SMURD
Encyclopedia
SMURD is an emergency rescue service based in Romania
. SMURD is the Romanian acronym for "Serviciul Mobil de Urgenţǎ, Reanimare şi Descarcerare", that means Mobile Emergency Service for Resuscitation and Extrication.
The first SMURD was created in Târgu Mureş, a city in the middle of Transilvania, in 1990 shortly after the revolution because of the critical situation of the traditional ambulance system.
Now SMURD is a complementary service, with a lot of bases in the whole Romania, still expanding, that services the worst emergency cases in a good collaboration with the traditional Ambulance (Serviciul de Ambulanţă). Also HEMS (helicopter emergency medical system) has been implemented in three cities (Târgu Mureş, Bucharest and Iaşi) while in other cities the system is only ambulance based or in exceptional cases police and army helicopters are used.
The emergency system is based on the 112 emergency number, now used in Romania for all the emergencies (police, firefighters, ambulance).
With the guidance of the Anaesthesiology and Intensive Care Clinic, in September 1990, an emergency system functional in other European countries was experimented. This system was based on the transfer of a full-equipped medical unit to the site where the critical patient was, in order to provide qualified emergency medical assistance. The unit is coordinated by a physician specialized in anaesthesiology, intensive care and emergency medicine
. At this early stage, the new service, called SMUR or the Emergency and Resuscitation Mobile Service, was endowed with only one equipped intervention unit, which had no possibility of transporting the patient, the transport being left to be made by a vehicle belonging to the County Ambulance Service.
. This unit brought a higher level of pre-hospital medical care, and easier one.
Until October 1990, the new system has functioned entirely based on volunteer work. The SMUR mobile unit's drivers were students at the Faculty of Medicine, physicians or Red Cross volunteers from Târgu Mureş. After failed attempts of cooperation with several institutions, in October 1991 an experimental period of time started, placing SMUR under the operative coordination of the Mureş Fire Department, which, at that time, was responsible for the employment of the drivers for the mobile unit, and to provide accommodation and training rooms for SMUR's medical staff. This experiment, which was to be a success and to become a permanent solution, was based on the models found in many countries in the world, where firemen are directly involved in providing of emergency medical assistance and first-aid. These models are functional in Germany, France
, Luxembourg
, the United States
, Canada
, Japan
, etc. In this new functional structure, SMUR was guided by the Anaesthesiology and Intensive Care Clinic from the medical point of view and by the Fire Department from the operative point of view.
from Sauda
started their support by donating SMUR mobile units and emergency medical equipment and the Emergency Service of the Royal Hospital in Edinburgh and the Strathclyde
Fire Brigade in Glasgow
have started an intensive support program for the development of emergency medical assistance and for the training and endowment of firemen in new fields, such as extrication and chemical hazards. In November 1992, following a training period of 3 weeks, with trainers from Germany, the Netherlands
, Scotland
and the United States, an exercise was performed to which were invited to participate the representatives of several Ministries and institutions. Following this exercise, the Minister of Health declared, by the Decision No. 1094 of November 5, 1992, the new system functioning in Târgu Mureş as the National Pilot Centre. This new status was to protect the new model, in the years 1993-1997, against the high level of opposition and the attempts to shut it down.
As a part of the training in 1992, the first laboratory for emergency training was donated by the Foundation for Open Society, United States.
Clinical Hospital, designed to continue the treatment of critical patients brought in by SMUR or arrived through other means, until their admission to the hospital's departments. The new Intensive Care Room staff members were the doctors, medical assistants and volunteers who worked in the pre-hospital emergency units. The new Intensive Care Room reduced the mortality within the Emergency Room of the Mureş County Hospital by approximately 50%.
Also in 1993, the Strathclyde Fire Brigade in Scotland has donated the first mobile extrication unit to the Mureş Fire Department, training the personnel within the Fire Department for the efficient and accurate use of the equipment. The first intervention the unit responded to took place in exactly the same day as the donation ceremony.
