Talk:Emergency medical services in France

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Hello all. I have expanded this page to provide more useful information, and to provide a standardized format for those pages covering EMS services in various countries. Please have a look and let me know what you think. Also the page could use some additional French photos (particularly action shots) to 'pretty it up', and also additional links to French EMS websites, if they exist. Also useful would be some additional Wikipedia pages (in English) for the various French SAMUs. If there is anyone out there who can write knowledgably about that system, we'd love to hear from you! Don't worry if your written English isn't 'perfect', we have people on the EMS Task Force who would be happy to help out with re-writes, etc., once we have the first hand facts. Emrgmgmtca (talk) 11:32, 3 September 2008 (UTC)

"Also useful would be some additional Wikipedia pages (in English) for the various French SAMUs" - Err, OK, but please make sure that WP:N and WP:V are carefully adhered to. Please don't create a tonne of non-notable articles - every article must prove it's notability, mainly through it's use of links to verifiable third party references. _TalkIslander 22:27, 3 September 2008 (UTC)

Assessment

This article has some difficulties with sourcing. The French Wikipedia, for example, is not a reliable source. ==Funding and costs== currently cites no sources. ===Vehicles=== does not have sources for anything except a minor translation of a name.

I'd also like to encourage you to use a different style of references. The existing style is appropriate for refereneces that only exist as websites, but you cite several excellent medical papers, and those citations should acknowledge the authors' names and the journal of publication. To the extent that you can find them at PubMed.gov, you might like to use User:Diberri's automagic ref-creating tool. It will produce something like this (I turned on "Add ref tag"):

<ref name="pmid14694898">{{cite journal |author=Dick WF |title=Anglo-American vs. Franco-German emergency medical services system |journal=Prehosp Disaster Med |volume=18 |issue=1 |pages=29–35; discussion 35–7 |year=2003 |pmid=14694898 |doi= |url=}}</ref>

which, if you paste it into your reference space, will give you something like this in the references section:

• Dick WF (2003). "Anglo-American vs. Franco-German emergency medical services system". Prehosp Disaster Med. 18 (1): 29–35, discussion 35–7. PMID 14694898.

You can see that there's a space for a URL if needed, but the PMID number is automatically clickable (directly to PubMed.gov), so the URL field is only used for a URL to some other website (such as the journal's website).

Finally -- and this is not a requirement -- most, but not all, editors prefer to put the reference immediately after the punctuation, like this.^[1] If the standard style appeals to you, then you might choose to you it in preference to this ^[2]. The choice is entirely up to you. WhatamIdoing (talk) 17:59, 18 September 2008 (UTC)

Looks good. Thanks for your substantial efforts here. WhatamIdoing (talk) 17:58, 19 September 2008 (UTC)

translation of image caption

Private Ambulance Company - Read the markings carefully!

The image caption states :

Private Ambulance Company - Read the markings carefully!

Sorry I can't read French, can you please provide a translation in the aricle or the caption, if this is so important to use an exclamation mark? Thank you. Greetings. Sebastian scha. (talk) 23:53, 3 October 2008 (UTC)

Hi Sebastian! Good to hear from you, and thanks for the input that both you and Winnie have been providing. In French, the markings on the vehicle translate as "Ambulance Morticians" (funeral directors)! This used to be more common, particularly in North America...but I was quite surprised to see it on a European ambulance, and particularly on a modern one! Emrgmgmtca (talk) 22:55, 4 October 2008 (UTC)

I think you're wrong: on the vehicle, it is written "Ambulances Mortuaciennes", "Mortuacien" is the adjective corresponding to Morteau, a small town of the Franche-Comté region (see Morteau in Wikipedia FR). It has absolutely nothing to do with funerals! I will remove the words "Read the markings carefully" from the image caption because they are pointless.71.125.76.162 (talk) 03:55, 27 January 2009 (UTC)

Merger proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

The result of this discussion was off-topic, so we can't really conclude anything from it. D O N D E groovily Talk to me 19:01, 22 February 2012 (UTC)

---

Oppose. Emergency medicine in France is an underdeveloped article and would be better merged into THIS article..--Hauskalainen (talk) 03:50, 27 January 2009 (UTC)

