Dovidjenja

Goodbye Croatia.

Sitting in the Zagreb airport awaiting our flight home. Our entire team has been very pleased with the success of our trip.

Last Night in Croatia

Our last night to a very successful trip. We have made connections and built relationships that will last for years. We are all very excited to have our new friends and colleagues come visit us in MN. We will be asking those of you reading this blog to join us in welcoming them and we are sure that as we have, you too will develop lasting friendships and professional affiliations. 

Zagreb

This morning we left the scenic slowed-pace beaches of Zadar and traveled to the capital city of Zagreb. The two cites have a very distinct look and feel. Zagreb is a busy urban city of approx. one million people with crowed streets and heavy traffic. One can clearly sense the energy of the city as celebrations are already underway to mark the occasion of Croatia joining the European Union, which officially occurs Monday. We've been cautious not to make much of the entree into the EU as it's been obvious it is a political issue here, with some people welcoming the new partnership and a larger role on the world stage, and others expressing some trepidation.

Soon after we arrived in the city we were welcomed to the national emergency management center (DUZS)'for a briefing about their system. This included a tour of the dispatch (112) center. A gentlemen from the US Embassy joined us for the meeting, and it turns out that he is from Woodbury MN, stationed here in Zagreb.

Afterward, two of our three Croatian hosts left to return to Zadar - a sad parting, as they have been so gracious to all of us. Tomorrow morning we'll leave Croatia to return home.

We look forward to our partners visiting Minnesota in September.

Farewell Dinner In Zadar

The Deputy Governor of Zadar County hosted our team for a farewell dinner this evening. As you can see we shared a meal and great conversation on the shores of the Adriatic Sea.

As has been previously mentioned, the sunsets of the Dalmatian Coast are among the most spectacular in the world, and tonight was no exception.

We are all feeling melancholy about leaving this beautiful place inhabited by such warm and genuine people. At the same time each of us are looking forward to returning home and seeing our own families whom we have missed.

We are already making preliminary plans to host an EMS team from Zadar in Minnesota come mid-September.

This has been an extraordinary experience. Tomorrow morning, it's a three hour drive on to Zagreb for a series of meetings. Then On Friday, Paris, Atlanta and Minneapolis.

The Pathology is the Same....the Umbrella's are Not

One of the things we have learned is that the pathology which Croatian EMS providers encounter is no different than what we treat in the US. However, the equipment used to treat patients is often quite different. For example every ambulance in Zadar has an advanced ventilator with a digital display. They can perform volume control ventilation in both assist control and SIMV modes. CPAP is also available but only for intubated patients as NIPPV masks are not routinely available. It turns out the Umbrellas are quite different too! The operation captured in the attached picture almost resulted in several "112" calls. Have you heard the joke " a doctor, an emergency manager and a hospital administrator try to put up a beach umbrella......"

Long Distance Transports

Just like in the United States the EMS transport times from the scene to a hospital can vary considerably throughout Zadar. One of the ways in which the Zadar EMS system addresses this variability in transport times is by adjusting the medications available to the physicians and nurses on the long distance ambulances. For example, EMS providers on the island of Preko have access to intravenous antibiotics including gentamycin which are not routinely available in other ambulances in the county. Research has demonstrated that the time to antibiotic administration in septic shock directly affects the mortality of the patients so decreasing the time to administration by providing antibiotics to front line providers in remote areas makes sense. This is but one of the many examples of things we have learned from our exchange which we may incorporate into our EMS practice back home.

Describing E.M.S. in the U.S.

On Monday afternoon a few of us had the opportunity to present how E.M.S. works in the U.S. and in particular, Minnesota. In attendance were nurses, technicians, and a physician from area ambulance bases in Zadar County. Those who were present were excited to learn about the similarities (and differences) that our two systems share, albeit from 5,000 miles away.

The presentation allowed for an idea on how the development of pre-hospital care in the United States came to be. Through the history of the first, "Battlefield Medic" and exposure to the Television show, "Emergency" with firefighter/paramedics, "Johnny and Roy", we also guided the presentation into our current system of operations and the ongoing development that the E.M.S. industry has experienced these past 40 years. Other topics discussed were definitions of EMT's and paramedics, along with the education requirements and scope of practice that each level of provider is allowed to perform under the direction of an emergency physician. The information was well received by all and brought about some fantastic observations that identified similarities and differences in our systems.

What was clearly apparent and unmistakably similar, was the desire to care for people; keeping them healthy, safe, and recipients of the best care that each of our services can provide to them. Within the room of the presentation, there was no doubt that we all recognized that we are members of a nobel and prideful profession. No matter the language that was spoken, or the land upon which we stood, EMS providers shared in a common bond that we will ALL forever hold in high regard.