Starting 1993, the Resuscitation and Emergency Mobile Service (SMUR) has become the Emergency Mobile Service for Resuscitation and Extrication (SMURD). Also in 1993, the first services following the Târgu Mureş SMURD showed up at Oradea and Sibiu, adopting the functional mode of the Târgu Mureş system.
, the first Emergency Department was built, following the models in Great Britain and the United States. The new department or "Emergency Service" was placed in the yard of the Mureş County Clinical Hospital and started its activity on July 31, 1994. Building this Emergency Service took almost a month and gathered lots of working people, from Scotland and Târgu Mureş, from the Army, the Gendarmerie and the Fire Department, and from organizations and volunteers, all wanting to see the new service working as soon as possible.
From the Fire Department point of view, 1994 has brought a new activity. The Scotland firemen endowed and trained the Mureş firemen for chemical hazard interventions, creating the first operative unit of this kind in all the Fire Departments of Romania. Alongside the firemen, doctors from SMURD attended the training programs.
In October 1996, the Military Fire Corps Law no. 121 was promulgated by the President. For the first time in Romania, in this law at articles 9 and 18.k it was established that Military Firemen have a duty to provide emergency medical assistance and extrication. This law has put the system within legal boundaries after an experimentation period of approximately 5 years. Consequently, the Emergency Mobile Service for Resuscitation and Extrication was named the Intervention Station for Emergency Medical Assistance and Extrication (SIAMUD). In Mureş County, currently both names are in use, SMURD or SIAMUD.
1998 was a very special year for SMURD Târgu Mureş. In June that year, the Fire Department was given an intervention boat, necessary for the drowning cases in the Mureş River. Only in August the same year, the Firemen and SMURD had 6 interventions using that boat.
In June 1998 a public fund-raising was organized, destined to gather funds necessary to purchase a new intensive care mobile unit, fully equipped. This fund-raising continued until December 1998 and was finalized with the acquisition of the most modern intensive care unit in Romania, at the cost of 183,000 DM, fully equipped by Miesen - Germany. The entire amount collected was donated by the people and the companies in Mureş County. The success of this project was and still is a measure of the community's perception of the SMURD activity.
s, one based at Târgu Mureş, and the other at Bucharest
; there is also a SMURD helicopter rescue service at Iaşi
but its helicopter crashed in January 2006.
For the future the health ministry intend to expand to all the counties of the country the SMURD service, and to acquire another 2-3 helicopters.
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...
. SMURD is the Romanian acronym for "Serviciul Mobil de Urgenţǎ, Reanimare şi Descarcerare", that means Mobile Emergency Service for Resuscitation and Extrication.
The first SMURD was created in Târgu Mureş, a city in the middle of Transilvania, in 1990 shortly after the revolution because of the critical situation of the traditional ambulance system.
Now SMURD is a complementary service, with a lot of bases in the whole Romania, still expanding, that services the worst emergency cases in a good collaboration with the traditional Ambulance (Serviciul de Ambulanţă). Also HEMS (helicopter emergency medical system) has been implemented in three cities (Târgu Mureş, Bucharest and Iaşi) while in other cities the system is only ambulance based or in exceptional cases police and army helicopters are used.
The emergency system is based on the 112 emergency number, now used in Romania for all the emergencies (police, firefighters, ambulance).
History
Emergency medicine
Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...
. At this early stage, the new service, called SMUR or the Emergency and Resuscitation Mobile Service, was endowed with only one equipped intervention unit, which had no possibility of transporting the patient, the transport being left to be made by a vehicle belonging to the County Ambulance Service.
1991
In 1991, SMUR received its first mobile resuscitation unit, donated from GermanyGermany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
. This unit brought a higher level of pre-hospital medical care, and easier one.
