From Call Receipt to Care Pathways: Routine Dynamics and Projective Work in Emergency Response[De la réception de l'appel au soin : Dynamique de routines et travail de projection en contexte d'urgence]

Stability and change are central issues in routine dynamics research. This perspective shows that routines are not fixed scripts but accomplishments in practice, sustained through performing and patterning work. In emergency contexts, prior studies have shown how routines can remain reliable under uncertainty, through mechanisms such as training, shared knowing, artefacts, temporal coordination, rhythm, and bodily preparedness However, these studies say less about contexts in which situations are highly variable and cannot be fully rehearsed. This paper addresses this gap through a qualitative case study of a French emergency medical call center. Drawing on observations, interviews, and documentary material collected in 2021 and 2026, we ask: how is projective work accomplished in the performance of emergency routines? Our findings show that projective work is central to how emergency routines are performed under uncertainty. We identify two connected forms of projective work: projecting the medical situation and projecting the care trajectory. These projections are supported by priority categories, temporal adjustments, artefacts, and social interactions.