[Organization of emergency medical care in Tuzla Canton]. / Organizacija hitne medicinske pomoci u Tuzlanskom kantonu.

The main duty for all health institutions and individuals is an organization and emergency medical care providing. The aim of this paper is to analyse the existing staff, equipment, facilities and emergency medicine organisation in 13 municipalities of Tuzla Canton. In this paper we have analysed 13 emergency medical services in Tuzla Canton: 1. Tuzla; 2. Banovici; 3. Celic; 4. Doboj-Istok; 5. Gracanica; 6. Gradacac; 7. Kalesija; 8. Kladanj; 9. Lukavac; 10. Srebrenik; 11. Teocak; 12. Sapna; 13. Zivinice. We have analysed the number of employed medical workers (doctors--specialists, general practitioners, senior medical technicians, medical technicians), ambulances and equipment (ECG, defibrillators, oxygen devices, intubation kits, aspirators) and communication system. Present situation is compared with standards and norms for every municipality, from our and heads' of units point of view, concerning equipment, staff and facilities for each unit. It is evident that the present situation is far from the needs concerning staff, equipment, facilities and emergency care organization in Tuzla Canton.

[Problems with organization and operation of emergency medical services in the post-war period in districts with a population of up to 60,000 inhabitants]. / Problemi organizacije i rada SHMP u poslijeratnom periodu u opcini do 60.000 stanovnika.

Demographic characteristics of Gracanica municipality:--Organization of the municipality on 15 local communities that are 5-20 km away from the centre of municipality.--Road conditions--Starting of industry within Gracanica municipality and social status of the employed population.--There are two main roads that are passing through the territory of municipality--These highways are passing through densely inhabited areas and traffic is heavy. Distance of Tuzla Clinical centre. Services of Gracanica Outpatient Department organize their work although lacking professional staff and equipment. Significance of Emergency Medical Service (EMS) for the municipality and broader community under these circumstances. Present EMCS organization in Gracanica is the following: EMS in Gracanica is organized as a separate service with three permanent teams and temporary engagement of 2 doctors who are on specialization in pediatrics and lungs diseases. A team comrising of a specialist of emergency medicine, three medical technicians and one driver works from 7.00 to 15.00 on regular working days and other doctors work at EMCS from 15.00 to 7.00 and on weekend as well. EMS doesn't examine patients outside the EMS rooms. EMS equipment consists of one ECG, one defibrillator, two aspirators, one oxygen concentrator and a resuscitation set. The Japanese Government donated equipment. Lack of intravenous solutions, drugs and other material for the emergency treatment is notified as permanent problem in emergency care service. Next problem is unsuitable and non-functional space with difficult access and lack of ambulances because the whole rolling stock was destroyed by shelling in 1992. In any case, all these circumstances diminish a team efficiency in providing emergency care. Even under these circumstances EMS had 10,415 examinations during the first sixth months in 2000, provided 45,265 services and treated 912 injuries out of which 64 were traffic injuries. Concerning the complicity of work in EMS Gracanica, standards and norms related to emergency medical care, which have been proposed by the Federal Ministry of Health couldn't be met. By these standards one team covers 20,000 inhabitants and EMS from 19.00 one day until 7.00 the next day and Saturdays and Sundays as well. The question is what to do between 15.00 and 19.00, when every Outpatient Department is closed? For normal functioning of EMS in Gracanica municipality we should do more work on the prevention and work organization in the surgeries of General Medicine in a distant local communities. In that way, EMS wouldn't be a surgery of General Medicine after 15.00. It's necessary to ensure an adequate space, professional staff (at least 4 teams with their leaders) new equipment, ambulances, medicaments, disposable material and furniture. It is necessary:--to develop a system of communication tha could cover municipality and Clinical Centre area,--make educational plan and to respect it,--to establish a cooperation with EMS in neighboring municipalities,--to discuss EMS role in relation to family medicine organization within General hospital in Gracanica.

[Personal experience in the organization of mass admission of traumatized refugees]. / Nasa iskustva u organizaciji masovnog prihvata traumatiziranih prognanih lica.

Here is showed experience and importance of Emergency Medical Service during mass reception of traumatised displaced persons from Srebrenica in July 1995. During organisation of reception a good willingness and experience of this service with repard a to fast action, examination and selection of more than 15,000 displaced persons. In short time, whole coming persons were examined; medicine treated and in other way cared. There were arranged, 234 doctor teams, 22 stomatologist teams, 42 laboratory teams, 42 hygiene-epidemiologist teams and 18 teams for vaccination of children. In the various pathology of coming displaced persons there were dominated: respiratory disease case and uncared skin infections in children, chronical cardiovascular disease and malnutrition in adults. For successful realisation of this complex tasks, like the organising of reception and medical care of huge number of traumatised displaced persons, it is needed to have well organised, qualified and technical equipped Emergency medical Service.