The state and future of emergency medicine in Macedonia

Nicks, Bret A.; Spasov, Marko; Watkins, Chris

doi:10.5847/wjem.j.1920-8642.2016.04.001

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…This case report describes a novel and significant development in emergency medicine in the Republic of Macedonia. Multiple rib fractures resulting from blunt thoracic trauma are commonly treated through conservative means for socioeconomic reasons and because of limited health insurance coverage [ 1 , 2 ]. To this end, the successful management of multiple rib fractures based on thoracotomy and surgical fixation is unique to our country.…”

Section: Discussionmentioning

confidence: 99%

“…In the Republic of Macedonia, market reforms and public incentives have been in place to improve the efficiency and quality of primary health care since the fall of former Yugoslavia [ 13 ]. However, despite these measures, emergency and trauma medicine is poorly established [ 1 ]. Shared efforts and infrastructure across public and private sectors can help to promote advanced clinical practice and innovation in medical science.…”

Section: Discussionmentioning

confidence: 99%

“…The public healthcare system in developing countries struggles to follow international clinical guidelines because of inadequate medical infrastructure, lack of expert medical staff, and limited financial means. Emergency and trauma medicine are limited in developing countries such as the Republic of Macedonia [ 1 , 2 ]. Consequently, trauma injuries remain a significant source of morbidity and mortality, in contrast to other Western countries [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Surgical plate fixation of multiple rib fractures: a case report

et al. 2018

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BackgroundThe healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit.Case presentationWe admitted a 41-year-old Albanian man to our emergency department following a pedestrian-vehicle accident 5 days earlier. He presented with severe upper thoracic pain, chest deformity, dyspnea, tachycardia, subcutaneous emphysema, and hematoma. Chest radiography pointed to hypoventilated lung fields and a minor pleural effusion. Computed tomographic scans indicated displaced fractures of right lateral ribs 5 –11, hyperdensity regions from bone fragments, and pulmonary contusion. The treatment consisted of surgical fixation of ribs 7–10 using titanium reconstruction plates and cortical locking screws. The patient’s clinical condition rapidly improved postoperatively. Follow-up at 6 weeks confirmed a full return to preoperative daily activities and a high quality of life.ConclusionsIn this case report, we present a novel and promising development in the field of trauma medicine in the Republic of Macedonia. Trauma injuries can be treated via advanced multidisciplinary medical care according to international standards, allowing optimal health recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical plate fixation of multiple rib fractures: a case report

et al. 2018

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“…The World Health Organization (WHO) in a systematic review of 59 low- and middle- income countries emphasizes the ongoing need to strengthen triage as a crucial requirement for efficient resource allocation and effective emergency intervention [ 3 ]. In upper middle-income countries such as Serbia, Bosnia, Herzegovina, and the former Yugoslav Republic of Macedonia (FYROM), the demand for emergency care has been growing, and the need for continuous strengthening of emergency care systems has been recognized [ 4 , 5 , 6 ]. The Clinical Centre of Serbia (CCS) located in Belgrade is a 3500-bed medical university center that serves the population of Belgrade and larger Serbia.…”

Section: Introductionmentioning

confidence: 99%

Strengthening Emergency Care Systems to Mitigate Public Health Challenges Arising from Influxes of Individuals with Different Socio-Cultural Backgrounds to a Level One Emergency Center in South East Europe

Twomey¹,

Šijački

Krummrey

et al. 2018

IJERPH

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Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is particularly pertinent as the influx of people seeking asylum or in transit mostly present with emergency care needs or first seek help at an emergency center. Triage not only reduces the risk of missing or losing a patient that may be deteriorating in the waiting room but also enables a time-critical response in the emergency care service provision. As part of a joint emergency care system strengthening and patient safety initiative, the Serbian Ministry of Health in collaboration with the Centre of Excellence in Emergency Medicine (CEEM) introduced a standardized triage process at the Clinical Centre of Serbia (CCS). This paper describes four crucial stages that were considered for the integration of a standardized triage process into acute care pathways.

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