Emergency medicine in Slovenia--emergency center, prehospital emergency medicine and academic emergency medicine.

Public health service is organized in such a manner so as to ensure all the inhabitants of the Republic of Slovenia the emergency medical assistance available at all times, including emergency transport and provision of emergency medicinal products as soon as possible and as close to the date of their manufacture as possible and during transport. Emergency medical assistance means the implementation of necessary measures by doctors and their teams with persons whose life is imminently threatened due to illness or injury and persons, respectively, who could be affected by such a risk in a short period of time according to the symptoms. Emergency calls are received and processed by the emergency medical assistance service which forms an integral part of the public health service network. Emergency patients with life-threatening trauma or disease are treated by prehospital emergency physicians at the scene and during transport. Emergency patients are guaranteed to be reached by an appropriate emergency vehicle and a respective crew within 10 minutes in 80% of the responses and within 15 minutes in 95% of cases. In Slovenia was established 30 years ago the so-called Franco-German system, with a highly developed pre-hospital emergency physician service and interdisciplinary hospital-based emergency medicine on different departments (trauma center, department for internal intensiv medicine, department of ananstesiology, department for neurology and pediatrics department (1). This gap is now closing fast because of the rapid advancement of hospital-based emergency medicine in Slovenia. In-hospital emergency medicine has been reorganized in many hospitals during the last few years. Economic and quality arguments have initiated the development of departments for emergency medicine in Slovenia. In the future, this will lead to new qualification criteria for physicians working in these departments. Four specific recommendations for development and organizations emergency medicine are required: the recognition as a specialty, the specialist training programme, the professional organization of emergency physicians and the presence of academic emergency centres (2). Slovenia is one of the 11 European countries who recognize hospital-based emergency medicine as a specialty (3, 4). This is 5-year specialty training (based on European curriculum) and the curriculum follows a symptom-oriented approach to emergency medicine, and includes a skilled description of the key competencies of the future trained emergency physicians (4). Slovenia has very well organised prehospital on-physician based emergency service and new qualification criteria for those physicians in emergency departments, therefore, need to be developed with primary education trainers for emergency medicine. In the model of integration of prehospital and hospital emergency medicine in academic emergency centers, emergency physicians work equal in ED and in the field on the method of rotation without changes of actual prehospital on-physicians based EMS.The integrative model have one in-door for emergency patients, mobility ofprehospital emergency physicians, a nurse-driven triage system and support of primary care physicians as gatekeepers.