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  1. Good day everyone! I'm glad to join this community and I hope to learn a lot from all of you, and maybe answer a few question you may have as I'm from a country with a peculiar system Indeed, I've been a volunteer EMT in Paris for 4 years, within the Paris Civil Protection (Protection Civile de Paris). I say EMT, but the actual french word is "Secouriste" which corresponds more or less to an EMT-basic life support qualification. I'm qualified for almost everything that is not invasive (with the only exception of blood sugar level) and my mission is to (in short): - Assess the patient's health state - Perform the emergency actions needed to answer the situation / Call for additional (or specialized) units if needed. - Transmit a complete and accurate description of the patient's state to the EMS. - Preparation and evacuation of the patient to the hospital. I'm a "foreman" (chef d'équipe) which mean I have to coordinate my team's action and take responsibility for my crew's safety as well as the patients' and third person's. To introduce you briefly the Civil Protection, you can easily compare it to St-John Ambulance. We have 3 fields of action: - Medical emergencies: >> "911 response" >> Rescue posts on planned events (festivals, sport events...) - Social support: >> Disaster relief >> Street patrols for homeless people - First aid training: >> EMT training >> First aid course for people How do we respond to a 911 call? In France, there are no paramedics. We have either EMT-B or emergency physicians. When: - The call wasn't clear - The situation doesn't seem to require an advance life support unit - The situation requires additional personals - The situation require a basic life support unit on top of an advanced life support unit We are dispatched. We are 5 EMT in the ambulance, but we can work in crews of 4. On other missions we can be 3 or 2. Our role is to get control of the situation, assess the patient(s) health, treat the injuries/distresses and report to the EMS. They take the decision. Then, if needed, we transport the patient to the hospital. An advanced life support unit can also be dispatched to start a treatment on the scene? In case of cardiac arrest: We start CPR with oxygen and defibrillator, we call the advanced life support unit. In most of the cases, the resuscitation will be performed on scene by the doctor's crew until the patient is stable. If nothing can be done, the patient is pronounced dead on the scene. If the patient is stabilized, he'll be quickly transfered to hospital. This is the "stay and play" theory you have in France and Germany, where doctors, in mobile ER will come on scene. It's called "bring the hospital to the patient". Why does France applied the "stay and play" system? Before 1968, rescue missions where carried out by fire departments and police departments. Those rough ambulance services were poorly trained and equipped, as it wasn't the main mission of neither. The mortality rate was very high so doctors decided they couldn't stay in the hospital and wait for dead patients. They created vehicles equipped like hospital emergency rooms, aboard which were the doctor and nurses. Today, those "mobile ER" still exist and board an emergency doctor, an emergency nurse (equivalent of a paramedic advanced) and a trained driver (equivalent of an EMT-. You can recognized them by the word "SAMU" written on the side. What's new in France EMS? The "stay and play" theory is to live long it seems, as the SAMU just created a mobile ECMO unit. This vehicle boards a specialized team (surgeon, nurses...) and all the equipment needed to set an ECMO procedure anywhere, on the street for instance. This unit is dispatched only under very precise circumstances, and aims to reduce even more the "low flow" time. Even if this vehicle is still in experimental phase, it shows well the will of french EMS to bring more and more heavy equipments outside the hospital, directly to the patient. Maybe one day, you'll get a scanner without leaving your bed! I hope you found some of this interesting, if you have further questions, feel free to ask Glad to join you all!
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