On strike since July 3, medical regulation assistants (ARM), unknown to the general public, are nevertheless those who, on the front line, respond to all calls to Samu. Gathered in operation centers, they receive and process emergency calls, which they then direct according to the seriousness and availability of the various teams and doctors.
MRAs are calling for wage increases and hiring, according to their national association, Afarm. Their indefinite strike is little seen, because the ARM strikers are, like many caregivers, “generally assigned by the administration, and therefore to their position”, without loss of pay.
ARMs are considered the first link in the French relief chain. They receive requests from a Samu reception and call regulation center (CRRA). They act under the responsibility of a regulatory doctor, with whom they work in close collaboration. They are recognized as healthcare professionals. When they receive a call, they need to be efficient and get to the point: spending more than 30 seconds per call delays other emergencies. During the Covid-19 pandemic, some centers had peaks of more than 4,000 calls per day. Every second counts.
The only cases in which the ARM can trigger an intervention without going through the regulating doctor are those of life-threatening emergencies. If not, a second assistant takes over with the call, allowing the first to attend to another patient. This double pick-up system frees up the lines and picks up as many calls as possible.
To become an ARM, you must be in possession of a diploma in medical regulation, training only provided in training centers for medical regulation assistants (CFARM). There are about twenty of them in France, for an eleven-month training.
Each year, the Samu receive a total of some 30 million calls. According to the Court of Auditors, this number increased by 22% between 2014 and 2021.
