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At the SAMU in Bordeaux, answering calls when emergencies are slowing down

How to continue to meet the needs of the population with one of the main emergency services of the territory which closes at night, for lack of sufficient carers? Faced with this puzzle, which began on May 18, the Bordeaux University Hospital is rolling out a crisis organization. From 5 p.m. to 8 a.m., the emergency room at the Pellegrin hospital center is now “closed”, with patient screening at the entrance. Only vital or acute emergencies continue to be directed there. And it is largely on the shoulders of the SAMU that the mission of sorting the requests rests, while the population was called upon not to go to the emergency room but to go through a call to 15.

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On the first day of the “experimentation” of this new protocol, “1,000 calls [ont été reçus] over the whole day, 400 in the evening, including 20 from the emergency intercom, which is a fairly normal situation”reassures Philippe Revel, head of emergencies and SAMU of the CHU.

For the slot from 5 p.m. to 10 p.m., when the number of calls can still be substantial, a “mirror cell” made up of volunteer students supervised by a medical regulation assistant (ARM) has been set up at the SAMU. His role: answer the intercom at the entrance to the emergency room and carry out an initial sorting. For the most serious cases, the call is then transferred to the usual SAMU responders, who judge the seriousness of their condition.

“We are all exhausted”

A few corridors from the mirror cell, in the regulation room of 15, the place where we try to find patients requiring hospitalization a service that can accommodate them, there is also a lack of staff. “Four, five positions”assesses Professor Revel. “We were taught to work with few staff and resources. This is a situation that has dragged on for years.”says an ARM in office for ten years, who wishes to remain anonymous.

The SAMU call center allows emergency patients to be regulated from 5 p.m. to 8 a.m., at the Pellegrin hospital in Bordeaux, on May 19, 2022.

In front of her screen, she shows the calls on hold, that is, the patients who have to wait before being able to obtain a contact. A situation that the SAMU platform experiences every day, but which has taken a more difficult turn lately. The young woman recounts, in fact, the desperate attempts, sometimes, to find a place that can accommodate patients. “All the emergencies in the Gironde are saturated”she is indignant.

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When it is not a real emergency, some callers are encouraged to contact SOS Médecins instead, open day and night, opposite the hospital. “Many calls to 15 come from general medicine”points out Philippe Revel.

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