When you call the SAMU, they are the ones who pick up: they are not doctors, but medical regulation assistants (ARM). While the Minister of Health now urges the French to dial 15 before going to the hospital, “Complément d’Enquête” looked into this link in the chain of emergencies, essential and yet unknown to the general public. . In this excerpt, here is a testimonial that describes a service on the verge of failure.
Why isn’t the ambulance coming? How many patients die after calling 15, while waiting for help – either because they are late in coming, or because the SAMU did not see fit to send them? What is wrong with the emergency chain? “Complément d’Enquête” has collected edifying testimonies, even as an information campaign, “Fait le 15”, supposed to unclog the emergency services, threatens to saturate the control centers.
Far from the 30 second maximum waiting time recommended
When you dial 15, those who answer the phone are medical regulation assistants (MRAs). They are the ones who, after evaluating your condition, must systematically refer you to a doctor. In Strasbourg, where the Naomi Musenga affair broke out in 2017, this young woman snubbed by an SAMU operator and rescued too late by SOS Médecins, an ARM agreed to speak to “Complement of the investigation”. If he testifies, with a hidden face, it is so that the public knows in what conditions these personnel work, “Why [les patients] don’t have their ambulance right away, why are they waiting so long”.
According to a recommendation from the High Authority for Health, ARMs should not make patients wait more than 30 seconds before answering a call. But, added to the chronic lack of staff, the saturation of services following the ministerial message further lengthens waiting times, sometimes to the point of tragedy.
“This kind of case happened not long ago: the call was on hold for half an hour to get a doctor. And when the doctor picked up the call, the patient was in cardiac arrest .”
A medical regulation assistant (ARM) from the Strasbourg SAMUin “Further investigation”
At the idea that“one person died” during too long a wait, and that “it could have been [lui] to arrive at [lui] like any other colleague, he cracks. According to him, this kind of situation “has been around for a long time, too long, but it wasn’t coming out”.
Over 97% of ARMs feel like they can’t do their job properly
He describes a service overwhelmed with calls, colleagues for many “morally exhausted”, a job where he goes “backwards, the ball in the stomach” for fear of making a mistake, and that he is considering quitting. In Strasbourg, he would not be the only one in this state. “Before taking up their position, more than 75% of employees feel stress, 62% feel unwell, more than 97% feel they do not have the means to do their job properly”, established a report in 2021. of the Force Ouvrière union on working conditions and psychosocial risks at the SAMU.
“We knock on all the doors, and we have the impression that… it’s a bit like the army. It’s not ‘la Grande Muette’, the hospital, but we try not to make waves and to manage it internally, and above all, that it doesn’t come out…”
Christian Prud’homme, nurse at the Strasbourg University Hospitalin “Further investigation”
The Strasbourg University Hospital nurse who is at the origin of this report, Christian Prud’homme, reports a “dramatic situation, that is to say that we are no longer up against the wall, we are in the wall”. He claims that in 2022, his union warned the hierarchy of dangerous situations on several occasions. “We alert the management, we alert the ARS, we alert the ministry… At the moment, I am meeting the deputies, he explains. We alert everyone, nothing happens, we are not given the means.
Extract of “When emergencies no longer respond!“, a document to see in “Complementary investigation” on the 1st June 2023.
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