Until October 1990, the new system has functioned entirely based on volunteer work. The SMUR mobile unit's drivers were students at the Faculty of Medicine, physicians or Red Cross volunteers from Târgu Mureş. After failed attempts of cooperation with several institutions, in October 1991 an experimental period of time started, placing SMUR under the operative coordination of the Mureş Fire Department, which, at that time, was responsible for the employment of the drivers for the mobile unit, and to provide accommodation and training rooms for SMUR's medical staff. This experiment, which was to be a success and to become a permanent solution, was based on the models found in many countries in the world, where firemen are directly involved in providing of emergency medical assistance and first-aid. These models are functional in Germany, France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
, Luxembourg
Luxembourg
Luxembourg , officially the Grand Duchy of Luxembourg , is a landlocked country in western Europe, bordered by Belgium, France, and Germany. It has two principal regions: the Oesling in the North as part of the Ardennes massif, and the Gutland in the south...
, the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
, Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
, etc. In this new functional structure, SMUR was guided by the Anaesthesiology and Intensive Care Clinic from the medical point of view and by the Fire Department from the operative point of view.
1992
In 1992, SMUR kept on progressing, concentrating on the training of the mostly volunteer personnel and on developing international relations with similar services from other countries. The first countries to establish a long term cooperation, even from 1992 were Great Britain and Norway. The Norwegian Red CrossNorwegian Red Cross
The Norwegian Red Cross was founded September 22, 1865 by prime minister Frederik Stang. In 1907 the Norwegian Ministry of Defence authorized the organization for voluntary medical aid in war...
from Sauda
Sauda
is a municipality and industrial town in Rogaland county, Norway. It is part of the region of Ryfylke. Sauda was separated from Suldal in 1842...
started their support by donating SMUR mobile units and emergency medical equipment and the Emergency Service of the Royal Hospital in Edinburgh and the Strathclyde
Strathclyde
right|thumb|the former Strathclyde regionStrathclyde was one of nine former local government regions of Scotland created by the Local Government Act 1973 and abolished in 1996 by the Local Government etc Act 1994...
Fire Brigade in Glasgow
Glasgow
Glasgow is the largest city in Scotland and third most populous in the United Kingdom. The city is situated on the River Clyde in the country's west central lowlands...
have started an intensive support program for the development of emergency medical assistance and for the training and endowment of firemen in new fields, such as extrication and chemical hazards. In November 1992, following a training period of 3 weeks, with trainers from Germany, the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
, Scotland
Scotland
Scotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the...
and the United States, an exercise was performed to which were invited to participate the representatives of several Ministries and institutions. Following this exercise, the Minister of Health declared, by the Decision No. 1094 of November 5, 1992, the new system functioning in Târgu Mureş as the National Pilot Centre. This new status was to protect the new model, in the years 1993-1997, against the high level of opposition and the attempts to shut it down.
As a part of the training in 1992, the first laboratory for emergency training was donated by the Foundation for Open Society, United States.
1993
In 1993, after SMUR had functioned for about two years providing emergency assistance in pre-hospital, a great development phase started in May, with the support of the colleagues at the Emergency Service of the Royal Hospital of Edinburgh. This development was the creation of the Intensive Care Room at the Mureş CountyMures County
Mureș is a county of Romania, in the historical region of Transylvania, with the administrative centre in Târgu Mureș.-Geography:The county has a total area of 6,714 km²....
Clinical Hospital, designed to continue the treatment of critical patients brought in by SMUR or arrived through other means, until their admission to the hospital's departments. The new Intensive Care Room staff members were the doctors, medical assistants and volunteers who worked in the pre-hospital emergency units. The new Intensive Care Room reduced the mortality within the Emergency Room of the Mureş County Hospital by approximately 50%.
Also in 1993, the Strathclyde Fire Brigade in Scotland has donated the first mobile extrication unit to the Mureş Fire Department, training the personnel within the Fire Department for the efficient and accurate use of the equipment. The first intervention the unit responded to took place in exactly the same day as the donation ceremony.
