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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 at 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.
In 1991,SMUR received it's first mobile resuscitation unit, donated from Germany. This unit had brought a higher level of medical care in pre-hospital, and an 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, psysicians or Red Cross volunteers from Tg. Mures. 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 Mures Fire Department, which, at that time, was responsible for the employment of the drivers for the mobile unit, and to provide accomodation and training rooms for SMUR's medical staff.
This experiment, which was to be a succes and to become a permanent solution, was based on the models found in many countries in the worls, 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 vue and by the Fire Department from the operative point of vue.
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In 1992, SMUR kept on progressing, concentrating on the training of the mostly volunteer personnel and on developping international relations with similar services from other countries.
The first countries to establish a long term cooperation, even from 1992 were Grat Britain and Norway. The Norwegian Red Cross from Sauda started their support by donating SMUR mobile units and emergency medical equipment and the Emergency Service of the Royal Hospital in Edinborough 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, Holland, 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 Tirgu Mures as 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.
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As a part of the training in 1992, the first laboratory for emergency training was donated by the Foundation for Open Society, United States.
In 1993, after SMUR had functioned for about 2 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 Edinborough.
This development was the creation of the Intensive Care Room at the Mures County 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 Mures County Hospital by approximatively 50%.
Also in 1993, the Strathclyde Fire Brigade in Scotland has donated the first mobile extrication unit to the Mures 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 the exact 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 Tirgu Mures SMURD have shown up at Oradea and Sibiu, adopting the functional mode of the Tirgu Mures system.
1994 was a very important yaer in the history of the development of emergency medical assistance in the Mures County and maybe in the whole country.
With the help of the Emergency Service of Edinborough and of the London BBC, 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 Mures County Clinical Hospital and started it's activity in July 31, 1194.
Building this Emergency Service took almost a month and gathered lots of working people, from Scotland and Tirgu Mures, from the Army, the Gendarmery 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 vue, 1994 has brought a new activity. The Scotland firemen have endowed and trained the Mures firemen for chemichal hazard interventions, so creating the first operative unit of this kind in all Fire Departments of Romania. Alongside the firemen, doctors from SMURD have attended the training programs.
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In 1995 and 1996 the system continued it's development, especially in the field of training and professional growth of physicians and medical assistants coming from all corners of the country.
Only in 1997 in Tirgu Mures a number of approximatively 250 doctors, medical assistents and firemen were trained, and in 1998 this number went over 300.
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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 is established that the Military Firemen have the duty of emergency medical assistance and extrication.
This law has put the system within legal boundaries after an experimentation period of approximatively 5 years. Consequently, the Emergency Mobile Service for Resuscitation and Extrication was named the Intervention Station for Emergency Medical Assistance and Extrication SIAMUD. In Mures County, currently both names are in use, SMURD or SIAMUD.
In 1997 and following a series of intensive training programs in the field of catastrophy 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 catastrophy 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 was a very special year for SMURD Tg. Mures. In June that year, the Fire Dept. was endowed with an intervention boat , necessary for the drowning cases in the Mures river.
Only in August the same year, the Firemen and SMURD had 6 interventions using that boat.
In June 1998 apublic 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 aquisition 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 Mures County. The succes of this project was and still is a measure of the community's perception of the SMURD activity.
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