“A deep reflection is needed on the notion of emergency in health”

Tribune. The presentation of the health pass is now required at the entrance to hospitals for care by appointment. It is specified that this measure does not concern people admitted to hospital in an emergency – the degree of urgency being left to the discretion of the caregivers. Such a decision suggests that it would be possible to carry out a systematic upstream screening of hospital access between what is urgent and what is not.

But on what criteria would the patient be able to determine whether or not his need for care justifies being treated immediately? Questioning these criteria could well be useful to us beyond the context of the health pass at the hospital. Indeed, while the issue of reorganizing emergency numbers has been giving rise to lively debate for some time now, this new measure is a reminder that in-depth reflection is needed on the notion of emergency in health.

Heterogeneous situations

Two visions of urgent aid clash: on the one hand, that carried by the defenders of a single “emergency” number which should only concern what can be qualified as an obvious vital emergency, such as road accidents or accidents. cardiac arrests. On the other hand, that of the SAMU which defends the single “health” number and reminds us that a vital emergency can be completely hidden under symptoms which seem to relate to general medicine. This is why the SAMU asserts its function as a place of orientation in the healthcare system and calls for not leaving patients the responsibility of deciding alone whether their problem is urgent or not.

The prospect of a stronger distinction between urgent and non-urgent could give us a glimpse of the future of our health care system if we allow the response to health needs to standardize a little more.

The SAMU, originally reserved for “medicine at the foot of the tree” to help victims of road accidents, today has a dual mission of responding to the vital emergency and access to permanent care. An activity which, unlike specialty medicine, is not based on a clearly defined object of work but rather on the overall care of patients, and often oscillates between social and medical.

We know that patients who request urgent medical help respond to very heterogeneous situations. This is why medical regulation exists. In order to provide the best care, this involves establishing a relationship between factors (age, symptoms, multiple pathologies, etc.) and personal circumstances. This exercise is complicated by the fact that users base their request for care on the basis of a perceived emergency. So, almost always, the need to resolve a health problem is urgent.

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