Emergency medical services in Italy

[1] Emergency medical services are under Public Health Authorities control in each Italian Region; the ambulance subsystem is provided by a variety of different sources.

In some locations, responsibility for the provision of EMS has been undertaken by the local hospital, while in others, services may be provided by a range of volunteer organizations, such as the Italian Red Cross (Croce Rossa Italiana),[3] ANPAS (National Association for Public Assistance),[4] Confraternite di Misericordia, or by private companies.

There is a great deal of variation in the training of EMS personnel in Italy like in many countries, where no distinction is made between volunteers and paid EMTs.

Italian EMTs are able to provide non-invasive prehospital care, including PBLS, PTLS and automated external defibrillation.

[7] In few regions EMTs are also trained to assist nurses or physician with endotracheal intubation, to establish venous access, to aspirate drugs and to execute a 12 lead ECG, which will be transmitted to the hospital or to the 118-operations room, where a cardiologist can examine it before the arrival of the patient.

While there are some ALS ambulances in Italy, they are typically not found outside larger centers, and in many cases, where they do exist, they are frequently required to have the 'emergency' physician present to perform ICU skills, in a manner very similar to the other neighbouring countries.

Emergency medicine is only now becoming slowly recognized as a medical specialty inside the hospital in Italy,[8] and there are no real plans to create a subspecialty for pre-hospital care.

Poor compensation and hours of work have reportedly resulted in a relatively high turnover rate among physicians in the system.

In order to do so, ambulance and emergency stations, with paid crews or volunteers, must be located at least in a minimum range of 5 km.

The queues are therefore mainly due to the absence of local structures and community medicine services capable of quickly and free of charge managing non-emergency situations that end up in the Emergency Rooms.