Impressions

Editor Comment: There are ten of us here in Croatia from four different EMS groups in MN. The posts you will see here are from all of us. We have taken the approach of sharing our story through our impressions - with the physicians generally commenting on clinical medicine, the operations leaders on ops, etc. That said, we are one team and if we slip into "first person" language consider it coming from the entire team.

Here are some initial thoughts.

Our hosts have been extraordinarily hospitable. We spent our first full of work day sharing information about their system and ours at day-long meetings at the Zadar EMS Institute. Zadar is on the Dalmatian Coast in the south-west part of the country. The weather is warm if not downright hot (30 C, mid 80's to 90 F). They tell us there are two climates in the country, continental in-land, and Mediterranean here on the coast where we are.

Our EMS systems are difficult to contrast directly because we are at such very different points in our development. However, we can tell you that while we are very proud of many aspects of our system in MN, we definitely have things to learn from our Croatian colleagues. I'll let our operations folks comment further but here's a few things to consider.

Emergency Medicine is relatively new to Croatia - which they call the land of 1,000 Islands (1,246 in fact) 67 of which are inhabited and need EMS services.

EMS is under a significant government reform - much of it sponsored by the World Bank following the war that took place here less than 20 years ago - more to come on that later. Before reform the Croatians themselves describe the system as "lousy". Good in big cities but disjointed with many left out, no standards or supervision. Administration Reform started 2009 - operational reform in 2011.

By our first accounts we can tell you that they have made great strides in a very short time. The system is governed by the Federal Government - the Croatian Health Ministry.

Staff members of the ambulance are primarily Physicians, and Nurses and medical technicians. They do not yet have a paramedic level of practitioner comparable to the US.

Emergency departments have not always existed within Hopsitals but are now being developed in all hospitals in the country.

Did you know the Dalmatian Coast is indeed associated with the spotted dog? St. Paul Fire Chief Tim Butler is trying to figure out how to get one in his suit case when we return home.

The Neck Tie was invented here, and the inventor Tesla is a national hero. And even though Leonardo Divinci is credited with making the first known drawing of the parachute, it was here in Croatia that was actually built and tested (no word on the EMS response that followed that first jump).

Our days ahead are filled with numerous meetings, discussions, tours and yes some fun like site sighting tours to the islands, 911 center (194 here in Croatia) and formal meetings with government leaders.

We are honored to be representing Minnesota and building stronger bonds with our Croatians colleagues as well as with our MN partners.







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