Starting 1993, the Resuscitation and Emergency Mobile Service (SMUR) has become the Emergency Mobile Service for Resuscitation and Extrication (SMURD). Also in 1993, the first services following the Târgu Mureş SMURD showed up at Oradea and Sibiu, adopting the functional mode of the Târgu Mureş system.
1994
1994 was a very important year in the history of the development of emergency medical assistance in Mureş County and perhaps in the whole country. With the help of the Emergency Service of Edinburgh and of the London BBCBBC
The British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...
, the first Emergency Department was built, following the models in Great Britain and the United States. The new department or "Emergency Service" was placed in the yard of the Mureş County Clinical Hospital and started its activity on July 31, 1994. Building this Emergency Service took almost a month and gathered lots of working people, from Scotland and Târgu Mureş, from the Army, the Gendarmerie and the Fire Department, and from organizations and volunteers, all wanting to see the new service working as soon as possible.
From the Fire Department point of view, 1994 has brought a new activity. The Scotland firemen endowed and trained the Mureş firemen for chemical hazard interventions, creating the first operative unit of this kind in all the Fire Departments of Romania. Alongside the firemen, doctors from SMURD attended the training programs.
1995–1996
In 1995 and 1996 the system continued its development, especially in the field of training and professional growth of physicians and medical assistants coming from all corners of the country. In 1997 alone in Târgu Mureş approximately 250 doctors, medical assistants and firemen were trained, and in 1998 this number surpassed 300.In October 1996, the Military Fire Corps Law no. 121 was promulgated by the President. For the first time in Romania, in this law at articles 9 and 18.k it was established that Military Firemen have a duty to provide emergency medical assistance and extrication. This law has put the system within legal boundaries after an experimentation period of approximately 5 years. Consequently, the Emergency Mobile Service for Resuscitation and Extrication was named the Intervention Station for Emergency Medical Assistance and Extrication (SIAMUD). In Mureş County, currently both names are in use, SMURD or SIAMUD.
1997
In 1997 and following a series of intensive training programs in the field of catastrophe medicine with the help of our colleagues in France, the Fast Response Group was created; it includes a number of 25 people wearing pagers which allow their calling in at any time in case of serious accidents. In 1998 this group was called in for the intervention on multiple victims accidents. The training in this area is continued with the help of the French Embassy in Bucharest, which is financing an annual training program in catastrophe medicine. Also in 1997 a new joined dispatch was founded, working for both the County Ambulance Service and SMURD. It is located within the Emergency Department and is staffed by County Ambulance Service personnel with the support from SMURD.1998
In June 1998 a public fund-raising was organized, destined to gather funds necessary to purchase a new intensive care mobile unit, fully equipped. This fund-raising continued until December 1998 and was finalized with the acquisition of the most modern intensive care unit in Romania, at the cost of 183,000 DM, fully equipped by Miesen - Germany. The entire amount collected was donated by the people and the companies in Mureş County. The success of this project was and still is a measure of the community's perception of the SMURD activity.
Future plans
Now there are 2 SMURD stations (helicopters) with Eurocopter EC 135Eurocopter EC 135
The Eurocopter EC135 is a twin-engine civil helicopter produced by Eurocopter, widely used amongst police and ambulance services and for executive transport. It is capable of flight under instrument flight rules .-Development:...
s, one based at Târgu Mureş, and the other at Bucharest
Bucharest
Bucharest is the capital municipality, cultural, industrial, and financial centre of Romania. It is the largest city in Romania, located in the southeast of the country, at , and lies on the banks of the Dâmbovița River....
; there is also a SMURD helicopter rescue service at Iaşi
Iasi
Iași is the second most populous city and a municipality in Romania. Located in the historical Moldavia region, Iași has traditionally been one of the leading centres of Romanian social, cultural, academic and artistic life...
but its helicopter crashed in January 2006.
For the future the health ministry intend to expand to all the counties of the country the SMURD service, and to acquire another 2-3 helicopters.