emergency Medical Assistance Service or Integrated Emergency Medical Service). SAMU is in the origin the name French hospital based Emergency Medical Service Call Center headquarter, the EMS Medical Regulator Center. This Medical Regulation of Emergencies concept was originated in 1956 by the first french Parisian MICU (Mobile Intensive Care Unit ) implementation . This EMS was extended to all French Territory in the Sixties and was officially founded in by generalization of Extrahospital Hospital MICU Services (Services Mobiles d’Urgence et Reanimation SMUR) and in the next years by official creation of the national SAMU network endowed with a National Medical Emergencies free Hotline (15).

SAMU acronym and logo actually used by several other countries for a similar sense . Many similar Medical Control Centers exist in many countries each one has a different name. But today “SAMU” is beginning to be an international exclusive acronym for calling the « Control and Medical Regulation Center of the local EMS » associated with the international Medical Emergency care Star of Life Mark or international labeling it should be a registered and protected Public Health official Mark . International Protected Logo of SAMU

SAMU is a Regional IEMS Medical Control or Regulation Center The main component of SAMU is the Medical Regulation Dispatch Center, this regional center is based in a third Level Hospital and Manned by a Medical Regulation Team (Physician Regulator and Assistants of Medical Regulation ). This Regulator team has : First to Analyse the Calls and Demands for Assessing the real Patient Emergency Care Needs on Medical Emergency Care. Second to Decide the Best Solution for the Patient Third to Dispatch , if needed, the best Mobile Effector* (MICU, Ambulance, or Mobile care Giver) and to orient the patient toward the mot efficient, available Emergency Care Resource of the Hospital or Primary Care Network

The name SAMU is also used by several French-speaking countries as Algeria, Andorra, Belgium, Benin, Luxembourg, Mauritius, Morocco, Monaco, Tunisia, France, Switzerland (in Francophone areas) as well as Spanish-speaking countries such as Andorra (which is actually a Catalan-speaking country, but Spanish is also widespread as well), Argentina, Colombia, Chile, Mexico and Paraguay. It is then standing for Sistemas de Atencion Médica de Urgencias (sometimes SAME, the E standing for Emergencias) and Portuguese-speaking ones such as Brazil and Portugal,

SAMU (15) in France

French SAMU (15) missions

• 
  French Hospital Based Samu with a Helicoptered MICU

SAMU missions were defined in a law of 1986 as Hospital services providing permanent Phone support, choosing and dispatching the proper response for the phone call request (Emergency Medical Aid Demand) in the swiftest delays. SAMU responses in function of the need (Emergency Care Needs) diagnosed by te Medical Regulator Physician can range from :

1 Telemedical Emergency advices (28% of the SAMU Calls )

2 Dispatching Emergency First Aid Ambulances*, from the Fire department for street accidents or in public sites or Subit and Critical illnesses emergencies at home (24% of the SAMU Demands)

3 Dispatching Private companies Basic Ambulances* for Emergency Evacuation to Hospitals (8% of the Demands) 4 Dispatching a Medical General Practitioner on the site (22% of the Demands )

5 Dispatching a Mobile Intensive Care Unit (MICU):, Hospital Mobile Intensive Medicalized Care unit, (UMH-Unité Mobile Hospitalière), or Helicoptered MICU Team for the most distant cases . The French IEMS Specificiy allows the Physician and Nurse staffed Mobile Medica Intensive Care Units to be dispatched only in critical life-threatening cases or for Intensive Care Patient Needs during interhospital transport decided by the SAMU Medical Regulator Physician.

It is important to note that during this time MICU dispatched number stayed at near the same level but Medical Conseiling , GP , Basic Ambulances where the more frequent responses. This confirms the Medical Regulation aims of the SAMU in an Integrated Emergency Medical Service to regulate in a Public Health Region Medical Emergency Demand Fluxes.

French SAMU (15) National Networking

All French Départements hold one SAMU (that is roughly one for More than 250 000 people), which makes a total of a hundred units, and 350 Hospital SMURs ech one with one or more MICU disseminated on whole France even il French Territories in the World (American, Pacific, Indian , Ocean French Islands and French Guyana). This is the Operational Indestructible National Network for Medical Emergencies depending of Public Health Ministery and financed by State and Social Security .

The Medical exclusive emergency number , Hot line for SAMU is in France the 15, in connexion with the 112 (European emergency telephone number), 17 (police) and 18 (Fire department). Who must connect with a SAMU hotline any Emergency Medical Problem. . The SAMU de Paris is in charge for Medical emergencies in fast trains (TGV) flying French aircraft but also French Embassies and Consulates Medical Emergency Requests. The SAMU de Toulouse is in charge for Ships at sea*.

