Field Hospital - France

France

Field hospitals in France are managed by the SAMU (French emergency medical service. Two types of mobile medical kits (poste sanitaire mobile or PSM) are used:

• The level one mobile medical kit (PSM1): it can handle 25 heavy casualties on any type of ground; it is made of about 400 kg of equipment and drugs placed in 10 tanks, with also logistic equipment (trailer, inflatable tent, lighting, generating unit) ; there are 42 PSM1 in France;
• The level two mobile medical kit (PSM2): it can handle resuscitation care for 500 patients; it is made of 8 tons of equipment and drugs (200 references) in 150 tanks, it can be divided ( is possible to set up several sub-fracedPSM2); in addition to the usual logistic equipment of the PSM1, the PSM2 has a tactical radio network and a management computer system. There are 21 PSM2 in France.

The PSM are stored in the hospitals where there are samus and smurs.

The field hospital is the core of the emergency plan called plan rouge; it is then called "advanced medical post" (poste médical avancé, PMA). It is equipped by a PSM.

The PMA is organized in four zones:

• a reception and triage zone, under the responsibility of a sort physician; the casualties are sorted and dispatched according to the seriousness of their state;
• two zones for medical care:
  • Absolute emergencies zone (UA: urgences absolues): prehospital resuscitation unit for very serious cases: extreme emergencies (EU: extrème urgence) and grave injuries (U1);
  • Relative emergencies zone (UR: urgences relatives): for the serious (U2) and light injured (U3)
• Mortuary zone (dépot mortuaire) for the deceased casualties. This zone is under the responsibility of the judicial police.

In case of really massive disaster, it is possible to have several PMA; the evacuation goes then not directly to a hospital, but to another big field hospital called "medical evacuation centre" (centre médical d'évacuation, CME), to avoid the saturation of the hospitals.

In case of a red plan, the PMA is under the responsibility of a physician chosen by the director of medical rescue (DSM), and he is assisted by an firefighter officer chosen by the commander of rescue operation (COS). The firefighter officer has in charge the identification of the living casualties and of the secretaryship. The aim of the PMA is to sort and stabilize the casualties before their evacuation to an hospital.

A similar system can be set up as a preventive measure for some very big events (sport championship, cultural events, concert...), but managed by first aid associations. It is then called an "associative medical post" (poste associatif médicalisé, PAM). (For smaller events, is simple first aid post, with only volunteer certified first responders and no medical staff, is set up.)

The Civil defence military units (Unité d'instruction et d'intervention de la sécurité civile, UIISC) have airborne field hospitals. The general system is called DICA (détachement d'intervention de catastrophe aéroporté, i.e. airborne disaster unit), and is specialized in search-and-rescue and in emergency medicine; it can be enhanced by the Fast civil defence medical unit, called ESCRIM (élément de sécurité civile rapide d'intervention médicale). The ESCRIM is a surgical unit (detachement d'appui chirurgical) assisted by a medical assistance unit (DAMHo, détachement d'appui médical et d'hospitalisation); the later is specialized in pre- and post-operation care, and allows 48h of hospitalization. The UIISC also has a PMA (i.e. sort, stabilization and evacuation structure) when the hospital infrastructure of the country is sufficient.