Emergency services: Samu 34 handles more than 1,500 calls at the weekend

The family of a woman from Alsace who is believed to have died following a delay in treatment by the Centre 15 in Strasbourg at the end of last December want the full truth to come out and have taken the matter to court. Whilst a police investigation is under way, supervised by the public prosecutor’s office, the management of Strasbourg University Hospital announced on Thursday that the dispatcher suspected of having responded dismissively to the victim, without taking her call for help seriously, has been suspended from duty until further notice. What is the situation regarding the operations of Smur-Samu 34? Here is the answer. The Hérault Departmental Emergency Call Centre (CDAU 34), based in the brand-new building of the Fire and Rescue Operations Centre – Codis 34 – in Vailhauquès, some fifteen kilometres west of Montpellier, is a hive of activity. In this bustling environment, where operators from the SDIS 34 fire service and Smur-Samu 34 work side by side, the number of emergency calls coming into the joint 18, 15 and 112 control centre exceeds 1,500 every weekend. A great many of the calls received, particularly at night, are not urgent at all: one person asks for the out-of-hours chemist in a town in the department, another wants to know whether a 1,000 mg effervescent aspirin will relieve their headache, and so on. Not to mention calls that do not relate to a life-threatening emergency, but rather to mental distress, or even psychiatric distress requiring urgent treatment. An eye-opening recording Thus, Metro received an audio recording of a call made to CDAU 34. It’s quite revealing: here is the transcript: The caller: “Hello. Good morning, sorry to bother you, but I was wondering – is this Sète Hospital?” The regulator: "No, this is the Montpellier Ambulance Service. Tell me what’s going on – I’m listening." The appellant: “I’ve got a problem here – I’ve got a toothache, and I need to have it pulled out. If I go to the hospital in Sète, will they do it for me there? This tooth is really hurting me.” The regulator: "Oh no, sorry, there isn’t a dentist at Sète Hospital." The appellant, who is violent: “Oh yeah? At Sète Hospital, they can’t even pull out a tooth? And that’s supposed to be a hospital? What’re you lot good for, then? You’re useless, aren’t you. You’ve got no heart. You faggot, you filthy bastard, you fat son of a bitch. Your wife and your kids are whores. I’m going to come and shove it up all your arses”…If this man from Sète recognises himself, we hope for his sake that he has managed to find a dentist. Calls of this sort, accompanied by a barrage of insults and threats – particularly in the early hours of the weekend, when callers are under the influence of alcohol – end up unsettling and demoralising the dispatch officers and are all too common. They come in between genuine emergency calls – such as a stroke or a cardiac arrest – which must be dealt with immediately, as the victims’ lives are at risk. Insufficient staffing The number of medical dispatch assistants (ARM) is clearly insufficient, and they handle these requests under considerable pressure. According to our information, at weekends and on public holidays, the MRAs seconded from Montpellier University Hospital to CDAU 34 must also manage the on-call medical service and handle calls and messages from SOS Sida Info Services, which diverts its national answering service to Samu 34! “Montpellier University Hospital has agreed that calls and messages received by SOS Sida Info Services from all over France should be handled here, without any financial compensation; I have never seen anything like it,” a healthcare professional reveals to Metro. Samu 34, based at Lapeyronie University Hospital in Montpellier, comprises 30 SMUR paramedics, around 20 nurses, around 10 anaesthetic nurses and around 30 doctors assigned to the A&E department. They have at their disposal five resuscitation ambulances, including a brand-new one that has just been allocated to the unit, three vehicles used exclusively to transport medical teams, and two logistics vehicles towing trailers carrying, in particular, advanced medical posts. Samu 34 has a paediatric emergency medical service (Smur) comprising specialist doctors – paediatricians, in other words – as well as paediatric nurses attached to the paediatric intensive care unit at Arnaud-de-Villeneuve Hospital in Montpellier. It also has helicopters, which are now yellow in colour. >> The Strasbourg case On 29 December last year, whilst suffering from severe abdominal pain, Naomi Musenga dialled ‘15’ to call for help. Her call was treated with contempt by operators at Samu 67, who advised her to call SOS Médecins. Finally taken to A&E after more than five hours of agony, the 22-year-old woman from Strasbourg died late that afternoon. The recording of the call made to Samu 67 bears witness to the lack of consideration, if not outright contempt, shown by the emergency service operators towards the young woman from Strasbourg who was in agony. This is a clear case of systemic failure that has sparked fierce controversy. The recording begins with hold music, followed by an automated message asking the caller to wait. Two women, the Samu operators, join the conversation. They snigger and mock the caller, suggesting that she would be better off contacting a doctor. "She called the police"", said one of them. "Is it because she's got the flu?", the other one snorts. "I don't know, but she told me she's going to die", replies her colleague, who is clearly amused by the situation too. What follows is a more or less vague exchange of information – address, name, telephone number, state of health, etc. – about Naomi. The sarcastic remarks resume, then the first operator takes the young woman’s call. Here is a transcript of the conversation: – “Yes, hello.” – “Hello… Please help me, madam… (weak voice)” – “Yes, what’s the matter?” – “Please help me…” – Right, if you don’t tell me what’s going on, I’m hanging up. – Madam, I’m in a lot of pain… – Well, you’ll call a doctor, won’t you? All right? Here, call SOS Médecins. – I can’t – You can’t? Oh really? You can call the fire brigade, but you can’t… – I’m going to die. – Yes, you’re going to die – one day, just like everyone else… – Call SOS Médecins – the number is 03 88 75 75 75, all right? – Please, help me, madam. – I can’t help you; I don’t know what’s wrong with you. – I’m in a lot of pain, I’m in a lot, lot of pain. – Where? – My stomach really hurts… I’m in pain all over. – Well, you need to ring SOS Médecins on 03 88 75 75 75 – that’s it; I can’t do that for you. 03 88 75 75 75. You need to see a doctor, or else ring your GP, all right? – All right – Goodbye.” The post-mortem revealed that the young woman died in hospital as a result of “multi-organ failure due to haemorrhagic shock”; several of her organs had stopped functioning. The Minister for Health and the Strasbourg University Hospitals (HUS) have launched an administrative inquiry to “shed light” on this terrible incident. One of the two dispatchers has been suspended from duty until further notice. >> We discussed this tragedy here, in a previous article.