French SAMU (15) and IEMS and French Prehospital Emergency Intensive Care Medical Strategies

When Out of Hospital Intensive Medical Emergency Care is needed in any point of France , the French doctrine relies on the hopes of survival for a critically injured patient decreasing exponentially with time, which explains why so many patients died during transportation. But to maximise the chances of recovery, it is believed important to cut down on beginning Diagnosis and Intensive Care time* on the spot, and bring a fully equipped and qualified team to the patient, rather than sending an ambulance to pick up the patient doubling the travel back to the nearest hospital and travel one more the to a second more sophisticated hospital (Secondary Transport) . To this effect, Mobile Intensive Care Units Units (MICU) based in Regional Hospitals (Services Mobiles d’Urgence et Reanimation = SMUR) are equipped with both a fully qualified emergency physician and medical equipment. But also to maximise the chances of the patient these MICU teams can be directed and even redirected by SAMU Regulator Physician to the Better Emergency Intensive Care facility in Surounding area even bypassing the Nearest Hospital Step Strategy* This doctrine also simplifies greatly the Emergency Services of Second and Third Level Hospitals and ensure that in the site, first Stabilized patient will receive Emergency intensive care from a Specialist The French IEMS* and SAMU* strategy is very different from EMS* from the USA and the United Kingdom; one notable difference is that MICU* may decide to Stay and Stabilize on the scene for a time longer than the typical 10 minutes that ambulances spend on a scene before picking up a patient and running to nearest hospital. This is often described and underestimated as Stay and Play strategy, opposed to the Scoop and Run strategy performed in the United States and in the United Kingdom. This feature is often misunderstood among the American public where the theory is to Scoop and Run to the Next Hospital. For instance, when Princess of Wales died in Paris, some British and US tabloids took outrage that the patient had “stayed on the scene for mre than a hour”, leaving the impression that the delay and french SAMU IEMS organization might have caused the death. Actually, the French SAMU IEMS doctrine allowed the patient to receive Intensive Care and Diagnosis during these time and during her MICU transport, including immediate treatment of a non predictible Cardiac Arrest . In reality through the Medical Regulation of the SAMU Medical Regulation, She, like anyone, yet under General Anesthesia and Intensive Care was reoriented directly to a Ready Extracorporeal Circulation Operating Room with a Ready to operate Cardiac Surgical Team bypassing the Intensive Care Service which was the first SAMU orientation. French think that Medical Care gain time by better Physicians Organization and Brain Working than Running Paramedic Fast Ambulances

French Integrated Emergency Medical System (IEMS) , SAMU network and Civil Sanitary Defense Strategies

In case of Sanitary or Medical Disasters or Sanitary Crises french SAMU Network is a reliable tool for Public Health Authorities.. It is to day the first immediate emergency response to any Medico Sanitary National or Regional Crises. With French “Hospital or Public Health White Plans” of Ministery of Health and other new progresses France has one of the most advanced integrated Public Health Plannings for Sanitary Disasters at the National Level. To day the first line to fight againts collective Medical or Public Health Emergencies from Viral, Hotwaves to Collective Traumatology is the SAMU and IEMS network… French Sanitary authority manages a Reserve Public Health Corps connected with Militar Medical Corps. French IEMS are also in charge with Universities Medical Faculties for the training of Emergency and Disaster Medecine , for Civil and Militar Physicians, Nurses , First Aid Responders, School Professors etc . SAMU de France , the French SAMUs’ Association , is conseilling Foreign State Authorities through French Foreign Office for many years and participated to SAMU/IEMS network implementation in many countries.

SAMU of other French Speaking Countries

SAMU of Andorra SAMU (100) of Belgium SAMU (112) of Luxembourg SAMU of Monaco SAMU (144) in French Switzerland SAMU in other French Speaking Countries in Africa SAMU of Algeria SAMU of Benin SAMU of Mauricius SAMU of Morocco SAMU of Tunisia

SAMU in Spanish Speaking Countries

SAMU 15/61/104/112 of Andorra, SAMU 061 de Andalucia, SAMU 061 de Asturias, SAMU 061 de Baleares, SAMU 061 de Cantabria, SAMU 061 de Valencia Samu of Argentina Same de Buenos Aires (DF) SAMU 144 of Chile each Chilean Region has a Samu SAMU of Colombia SAMU de Bogota SAMU of Paraguay

SAMU in Portuguese Speaking Countries

SAMU (112) of Portugal Called CODU in Portugal depends on a National Public Health agency Instituto Nacional de Emergencia Medica (INEM)

SAMU (192) of Brazil To day the most extended modern Public Health Federal Intergrated Emergency Medical Systems (IEMS) in the world. Brazilian . SAMU Brazilian Federal laws and a Manual of Medical Regulation are implemented in all the Country .

SAMU 061 de Gallicia (Spain) Is abilingual SAMU Spanish and Gallician Samu

SAMU in Central Europa Countries

Most of the countries of this area have an Public Health Integrated IEMS and a Samu from many years

SAMU (104) in Hungary SAMU i(999) n Polland SAMU 155 in Czech Republic

==Systems== Care EMS is a mistranslation of SAMU! (Better would be IEMS Emergency Medical Call center)

• Argentina: Healthcare in Argentina
• Brazil: Healthcare in Brazil
• France: Emergency medical services in France Service d'Aide Médicale Urgente
• Polland: Emergency medical services in Polland
• Hungary: Emergency medical services in Hungary