School of Medicine and Health Sciences Poster Presentations

Title

Pre-Hospital Emergency Medical Systems: A Comparison between the Franco-German and the Anglo-Saxon Models

Poster Number

243

Document Type

Poster

Status

Medical Student

Abstract Category

Global Health

Keywords

EMS, paramedic, EMT, France

Publication Date

Spring 2018

Abstract

Motivation: In collaboration with L’Hopital Tenon in Paris, France, I spent my summer riding ambulances alongside the physicians of the SAMU. My goal was to compare the Franco-German system of emergency medicine to that of the United States, in hopes of uncovering which part of each system is running more efficiently and why. In France, emergency medical services (EMS) are often led and coordinated by physicians, who are able to perform the appropriate medical interventions that other pre-hospital providers (EMTs and paramedics) are not licensed to perform. This is in contrast to the EMS system in the United States, where physicians do not lead the teams. Some research claims that the Franco-German method is superior because although it costs more money in the pre-hospital setting, it is leading to better outcomes. These researchers often criticize the American medical system for cutting costs at the expense of quality. On the contrary, studies point out the concern for the prolonged wait time on scene of the emergency in France, suggesting that this is the reason for reduced survival outcomes of certain parameters such as trauma and stroke.

Methods: I spent a lot of time talking with the doctors and students and interviewing them about their take on their emergency medical system. I had the rare opportunity to watch the doctors work on the scenes of emergencies, and then ride alongside them to the hospital where I could watch the care be continued. My observations of the two systems were analyzed in light of the literature comparing outcomes and efficiencies between the two systems.

Results: Only 65% of calls to the emergency center in France are actually dispatched due to triage by the physician who is receiving the call, in comparison to nearly 100% of the calls dispatched in the United States.

Conclusions: While a physician-led ambulance service results in more efficient triage in the field, such a system is unlikely to be adopted in the United States due to the cost burden of hiring physicians to staff ambulances and call centers. In order to reduce the emergency room burden in the United States, we should look at ways to improve pre-hospital triage by empowering paramedics and citizen call takers to make medically sound and more efficient decisions prior to and during dispatch.

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Pre-Hospital Emergency Medical Systems: A Comparison between the Franco-German and the Anglo-Saxon Models

Motivation: In collaboration with L’Hopital Tenon in Paris, France, I spent my summer riding ambulances alongside the physicians of the SAMU. My goal was to compare the Franco-German system of emergency medicine to that of the United States, in hopes of uncovering which part of each system is running more efficiently and why. In France, emergency medical services (EMS) are often led and coordinated by physicians, who are able to perform the appropriate medical interventions that other pre-hospital providers (EMTs and paramedics) are not licensed to perform. This is in contrast to the EMS system in the United States, where physicians do not lead the teams. Some research claims that the Franco-German method is superior because although it costs more money in the pre-hospital setting, it is leading to better outcomes. These researchers often criticize the American medical system for cutting costs at the expense of quality. On the contrary, studies point out the concern for the prolonged wait time on scene of the emergency in France, suggesting that this is the reason for reduced survival outcomes of certain parameters such as trauma and stroke.

Methods: I spent a lot of time talking with the doctors and students and interviewing them about their take on their emergency medical system. I had the rare opportunity to watch the doctors work on the scenes of emergencies, and then ride alongside them to the hospital where I could watch the care be continued. My observations of the two systems were analyzed in light of the literature comparing outcomes and efficiencies between the two systems.

Results: Only 65% of calls to the emergency center in France are actually dispatched due to triage by the physician who is receiving the call, in comparison to nearly 100% of the calls dispatched in the United States.

Conclusions: While a physician-led ambulance service results in more efficient triage in the field, such a system is unlikely to be adopted in the United States due to the cost burden of hiring physicians to staff ambulances and call centers. In order to reduce the emergency room burden in the United States, we should look at ways to improve pre-hospital triage by empowering paramedics and citizen call takers to make medically sound and more efficient decisions prior to and during dispatch.