Did you even read the template? It suggests merging with.LincolnSt (talk) 09:36, 27 January 2009 (UTC)

Hello LincolnSt. I have gone through the SAMU material that you merged with the existing article and have attempted to 'tidy up' the English. I've tried to keep your content exactly the same in terms of facts, but I'd appreciate it if you'd have a look and just verify that. The content that you have merged makes a nice addition to the article. I would, however, suggest one thing. The material that you have merged does not contain any formal references for the most part. The guidelines for a 'B' standard article (its' current rating) requires at least one formal reference per section, with additional references required for any sections that might be challenged for factual content. The statistics that you provided on call volume outcome distribution would be good examples of such sections. Guidelines do not state that the references must be in English, so if your material is based upon French language sources, that's fine. Anything that you can do to help reference the merged material would be greatly appreciated. Thanks for your contributions. Emrgmgmtca (talk) 12:02, 29 January 2009 (UTC)

Wikipedia english: SAMU article has been suppressed and merged with Emergency Medical Services in France! Why? . SAMU exist in other countries than France. SAMU is not EMS and EMS is an only prehospital service in Anglosaxon litterature not in other countries. Wikipedia in English gives a very biased and despising description of Emergency Medical Care in the World done by American EMTs lobbies. It may be the reason of American Physicians or Public Health specialists non participation Wikipedia publications on the Subject I will be fond to read an American Wikipedia description of his neighbouring Cuban SIUM!. American Emergency Care Systems and Organization are not Models for other countries!!! —Preceding unsigned comment added by 90.24.238.2 (talk) 10:31, 6 October 2010 (UTC)

I'm not sure how many times we have to go round this same loop on different pages, but the two articles on SAMU and EMS in France were practically duplicates of each other. Despite repeated requests, you have not provided any evidence that SAMU and EMS are different, apart from in the qualification of the attending medics. The article at emergency medical services covers all the salient points about the use of physicians, triage etc. and now this article gives a sensible description of the French system. It seems that you have a misrepresented view of EMS in the world, and especially of the 'anglo-american' system. The exact same processes seem to be followed, with a variation in qualificaiton and intervention level certainly, but the key points are the same. OwainDavies ^(about)_(talk) edited at 11:43, 6 October 2010 (UTC)

You stay confounding an International concept of SAMU (that is not to day only a French a Public Health Emergency Medical Regulator Call Center) , with an USA American Concept of Prehospital Ambulance System , and an UK Public Health national Ambulance System . 911 centers are not the Same than EMS  !!!! . I am sory and because I feel being realy censured I will abandon my participation to this area of Wikipedia that is too biased waiting for a special Article on SAMU in the world in English ( but not censured by those who dont have it!).

I will wait that other Americans that have implemented a SAMU national network , like Brazilians or Chilians can write in english Wikipedia in English about their SAMU and their Public Health Integrated EMS!!. —Preceding unsigned comment added by 90.2.242.153 (talk) 08:20, 8 October 2010 (UTC)

At the risk of repeating myself, you keep claiming it is different, but still haven't presented any evidence that this is the case. As the article stood, there was no apparent difference, so it was right to merge it here. If you have additional cited and verifiable evidence that it is different, then please bring it here to the talk page, and if you're right, i will happily help you recreate the article. If its easier, then please just explain how its differnt, and i'm sure we can then look for the evidence. However, as it stands, nothing i've seen indicates that anything about SAMU is different to EMS. OwainDavies ^(about)_(talk) edited at 08:33, 8 October 2010 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Franco German (SAMU) vrs American Prehospital systems

The SAMU (Franco-German) Emergency contrasts sharply with the Anglo-American Model. My perspective is that of a US residency trained, emergency medicine specialist who is engaged in emergency medicine development work in Latin America.

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, are futile 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.

All of that being said, emergency care in austere environments may require a system that provides a mobile emergency and critical care "micro climate" which could resolve many lesser episodic problems while trasporting the rest for more definitive care. Unfortunately, this tends to be is a membership model or fee for service model, which does not necessarily provide for the needs of the general population. HaywoodHall (talk) 07:20, 8 November 2009 (UTC)

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