Large concentration of mines, unexploded ordinance and primitive infrastructure in post war Bosnia-Herzegovina poses difficulties in reaching the casualties within the “golden hour”.

As a part of the peacekeeping operation immediate response teams (IRT) are in place to save life and prevent further injury. We studied the efficacy of such a team in Sipovo, Bosnia. It depends on co-ordination between the chain of command and the IRT.

We retrospectively reviewed all our IRT call-outs at Sipovo from April 1999 till December 2001. We noted the response time and the priority state of the patients.

Weather conditions permitting the IRT call-outs has been by helicopter for priority 1 patients. There were 89 IRT call outs in the above mentioned period. The average response time from the call for help to the medical team reaching the patient was 75 minutes. Within that the average flight time was 45 minutes. The priority states at the site and of the casualties at the hospital are: Priority 1 at site 128, Priority 1 at Hospital 23, Priority 2/Priority 3 is 105, Medical Emergencies is 15, and Priority 4 being 9.

The suggested priority state was overestimated in 82% percent of the patients. There was a conflict between the chain of command and clinical judgement resulting from multiple levels of communication. However we felt the presence of the IRT was not only clinically efficacious but an important factor in uplifting the morale of the peace keeping force.