Talk:SAMU

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Might be nice if somebody could come up with more solid facts to illustrate the "... arguably on of the best". Like this, it sounds a little bit partisan.

Also, I heard critics from some British press (in Murdock style of course) about the death of Pricess Diana. The argument at that the French had taken hours to bring her to hospital, which is a good illustration of the misconception that "the faster the better" (actually Diana was getting hospital-quality care long before she was de-incarcerated from the wrenches of her car). If someone could come up with a reference to such an article it would be interesting.

An Opposing view

The SAMU (Franco-German) Emergency contrasts sharply with the Anglo-American Model. My perspective is at least as biased as the writer of the SAMU entry, but representing the opposite perspective: that of a residency trained, emergency medicine specialist who is engaged in emergency medicine development work.

Any fair comparison between the French and American pre-hospital systems would have to account for the customs, population density, percent urban, rural and suburban, distribution of specialist and the general quality of health care in the society as a whole, among other intangibles. We are also comparing socialized and private health care systems to some extent, although in the United States, emergency care is provided by law. It would be almost impossible to compare these two systems in their respective home environments. However, a few observations are in order:

The fanciful idea of having a fully equipped hospital respond to emergencies in the pre hospital arena is very attractive to the un-informed. Who would not want a specialist to appear at their door when they have a specialty problem? But then, is that chest pain a heart problem (Cardiologist), or a lung clot (Pulmonary)? And what if the person in pregnant as well?

The fact is, trained Emergency Medical Technicians and Paramedics are capable of stabilizing and transporting the 99% problems that they run into in the field and bring them to the best place for the patient to have definitive care: An emergency department that has an emergency medicine specialist (not generalist who works in an emergency department) who can coordinate the pre-hospital and initial hospital care.

The fact is that even the most “tuned” pre-hospital physician in a Franco-German model, might see a handful of patients per day and have limited modalities to manage the problem at hand, especially when there are (or maybe) multiple systems, or multiple patients involved. An emergency physician is trained for 3 – 4 years after Medical School as a specialist to manage 30-40 patients a day in an environment where ultimately the entire hospital, it’s diagnostic and treatment modalities, can bear down on the problem while definitive care is arranged.

Cardiopulmonary resuscitation can be done by a Paramedic, probably as well as anybody else. Resuscitation efforts, as anybody who know will tell you, if meaningless if you can't get to the underlying problem. There are specific life saving modalities that these technicians are trained in (chest decompression for pneumothorax, endotracheal intubation, surgical airways) which may make a difference in survival. The most complicated life threatening problems need to be managed at an appropriate center. The pulmonary artery injury that Princess Diana died from could have never been fixed in the back of an ambulance regardless of their level of training. It could certainly not make a difference 2 hours later when she finally arrived at the hospital just 7 Kilometers away.

Refer to this source:

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijrdm/vol1n2/princess.xml

The real point is that, would you rather your emergency handled by someone who is well trained, manages a large range on complicated emergencies a day in a hospital, or someone who only sees a few people a day in a pre hospital setting, and is either a generalist (not an emergency specialist) or an anesthesiologist...“staying and playing”? And which system ultimately created the best emergency departments and emergency systems? Do we really believe that it is cost effective to put lumbering mobile hospitals in the streets as a matter of routine?

The Franco-German model is beginning to find its way into developing systems in Latin America, before effective emergency single specialty departments are being developed. In this setting, these systems may even actually represent a form of economic triage adding yet another thorny issue.

Bias

As a surgical resident at a Level 1 trauma center, affiliated wtih one of the United States's finest university medical centers, I do know from my trauma rotation 3 months ago and by taking trauma call, that the scene is no place for adequate trauma care. The OR and the SICU (or TICU) are the main destinations where definative care can be given, and should be given; the field is no place for this, and there is not enough space in French ambulances to carry all the required equipment that is instantaeously availible in the Trauma Bay of and Emergency Department. This person seems heavily biased towards the French method; this has further been proven by some medline source that their is higher mortality in this system than in others, such as Anglo-American systems. When fatalities per billion kilometers driven and looked at, France is always one of the highest, whereas places where patients are rushed to level 1 trauma centers (such as the US, Sweden, Israel, and Canada) have substantially lower fatality rates per billion kilometers driven.

-- You are looking only at road accidents and the "per billion km driven" ratio makes little sense in the geographical and social contexts involved. The French system is more expensive but saves more MI patients.

• In France or Germany, the scene of the accident is not the place where the definitive treatment is administrated either (funnily enough).
• French ambulances do not carry the equipment of a hospital. The thing is that full medical doctors are summoned on the place of the accident, where they can administrate a full range of drugs and even perform some emergency surgery -- as opposite to injecting standard drugs after requesting authorisation per fax to a doctor who stays back in hospital, and rushing an unstabilised victim. Rama 14:42, 2 November 2006 (UTC)

This is, the point is not "generalist doctor vs specialist doctor", it is "emergency doctor vs technician grunt when life prognosis is at stake, and specialised department vs emergency department when arriving in hospital". Rama 16:05, 2 November 2006 (UTC)

-Although the above user claims that France has a higher MI save rate, I'd like to see France get a STEMI (ST segment Elevation in acute Myocardial Infarction) through the reperfusion process as quickly as the US systems do. Good luck having a French generalist try to manage your case with heparin or tPA and some beta blockers in the field, which works perfectly well until the tissue dies from an occluded coronary that is much better managed via percutaneous coronary interventions where you need a cath lab, or that the tPA works well, only causing life threatening intracranial hemorrhaging about a day after use.. I'll take rapid assessment, EKG and treatment and swift transport to a cath lab over by well trained paramedics over getting maimed in the field some generalist. Studies have even proven US paramedics (Seattle Medic One) to be better at field intubation over their French physician counterparts (SAMU de Paris) with success at (98.34% vs 89.10%) and survival to hospital discharge at 99.02% vs 92.14% —Preceding unsigned comment added by 74.87.102.163 (talk) 08:39, 2 August 2008 (UTC)

Merger proposal

Oppose. An article about SAMU should be listed under SAMU. There is already a cross link from the other article to this one.--Hauskalainen (talk) 03:47, 27 January 2009 (UTC) --Hauskalainen (talk) 03:45, 27 January 2009 (UTC)

Oppose An article about SAMU should be listed under SAMU in French Spanish Portuguese Italian English because it is an international name/logo/acronym of a Public Health Service that can not be litteraly traduced to the original french expression Service d'Aide Médicale Urgente (Like Calvados or Gruyere or Bourbon). Medical Medico Sanitary Regulation of Emergencies is a new Public Health funtion. not a Service. I dont agree SAMU is not a traduction to EMS that is only in English acronym for an only prehospital First aid not public health organisationMiguel Martinez Almoyna (talk) 07:08, 20 July 2010 (UTC)

Support Emergency medical services in France refers to mainly SAMU. This article has zero references.LincolnSt (talk) 09:01, 27 January 2009 (UTC)

Cleanup needed

There is unneeded capitalization throughout. Capitalization is only needed for proper names and the first word in each sentence. The opening sentence makes little sense. Chris the speller (talk) 15:14, 3 July 2010 (UTC)

Sory for my poor English writing but my present prority is to fight against Conceptual/cultural conflicts , mistraductions between EMS/SAMU , a many other conflictive mistraductions and against administrators deleting menaces! In Wikipedia EMS is a mistranslation of SAMU and vice versa!. SAMU is a Service!. Medical Regulation is a process different of Dispatch, Control etc. Thank you for your aid and patience! We shall overcome!Miguel Martinez Almoyna (talk) 14:39, 20 July 2010 (UTC)