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Good day everyone! I'm glad to join this community and I hope to learn a lot from all of you, and maybe answer a few question you may have as I'm from a country with a peculiar system Indeed, I've been a volunteer EMT in Paris for 4 years, within the Paris Civil Protection (Protection Civile de Paris). I say EMT, but the actual french word is "Secouriste" which corresponds more or less to an EMT-basic life support qualification. I'm qualified for almost everything that is not invasive (with the only exception of blood sugar level) and my mission is to (in short): - Assess the patient's health state - Perform the emergency actions needed to answer the situation / Call for additional (or specialized) units if needed. - Transmit a complete and accurate description of the patient's state to the EMS. - Preparation and evacuation of the patient to the hospital. I'm a "foreman" (chef d'équipe) which mean I have to coordinate my team's action and take responsibility for my crew's safety as well as the patients' and third person's. To introduce you briefly the Civil Protection, you can easily compare it to St-John Ambulance. We have 3 fields of action: - Medical emergencies: >> "911 response" >> Rescue posts on planned events (festivals, sport events...) - Social support: >> Disaster relief >> Street patrols for homeless people - First aid training: >> EMT training >> First aid course for people How do we respond to a 911 call? In France, there are no paramedics. We have either EMT-B or emergency physicians. When: - The call wasn't clear - The situation doesn't seem to require an advance life support unit - The situation requires additional personals - The situation require a basic life support unit on top of an advanced life support unit We are dispatched. We are 5 EMT in the ambulance, but we can work in crews of 4. On other missions we can be 3 or 2. Our role is to get control of the situation, assess the patient(s) health, treat the injuries/distresses and report to the EMS. They take the decision. Then, if needed, we transport the patient to the hospital. An advanced life support unit can also be dispatched to start a treatment on the scene? In case of cardiac arrest: We start CPR with oxygen and defibrillator, we call the advanced life support unit. In most of the cases, the resuscitation will be performed on scene by the doctor's crew until the patient is stable. If nothing can be done, the patient is pronounced dead on the scene. If the patient is stabilized, he'll be quickly transfered to hospital. This is the "stay and play" theory you have in France and Germany, where doctors, in mobile ER will come on scene. It's called "bring the hospital to the patient". Why does France applied the "stay and play" system? Before 1968, rescue missions where carried out by fire departments and police departments. Those rough ambulance services were poorly trained and equipped, as it wasn't the main mission of neither. The mortality rate was very high so doctors decided they couldn't stay in the hospital and wait for dead patients. They created vehicles equipped like hospital emergency rooms, aboard which were the doctor and nurses. Today, those "mobile ER" still exist and board an emergency doctor, an emergency nurse (equivalent of a paramedic advanced) and a trained driver (equivalent of an EMT-. You can recognized them by the word "SAMU" written on the side. What's new in France EMS? The "stay and play" theory is to live long it seems, as the SAMU just created a mobile ECMO unit. This vehicle boards a specialized team (surgeon, nurses...) and all the equipment needed to set an ECMO procedure anywhere, on the street for instance. This unit is dispatched only under very precise circumstances, and aims to reduce even more the "low flow" time. Even if this vehicle is still in experimental phase, it shows well the will of french EMS to bring more and more heavy equipments outside the hospital, directly to the patient. Maybe one day, you'll get a scanner without leaving your bed! I hope you found some of this interesting, if you have further questions, feel free to ask Glad to join you all!

Hello to all EMT City folks---past, present and future. Some of you know me on a very personal level, some just know of me and some could care less...that is life. Regardless, now that I have awarded this year's CAP Lab Scholarship in honor of Rob Davis, my next step is to say good bye to all those I have come to know, love, and respect here on EMT City. Yes, it is true, AK is retiring. Writing this open letter has been a very difficult and emotional process. I have been with The City since 2004 and participated in many adventures because of it...good times, bad times, you name it I have been a part of it. Countless poser bustings, challenging debates, informative sessions...those have been fun and educational. As for relationships, I have made life long friends, I have had short time friends, I have had friends die, get married, get divorced, make babies...suffered through their problems right beside them, because that is what friends do. I have met some of the most inspirational people who receive all my respect in the world, there have been such amazing discussions offline....all of it has been amazing. There has been a very special person in my life because of this site, one who will never be forgotten, and this person knows who they are. As I reflected on the years with The City, I realized how much like a family this is and I see how retirement is a process, very much like a relationship ending. I will miss everyone of course and there are those of you out there who know how to find me. If I have enjoyed it so much...why am I leaving? This is a fair question and I will explain...being an integral part of The City has become an obligation. In my personal life, I have had many changes to include starting a new business. The business takes all my time and focus; this will not change anytime soon. I feel like a relic around here as none of my information or experience is relevant or valid. I feel like the old man on the front porch longing for the old days. I suspect part of the problem as well is the repetitive/cyclic nature of postings. Not that there is anything wrong with them, I just personally no longer have the energy or desire to assist and inform as much as I used to. I am no longer a willing participant. Please do not misunderstand any of the above as bashing or negative. It is all personal changes within my life that has brought this forward. You, if you care, deserve an honest explanation. I wish all of you the best and I know the "New Guard" will deliver to all the neophytes coming up through the ranks. The transition has been in effect for quite some time and is fun to watch...baby medics I mentored through school are now medics with years of experience and wisdom and are passing it on. It is an amazing process to watch. Take care, stay safe and keep pushing for higher standards of education within our EMS system! (I will be checking in for a couple more weeks only because of I have some active threads that I wish to close out, but yes this is a final act). Thank you everyone!