The Division of Advanced Internal Medicine with a Coronary Care Unit is located in the old internal medicine building together with the Internal Medicine Emergency Room and Cardiology Department. The same building houses the ergometry and echocardiography clinics staffed by cardiologists from the Sisak General Hospital (GH). The department has ten beds, but this number can often rise to twelve because patients from the day hospital who require monitoring are also cared for at the department. These are most often patients diagnosed with paroxysmal cardiac rhythm disturbances, anaphylactic reactions, and syncope and intoxication with medications or alcohol.

As the name of the department indicates, in addition to cardiological patients the department also treats patients diagnosed with gastrointestinal bleeding, sepsis and septic shock, pulmonary embolism, pulmonary edema, pancreatitis, ketoacidosis, etc. All patients are monitored and under 24-hour supervision by physicians and nurses working at the institution. Physicians working at the department are educated in and perform central venous catheter implantation as well as implantation of dialysis catheters and temporary pacemakers. The department is equipped with all medical devices needed for respiration, from defibrillators to respirators. Patients are cared for by eighteen nurses, of which nine are vocational school graduates, eight have a bachelor’s degree in nursing, and one is a nursing graduate, in addition to three cardiologists. Given the lack of physicians with the required training and education to work in the coronary unit, the department is also covered by physicians with other specializations during holidays and for call duty when the department’s physicians are not available.

Prior to the founding of the Croatian Network for Interventional Treatment of Acute Myocardial Infarction, patients with acute myocardial infarction (AMI) were treated with fibrinolysis with good results and low incidence of side-effects. Today this form of AMI treatment is only applied when transport of patients to the interventional center in the city of Zagreb is not possible, with alteplase is the treatment of choice. After the network was founded, the Sisak GH worked in cooperation with the University Hospital Centre (UHC) Zagreb until 2007, whereas after 2007 patients with AMI are transported to the UHC “Sestre milosrdnice”.

Upon admission of a patient in whom the diagnosis of AMI is suspected, the department staff performs all the necessary procedures to establish the diagnosis. Transport of the patient to the other institution is arranged by cardiologists from both institutions, and the patients receives all necessary treatment before transport. The patient is transported using an ambulance vehicle staffed by a nurse and usually accompanied by a specialist physician from the Sisak GH. After percutaneous coronary intervention has been performed, patients are returned to the Sisak GH where they continue their treatment.

Although it is small and limited in funding, the Sisak GH and its staff strive to responsibly and professionally treat its patients regardless of their age and diagnosis. In the near future we will be introducing the Joint Emergency Hospital Admission system in the central pavilion building (Figure 1) which is currently under construction. We hope that our medical services will thus be further improved to the benefit of all our current and future patients.