Paramedics in France

Until very recently, the French pre-hospital care strategy was based on either first responders (firemen) or prehospital medical teams (MD + nurse + ambulance driver) called Smur (service mobile d'urgence et de réanimation, emergency resuscitation mobile unit). With this organisation, any situation requiring a paramedic is handled by a physician who specialises in pre-hospital emergencies.

Due to a lack of physicians, interhospital transportation requiring intensive care was often performed by an ambulance driver and a nurse working on protocol, although it was not entirely legal (the nurses are allowed to apply a medical protocol, but the definition of a Smur necessarily includes a MD). In any case, the protocols had to be written specifically for a given patient, so such protocols could not be used for pre-hospital emergencies (the patient was not seen by the MD who wrote the protocol).

The legislation evolved in 1997, and nurses belonging to a fire department (or ISP–infirmier sapeur-pompier) can now apply emergency protocols in pre-hospital situations, in the same way as paramedics. They can also receive oral prescriptions by phone or radio and thus provide specialised care.

Therefore, there is no specific paramedic profession in France, but the existing nursing profession have evolved to meet the needs of pre-hospital care.