La régulation médicale en médecine d'urgence

Medical regulation is a medical act carried out on the phone by a doctor acting in a call centre dedicated to emergencies. In response to a call, the regulator doctor determines and puts into action the most suitable solution according to the case, and, if necessary, orientates the patient directly toward an appropriate hospital unit. The medical regulation practice necessitates a dedicated structure, the Samu Call Centre within a hospital emergency service. In France, medical regulation plays an increasing role in the management of prehospital emergencies. Each year, 10 million cases are taken in charge by Samu call centres. Main responses to calls are advices, sending of a general practitioner on duty, an ambulance car, or, in the most severe cases, a hospital Mobile Intensive Care Unit (MICU) with a physician on board. For example, the Samu, facing a patient with a chest pain possibly related to a coronary disorder, dispatches immediately a MICU, and orientates the patient directly to a coronary care unit, mobilizing the physician, often on duty or at home, before the patient's arrival. Medical regulation helps the patient to access rapidly to the right care. It optimizes the daily use of hospital resources and contributes to a better structuring of health care organisation on a territory. It is also a factor in social equality and cohesion.