Emergency response to 999 calls

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7375.1299 (Published 30 November 2002) Cite this as: BMJ 2002;325:1299

Alternatives to the emergency 999 response can be seen in Europe

  1. Bernard A Foëx, acting consultant in emergency medicine (bernard.foex@smuht.nwest.nhs.uk),
  2. Darren Walter, consultant in emergency medicine
  1. South Manchester University Hospital, Manchester M23 9LT
  2. Isle of Wight Healthcare NHS Trust, Ambulance Service, St Mary's Hospital, Newport, Isle of Wight PO30 5TS
  3. Child Development Unit, Gulson Hospital, Coventry CV1 2HR

    EDITOR—Snooks et al point out that the current 999 emergency response system has problems: increasing demand from the public and ever shorter response time targets.1 They find a lack of evidence on alternative systems and responses in the English medical literature. By restricting their search, they overlook live examples only a few miles from these shores.

    France, since the mid-1960s, has had a system which incorporates many of the alternatives quoted by the authors: the Service d'Aide Medical Urgente (SAMU).2 Calls to the control room are logged by trained telephone operators and then passed on to a “medical dispatcher”: a doctor in emergency medicine, trained by the service. Medical dispatchers may simply provide medical advice to the caller, or they may decide to use one of a range of other responses to a call. These are referral to, or the dispatch of, a primary care doctor; arranging non-urgent transport by a private ambulance; urgent transport by pompiers (emergency technicians working through the fire service); or sending out a mobile intensive care unit with a doctor trained in emergency medicine. Medical dispatchers also coordinate the deployment of additional resources and decide on the most appropriate destination for a patient.

    In 2001 the service covering Paris received 300 000 calls (about 820 calls per day). Only 6% of the calls (50 per day) resulted in the dispatch of a mobile intensive care unit. In …

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