Question 15853 — health professions

Summary

Mr. Hadrien Clouet draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the persistent statutory invisibilization of ambulance workers in mobile emergency and resuscitation services (SMUR). Although full members of the emergency trifecta (doctor, nurse, paramedic), these professionals operate in a worrying legal vacuum: no specialty is officially recognized and no additional national certification is listed in the national directory of professional certifications (RNCP). This statutory and salary recognition would, however, be commensurate with the major public utility of this profession, guaranteeing the survival of citizens in times of greatest vulnerability. In addition, the absence of a harmonized framework obscures a specific technicality essential for handling emergencies. vital. Far from being limited to driving a priority general interest vehicle, the SMUR ambulance driver provides critical assistance with resuscitation procedures. Under medical responsibility, he actively participates in assisting with oro-tracheal intubation, manual ventilation and the implementation of complete patient monitoring. Its ability to anticipate clinical needs in a constrained environment and to prepare Complex devices, such as electric syringe pumps or respirators, are the major lever for the collective performance of the mobile unit. Beyond daily intervention, these agents are responsible for complex clinical logistics. They ensure the management and compliance of on-board biomedical equipment, the traceability of consumables and the implementation of hygiene and decontamination protocols, essential to the safety of care. Their expertise extends to the management of exceptional health situations (ESS) and nuclear, radiological, biological and chemical (NRBC) risks, where they manage the deployment of mobile health posts (PSM) and participate in the sorting of victims under high tension. The lack of recognition of this professional expertise creates a heterogeneity of territorial practices detrimental to the provision of care. However, the creation of a level 4 specialty at the RNCP would make practices safer and significantly improve hospital efficiency. Impact studies demonstrate that an optimized paramedical pair (nurse and specialized ambulance driver) contributes to the reduction of average lengths of stay (ADR) and the avoidance of irrelevant hospitalization days. On an economic level, the cost of such specialization would be quickly offset by the gain in full hospitalization days in medicine, surgery and obstetrics (MCO). In addition, France is lagging significantly behind its European neighbors such as the United Kingdom or Germany, which have structured regulatory and academic frameworks for their specialized ambulance workers (“Paramedics” or “Notfallsanitäter” recognition). In France, despite the transition to the sector caregiver in 2022, the feeling of lack of recognition remains strong among these professionals, 76% of whom consider their profession “demanding” but “little recognized”. He therefore asks her if she finally plans to initiate the creation of a state diploma for ambulance specialists specialized in pre-hospital emergencies, accompanied by a national skills framework and an index upgrade commensurate with the responsibilities exercised; such a measure being imperative to guarantee the attractiveness of the profession, legally secure the actions carried out on a daily basis and ensure optimal care of patients throughout the national territory.

Machine translation from French. The official text remains authoritative.

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