This Mobile Paramedical Hospital Unit was set up last March in Bordeaux. It is one of the first in France to have seen the light of day. A nurse and a paramedic come to your home while maintaining a permanent telephone link with a doctor. This team does not intervene in the event of a life-threatening emergency and helps decongest emergencies which receive up to 4,000 calls per day.
All sirens blaring, the ambulance heads towards the home of a 70-year-old woman. On board, an ambulance driver and a nurse connected by telephone to the emergency doctor. “We must act quickly to remove the doubt”, explains Pascale Martinet, nurse at the Emergency Department of the Bordeaux University Hospital. “This is a person who presents with chest pain that is still typical. This may hide a heart attack.”
Once there, the paramedical staff conducts the consultation. “Does it hurt when I press?” Pascale Martinet asks the patient. “I am going to do an electrocardiogram which we will send to the regulating doctor who will analyze it.” An examination in which the nurse has been trained and which she sends directly to the doctor with whom she speaks on the telephone. “Do you have anything to take vital parameters?” asks the person at the end of the line. “We see the patient’s heart rate, saturation, and blood pressure live,” explains Emmanuel Degonde, emergency doctor at Bordeaux University Hospital. “If they want to do an electrocardiogram, they can transfer the image to us. So, we have the visual and then, we obviously have the phone.”
We are always in touch with what is happening on site.
Emmanuel Degonde,emergency doctor at Bordeaux University Hospital.
Pascale Martinet examines the patient while remaining on the line with an emergency doctor.
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© FTV
The doctors therefore validate the protocols put in place by the mobile team. They are also the ones who make the decision to hospitalize a patient. Pascal Martinet, in this case, is instructed to send the patient for additional examinations in the nearest clinic since her condition is not considered serious. The firefighters then take over to allow him to get there.
“Apart from situations of vital distress and situations at risk of vital distress, for for which the sending of a Medicalized Mobile Hospital Unit (UMH-M) is necessary, and in order to
allow an early and graduated response to emergency situations, a nurse can be authorized to
carry out diagnostic and therapeutic procedures in the form of protocolized actions under validation
from the emergency medical officer of the SAMU“, indicates the Bordeaux University Hospital.
Here are the interventions that these mobile units can carry out:
– Medical or traumatic pain
– Hypoglycemia with behavioral disturbance and difficulty in resugaring orally
– Non-traumatic chest pain with low risk of ACS (Acute Coronary Syndrome)
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This team does not intervene in the event of a life-threatening emergency and helps declutter emergencies. A nurse and a paramedic come to your home while maintaining a permanent telephone link with a doctor.
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©FTV
An experienced emergency team
This management of non-vital emergencies generates more autonomy for the paramedical team, but also more responsibilities. “It’s still a little pressure anyway because we have more doctors.” explains the nurse. “There, it’s really us who are responsible for our actions and what we do.”
We are the eyes and ears of the regulatory doctor.
Pascale Martinet, nurse.
“Only nurses working in an emergency structure with experience and continuous practice of the specific activity of SMUR in a Medicalized Mobile Hospital Unit, or in an ED with a vital emergency reception room activity are authorized to intervene in the emergency room. within the Paramedical Mobile Hospital Unit”specifies the management of the CHU.
During the intervention, the mobile team is in constant contact with an emergency doctor.
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© FTV
For the emergency manager, this device represents a real revolution. Every day, the emergency control center receives an average of 2,000 calls. This can go up to 4,000 during high activity. “The goal is to provide a response adapted to health needs and not necessarily medicalize everything, because there is not necessarily the need, and to better use everyone’s skills.“, analyzes Thomas Mesnier, head of the Emergency department at Bordeaux University Hospital.
“This is not a question of offering a degraded offer intended to compensate for a lack of Mobile Unit
Medical Hospital (UMH-M), but to rationalize the use of medical resources, by putting
take advantage of the possibility of positioning an emergency structure nurse and a SMUR ambulance driver
on defined types of interventions and subject to nursing care protocols
specific“, explains the CHU.
Next September, the unit should be strengthened with the aim of extending its scope beyond the Bordeaux metropolis and recruiting twelve people (six nurses and six paramedics) for daily mobilization, 24 hours a day.
