Experience of the Center for Emergency Medicine of the University Medical Center in Sarajevo and principles of the emergency medical care system

: In siege and blocked Sarajevo, in 40 months, in primary care unit and than in Emergency Department 42,075 injured and ill persons have got the first aid. Out of that, 37% were injures 16% acute surgical conditions, 23% internal urgent conditions (since October 1994). There were 24% non-urgent cases from the surgical field. In this period of time 107,453 patients were treated hospitably, with an average of 2.108 hospital beds. In 1996, the primary care was given in 21,708 urgent cases, or 60% of 36,312 hospitably treated persons in total. There were 29% injuries, 24% of acute surgical cases, and 47% of internal medicine cases. Urgent centre received 53% individual paints who came by themselves without any medical aid; 25% from health centres where they have bog a primary care, and 22% came after received first aid of primary care in the Emergency department. By applying war surgical doctrine and general medical doctrine, with appropriate services for prompt diagnostics and treatment, with qualified specialists and consultancy services, a good quality of adequate treatment and care has been achieved, the mortality has been reduced, the hospitalisation has been rationalised, and treatment length has been reduced. Analysis demonstrates the reasons for existence of such medical centres in large hospitals. We have recognised the problems we are facing with, and which have to be solved progressively, as well as those concerning the functioning health services in Sarajevo Canton, and Federation of B&H. On the basis of all these knowledge's we believe that a well organised urgent medicine implemented in practice has great importance in the overall treatment. Basic objectives for establishing the urgent medicine as a system are: The first priority is to organise a modern system of urgent medicine, based on the principles of general medical doctrine and complementing with health care system. Urgent medicine programme should be incorporated in the process of medical education of the medical staff, giving a priority to the activities in practice. Provide modern equipment and adequate working space. Develop already developed co-operation with institutions and professionals from Europe and USA. Improve the low level of the first aid training of the population through the first aid courses.