CRO_map



[accordion] [acc_item title=”General”] Capital – Zagreb
Land Size – 54,594 sq km
Population – 4,486,881
Language(s) – Croatian 96.1%; Serbian 1%; other undesignated 2.9%


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World Bank: Upgrades to the Emergency Medical System Saves Lives in Croatia
[/acc_item] [acc_item title=”Overview”]

  • “As in most countries the main restriction to positive change in the Croatian EMS is the limited resources available in an area where demand will always outstrip supply” (Hunyadi, 190)
  • Franco-German Model
    • “In pre-hospital EMS most of the doctors are inexperienced and have inadequate education in emergency medicine. These jobs are frequently considered as temporary prior to commencing residency training in established specialties” (Hunyadi, 188)
    • In past, surplus of medical school graduates were temporarily assigned to EMS units
      • Recent decline in medical school applicants will presumably lead to shortage of MDs in EMS
    • “Although there is a local expectation that physician staffed ambulances will continue to play a role in the EMS there is a need to bring other ambulance staff up to EMT and Paramedic level” (Hunyadi, 189)
[/acc_item] [acc_item title=”EMS System Model”]
  • Franco-German Model
    • Physician-staffed ambulances
    • On-call general practitioners
  • EMS Facilities & Response Areas
    • 4 major cities w/EMS Centers
      • Zagreb, Rijeka, Split, Osijek
      • Cover 35% of country’s population
    • County Health Centers
      • 54 total (as of 2003) – 24h service
      • 1-2 units w/addt’l unit for non-urgent transport
      • Cover 64% of country’s population
    • Smaller county health centers/health stations
      • Areas w/pop. <30,000
      • Provided by On-Call family physicians
      • Cover 2% of country’s population
    • “In smaller cities and rural areas, the EMS frequently serves as a substitute for the primary health care that should be provided by primary care physicians. This burdens EMS doctors with non-urgent care and leaves less resource for real emergencies” (Hunyadi, 189)
[/acc_item] [acc_item title=”Lead Agency”]
  • Ministry of Health and Social Affairs
[/acc_item] [acc_item title=”Funding”]
  • Nearly entire population is covered by tax-funded basic health insurance
[/acc_item] [acc_item title=”Levels of Care”]
  • 4 types of teams w/in EMS system
    • EMS Team
      • 1 MD w/min 1yr experience
      • 2 RNs w/EMS education and a driving license (1 nurse is also driver)
      • Diagnose/Treat/Coordinate w/other services & Transport if necessary
    • On-Call EMS Team
      • 1 MD
      • 1 RNs (is also driver)
      • Diagnose/Treat/Coordinate w/other services & Transport if necessary
    • Emergency Transport Team
      • 2 RNs w/EMS education and a driving license (1 nurse is also driver)
      • Transport from scene to facility w/ or w/o accompanying MD
    • Dispatch Units (See: Dispatch for duties)
      • 1 MD w/min 3yrs EMS experience
      • 1 RN w/min 5yrs EMS experience
[/acc_item] [acc_item title=”Education and Training”]
  • MDs & RNs are required to complete basic EMS education prior to working in field
    • Initial basic education – 70hrs MDs; 120hrs RNs
    • Continuing medical education – 30hrs MDs; 50hrs RNs
  • Croation Resuscitation Council – est. April 2002
    • Organizational and financial support by Croatian MOH
    • Early progress has been demonstrated toward improving care through various courses: ALS, ILS, BLS, EPLS
    • “There are plans to train policemen, firemen, flight attendants, security guards, and lay people” (Hunyadi, 189)

ŸHunyadi-Anticevic S: “EMS system in Croatia” Resuscitation 2006;68:185-91.
[/acc_item] [acc_item title=”Medical Direction”]

  • Definite need for patient care protocol standardization
[/acc_item] [acc_item title=”Specialty Services”]
  • HEMS
    • Has been organized by various agencies since 2000
    • Mainly used for interfacility and neonatal transfers, or as primary transport service during tourist season
    • Originally, helicopters were under-equipped and staff under-trained for emergency medical transports
    • Recent proposals have been made to upgrade HEMS, including 5 helo-bases to cover majority of geography
    • Also hoping to include available Mountain S&R teams
  • Public Education
    • “A public education campaign regarding the use of EMS, public access defibrillation and injury prevention is overdue” (Hunyadi, 189-90)
[/acc_item] [acc_item title=”Dispatch”]
  • Dispatch Units
    • Specialization takes 5 yrs (former plan to allow doctors with more than 10yrs experience to automatically become specialist was removed)
    • Take Call
    • Decide priority
      • Level 1 – Immediate
      • Level 2 – Urgent
      • Level 3 – Non-Urgent
    • Dispatch appropriate team
      • T1 team – MD, RN and driver
      • T2 team – RN and driver
    • Notify ED about patient arrival
    • Coordinate w/PD, FD and other agencies
    • Provide medical advice to callers
[/acc_item] [acc_item title=”Emergency Medicine”]
  • EM recognized as a distinct specialty since 2010
  • Significant advances achieved through a “World Bank-supported projectt [to improve] the efficiency and outcomes of Croatia’s Emergency Medical Services and at strengthening the capacity of the country’s Ministry of Health to develop and implement medical directives of the European Union”
[/acc_item] [acc_item title=”Disaster”]
  • EMS agencies work in coordination with Crisis Headquarters of the Ministry of Health and Social Affairs
[/acc_item] [acc_item title=”References”] [/acc_item] [acc_item title=”Links”] [/acc_item] [/accordion]
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Comments
  • kassay krisztián

    Cher leader!

    Recommander possibilités de coopération.
    Je parle hongrois et en anglais.
    Nous sommes en Hongrie, Budapest, Kecskemét, Veszprém et Kaposvar.
    Slovénie, la Croatie, Serbia, la Roumanie, l’Autriche, l’Allemagne peut bientôt se rendre à.
    Nous acceptons l’assurance, le transport international de patient, voiture internationale des cas.
    Les véhicules sont sur ​​les photos ci-jointes.
    Si oui, s’il vous plaît répondre dès que possible.

    Sincèrement chef Kassay Krisztian.

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