How long does it take to train resuscitators, so crucial in hospitals, as the Covid-19 epidemic cruelly reminds us? The question arose on RTL, Monday, January 3, during an interview with Valérie Pécresse.
The candidate Les Républicains (LR) in the presidential election of 2022 there affirmed (from 5’15 of the replay below) wanting to count, during her possible mandate, on “25,000 recruited caregivers […] specifically for the hospital, 25,000 new caregivers trained. “
To the journalist who stressed in return that it took “between 10 and 15 years to train doctors, resuscitators, anesthetists”, Valérie Pécresse was formal: “It is totally inaccurate. Training a doctor, yes, it takes between 8 and 10 years. But train a resuscitator today […], it may take a year or two. “
And, in response to another journalist, indicating that it takes rather “five years”, Valérie Pécresse then indicated her solution: “We can take doctors who are already hospital and qualify them to be in intensive care. “
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Joined by 20 minutes, Anne Geffroy-Vernet, president of the enlarged National Union of Anesthetist-Resuscitator Hospital Practitioners (Snphar-e), indicates that “in the past, and in extremely specific circumstances, for doctors who had a specialty close to resuscitation, such as cardiology or pneumology, it was possible to train in resuscitation in one or two years ”.
“But with the reform of the 3rd cycle, which entered into force in 2017, this device was abandoned”, she adds. Marc Leone, Deputy Secretary General of the French Society of Anesthesia and Resuscitation, abounds with 20 minutes : “The studies of medicine last 6 years, then comes the examination of the national classifying tests (ECN) and there, according to its classification, one chooses its city and its specialty. “
“To carry out resuscitation, there are two possible equivalent courses: anesthesia-resuscitation, where we will develop skills in operative anesthesia and resuscitation for critical care, and intensive care medicine (MIR), which gives access to intensive care. The two durations of studies on this 3rd cycle are 5 years, with a minimum of 2 years spent in intensive care, or 11 years in total to train a resuscitator with the requirements that can be expected today. “
Training for specialists with less activity due to deprogramming
For its part, the team of Valérie Pécresse indicates to 20 minutes that, “in his statement, [la candidate] was obviously referring to the exceptional crisis situation that our system has known for many months and to the fact that, two years later, we are still at the same point in terms of resuscitation, in the lack of preparation and without real support provided to the teams. “
“As the National Professional Council for anesthesia and resuscitation reminds us, in its help guide in the establishment of an ephemeral resuscitation, in the event of “an influx which exceeds the capacities of care, it is necessary to treat differently, differently from the usual practices” “, continues the team of the candidate.
“In this case, Valérie Pécresse was referring in particular to doctors who had less activity due to deprogramming, in particular anesthesiologists, whose diploma is still a specialty of anesthesia-resuscitation”, she underlines, the latter being able to “Support the teams” after training to deal with “a new massive influx of intensive care patients”.
“This targeted audience could have been offered training adapted to the circumstances in which we live, built with learned societies and professionals. It would then be a question of making an inventory in each hospital establishment of hospital practitioners who have had experience in resuscitation and / or working in disciplines frequently requiring resuscitation, ”concludes Valérie Pécresse’s team.
“It is not a viable solution”
Still, for resuscitation professionals, this kind of scenario poses another concrete problem, as explained in 20 minutes Julien Pottecher, president of the National College of Teachers of Anesthesia and Resuscitation (Cnear): “Doctors from other departments, such as cardiologists, do not wait for their office to be needed, they exercise a specialty for which they are trained. They don’t represent a mass of potential doctors, they are vital where they are. “
“If it is done for an extremely punctual crisis, we can understand that, for 15 days or 3 weeks, we can draw on these doctors, but it is not a viable solution, and it is impossible in the context of the Covid-19 crisis which has lasted for two years, ”he said.
329 resuscitator positions are now vacant, as explained by more than a hundred professionals in a platform at Le Figaro January 31, 2021 by pleading for a “sustainable” increase in the number of doctors trained in resuscitation. According to a report from the General Inspectorate of Social Affairs (IGAS) dated July 2021
revealed by Le Monde, “From 2021, and until 2030, the inspectors consider it necessary to open” at least “40 additional internships per year, divided into the two specialties of intensive medicine and resuscitation and anesthesia-resuscitation”.
The solution: a call to anesthesiologists currently in interim?
And Anne Geffroy-Vernet concludes: “Resuscitation is an extremely specific, extremely technical profession, where relations with death are significant, especially in times of Covid-19, it is not something that can be improvised. The real solution would be to call on anesthesiologists who act as interim workers and work mostly between the public hospital and the clinics, providing replacements. “
“When we talk to them, they explain that they chose this option because they like the public hospital and that they have worked there, but that the conditions have become so crumbling, with insufficient remuneration and poor working conditions. , that this is no longer possible. We must therefore make these professions more attractive again ”, considers the president of Snphar-e.