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Mobile Service of Emergency and Resuscitation (SMUR)
from the Alpes-Maritimes
The Mobile Service of emergency and intensive care (SMUR) is the structure of prehospitalian intensive care which intervenes, apart from the hospital, at the request of the regulating doctor of the SAMU.
Two types of intervention are carried out by the SMUR teams:
The CHU of Nice thus carries out the transfer of patients coming from public or private hospital complexes of Antibes, Cannes, Grasse, Draguignan, Menton, Monaco, Fréjus Saint-Raphaël as well as Corsica.
Each team which intervenes has according to the nature of the intervention:
Une équipe SMUR spécialisée pédiatrique est également disponible H24. Sa mission est d'assurer les transports de néonatalogie.
A SMUR team specialized in pediatry is also available H24. Its mission is to ensure transport of neonatalogy (it carried out the transport of more than 144 new-born in 2002).
SMUR Team remains in permanent contact, in particular by radio, with the SAMU and the regulating doctor.
Once arrived on the spot of the intervention, after examination of the victim, the doctor implements the suitable treatment and informs the regulating doctor of the SAMU.
According to the state of the victim, of his desire and of the availabilities of reception of the hospitals, the regulating doctor decides on the patient orientation towards the hospital likely to receive him.The hospital will be informed of its arrival.
The intensive care teams of the SMUR are likely to implement sophisticated technics of anaesthesia-reanimation (general anaesthesia, methods of particular assisted ventilation, transport under intra-aortic balloon of counterpulsation…).
The SMUR staff of Nice is composed of:
Radioelectric means of the SMUR of Nice:
Average mobiles of intervention of the SMUR of Nice:
The SAMU 06 established with the CHU of Nice has a departmental vocation. Concerning the medicalization of the emergency calls, it gathers, by convention, the whole of the departmental SMUR.
Like all of the CHU, the SAMU disposes of a SMUR (the SMUR of Nice) which is located in the buildings of the SAMU 06.
The other departmental SMUR of the Alpes-Maritimes are:
In January 1998, the Alpes-Maritimes Prefect, entrusted to the SAMU 06 the responsibility of the regulation and organization of the medicalisation of the operations of mountain emergency.
Thus, in accordance with its lawful mission, the SAMU 06:
By convention with the Company of the Alpes Maritimes Emergency Mountain service, the radioelectric SAMU 06 networks (15 relay) and Help in Mountain (5 relays) can be inter-connected to facilitate the operations of help in mountain.
With the organization of permanent Emergency Mountain service (CRS 06 or the PGHM, in alternation one week out of two, reachable by only one number the: 04 97 22 22 22) SAMU 06 ensures a 24h/24 listening network radio operator Help in Mountain.
The first-aid mountain team of CRS 06 and the High Mountain military police group (PGHM) as well as the chief trackers of the Alpes-Maritimes ski resorts also have a direct access to the radio operator network of the SAMU 06.
The Alpes-Maritimes Company of Emergency Mountain service and the SAMU 06 filed out the 7 refuges kept by the first aid French Alpine Club:
Thus, when a problem occurs, the guards of the refuges can contact the SAMU 06 per radio.
A dialogue pursues between the guard and the regulating doctor, and, according to the gravity of the call, a decision is taken:
A specific “first aid” training is given to the refuges guards by the SAMU 06 doctors.
Two physicians of the SAMU 06 are included in the Medical Group in perilous environments of Alpes-Maritimes.
The July 22,1987 law allows for the estabishment of emergency plans. The plan, called “RED PLAN”, intended to carry help to many victims is the most frequently implemented emergency plan.
Primarly, it attempts to organize the help chain, in particular, at the medical level.
The SAMU 06 and the departmental SMUR are the fundamental elements of their implementation.
Essencially, once the release of an alarm, the SAMU 06:
On the spot, the SAMU 06 medical teams participate with the other actors concerned in the medicalisation of the help:
The Medical Director of the SAMU 06 or his representative fills the function of Director of the Medical Helps (DSM) if the Prefect of the Alpes-Maritimes deems it necessary.
The transporting of victims is accomplished with the assistance of the departemental SMUR means, the means of the Firemen of the Departmental Service of Fire and Help (SDIS 06), of officially agreed first aid associations and the private companies of medical transport approved by the Prefecture, and, required if necessary as well as the helicopter available means (civil safety, military police…).
In accordance with the December 24,1987circular, the publicly-owned health establishments worked out an internal plan of organization intended to withstand a surge of victims (commonly called White Plan).
The SAMU 06 intervened these last years within the framework of these Red Plan releases on several occasions:
The SAMU currently takes part in the exercises intended to test the various aid plans of the Alpes-Maritimes department (airport, tunnel, emergency plan in case of a shipwreck, mountain help plan, risks NRBC at the time of an attack...).
The batch of the second generation Mobile Medical Station (PSM II) is a medical and technical material batch placed at the disposal, by the Senior official of Defense near the Health Ministry, near a certain number of hospitals distributed on the national territory and intended to be implemented in the event of catastrophic events in France or abroad.
It ensures the caring of more than 500 wounded during 48 hours and can also be placed at the disposal in reinforcement of a hospital.
A lighting batch, a heating batch and an autonomous radio operator batch supplement this equipment.
Equipment for exceptional situations:
Since 2008, the CHU of Nice has been endowed by the HFD of the Ministry of health of a hospital decontamination unit brand "Utilis MDC module 30".
It is designed to decontaminate up to 30 victims at the time, valid/invalid, men and women separately in case of chemical accidents, biological, nuclear, industrial, terrorist attack or war.
Immediately available in a trailer for the decontamination of the University Hospital or within a department or area (reinforcement possible at the request of SAMU Zonal), it protects the health facility of contamination of staff and patients, ensuring a "SAS decontamination" upstream of medical care.
Staff SMUR Nice is regularly formed and trained in assembling the 54m2 module, and specific medical management of victims contaminated with a toxic chemical, biological or radiological.
The catastrophes cause not only physical injuries but also individual and colective psychological injuries, immediate or differed, acute or chronic wounds.
These victims require ermergency care just as much as the physical casualties.
The fast intervention trained psychiatrists, psychologists and nurses, have to ensure an immediate and post-immediate therapy. This therapy must be extended to the psychological support of the families of the victims as well as to the rescuers.
In the Alpes-Maritimes department, a Médico-Psychological emergency cell, integrated into the SAMU 06, was put in place in 1997. It is coordinated by an hospital psychiatrist of the Nice CHU, Doctor Michel BENOIT ( departmental referent of the médico-psychological emergencies which organize this psychological assumption of the victimes, the families of the victims and rescuers.
This organization is based on a departmental list of volunteers doctors, psychiatrists, psychologists and nurses. When the activation of the CUMP was decided (usually when the launching of a help plan takes place) the mobilized health professionals join the SAMU 06.
Specific equipment (uniforms, means of communication, case of intervention…) is placed at their disposal. The first team constitutes a médico-psychological antenna of help composed of a psychiatrist, a psychologist and a nurse. It is integrated into the elements of the SAMU 06 intervention and conveys on the spot of the disaster.
These provisions are gradually integrated into the various help plans of the Alpes-Maritimes, progressively with their revision.
This cell intervened on several occasions since its installation and takes part in different exercises with the SAMU 06 (red plan, airport plan, avalanche plan, shipwrecked men pan…).