# Italian EMS



## Jac [ITA] (Jan 4, 2009)

First of all a little disclaimer: I'll try to be as complete as possible but due to the difference between city and city what I'm going to write can be partial and not applicable to every city in Italy.

The first thing that I want to underline is that all EMS is preformed by volunteer. Well, not all but say the 90% of people in the ambulance are volunteer. There is a little quota of paid employees but is only to backup the volunteer work. 

Said that how is organized the system of prehospital emergency care. In Italy the dispatcher is not the same for all emergency agency: there is the police dispatcher, the fire dispatcher, and the EMS dispatcher. Everyone of this has its own number to dial. So if you need fire you dial 115, need an ambulance dial 118 and so on. This means that the inter agency cooperation is a bit slow. For example: in case of a building fire the citizen call 115, fire dispatcher, they send the fire engine then the fire dispatcher call the ambulance dispatcher to request ambulance. 
Another problem is when the police is needed, reading this forum I understand that often the PD is on scene before the ambulance, in our reality the ambulance crew has to ask for police back up when on scene. 

In details how the call for help works? The citizen call 118 (EMS dispatcher called _centrale operativa_ "central"), explain the situation, the dispatcher choose a color code for the run (the color could be green, yellow, and red you know what they means  ) then call via telephone the ambulance company and send them to the scene. If the code is red we turn on lights and sirens otherwise we ride quietly. If the code is yellow it can be "promoted" to red for traffic by asking the dispatcher via radio. When the ambulance is on scene take care of the patient and load him for the hospital. Then we communicate with the central to inform of the destination hospital. 

Who is on board of the ambulance? As I said before there is only volunteer. So the ambulance are almost all BLS ambulance because we are not enabled to use IVs, administer drugs or make any kind of diagnosis. But there is also the "_ambulanza infermierizzata_" that is an ambulance with a registered nurse in addition to the volunteer so he/she can use IV and other "advanced" instrumentation. 
If a physician is needed the "_automedica_" (physican-mobile) can be dispatched. The _automedica_ is a car with a driver, an emergency physician and a nurse. It cannot transport the patient so it's always dispatched with an ambulance, or they meet directly on scene. The _automedica_ is our ALS unit. 

That's all, I've tried too give an overview of the organization but it's a large topic so fire your questions so I can be more specific!  

If you want see some photo of our ambulance go here for Verona or here for all Italy


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## Airwaygoddess (Jan 4, 2009)

*Amazing!*

WoW!  That is an amazing that 90% of all of EMS is vollie and I know that you service is very busy!  I am so happy that Matt has started this section for "all over the world" EMS   Welcome to the tribe!!  Cieo!


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## artman17847 (Jan 4, 2009)

WOW!! Thats how it was back in the early days of EMS in the USA. Having to pick up nurses and doctors.


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## phabib (Jan 5, 2009)

How many hours of training did you need before getting on an ambulance? Also, do you think workers will want to be paid in the near future? (especially in larger cities.)


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## Jac [ITA] (Jan 5, 2009)

phabib said:


> How many hours of training did you need before getting on an ambulance? Also, do you think workers will want to be paid in the near future? (especially in larger cities.)



The number of hours in training is different between agency but the most common is 120 hours of lesson plus the a ride along period. 

Yes, I think that the future will go towards paid workers. And, how you can imagine, there is a diatribe between the supporter of "all volunteer system" and the "all paid system"


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## Explorer127 (Jan 5, 2009)

Do the emergency physicians work at a hospital emergency room and respond if needed?


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## Jac [ITA] (Jan 5, 2009)

Explorer127 said:


> Do the emergency physicians work at a hospital emergency room and respond if needed?


No, they work for the ambulance company and they are in the station along the other crew. The reason for having the ALS unit separate from the ambulances, they ride in station wagon cannot transport, is to be able to clear the unit as soon as possible. Its frequent that the ambulance is called only to transport the patient already stabilized and "packed" by the _automedica_ crew.


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## Jac [ITA] (Jan 7, 2009)

Just two things I forgot: the ambulance service is separated from the fire brigades, which is public at the dependence of the interior minister. Also the ambulance service and the ER care is completely free for the patient unless it's a non emergent situation; in that case the pt has to pay the ER care but not the ambulance.


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## AlaskaEMT (Jan 7, 2009)

That's interesting... making real emergencies free of charge and requiring payment for Bull S calls... what a concept!  It sounds like automedica is a sweet job.  B)


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## Jac [ITA] (Jan 12, 2009)

Inspired by the "Ever get mistaken for a police officer" and the "Is a T-shirt a PROFESSIONAL EMS Uniform ?" threads I thought to show the uniform in Italy. 

Basically the uniform are high visibility orange with reflective stripes. Underneath it a blu or withe polo shirt (depending on agency) with the logo of the agency on it; a t-shirt in the sumer. So no possible confusion with the police!  
The uniform is high visibility and waterproof because it's issued as a protective equipment both from body fluids and from being hit by a car. Due to this it's mandatory to wear long sleeve during patient care. 
The uniform are specially designed to be hot in summer and cold in  winter  Just kidding! 

I've attached a photo of an uniform, imagine it with matching pants, and a photo of one of our _automedica_! ^_^


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## Bosco578 (Jan 12, 2009)

*Awsome*



			
				Jac [ITA];115965 said:
			
		

> Inspired by the "Ever get mistaken for a police officer" and the "Is a T-shirt a PROFESSIONAL EMS Uniform ?" threads I thought to show the uniform in Italy.
> 
> Basically the uniform are high visibility orange with reflective stripes. Underneath it a blu or withe polo shirt (depending on agency) with the logo of the agency on it; a t-shirt in the sumer. So no possible confusion with the police!
> The uniform is high visibility and waterproof because it's issued as a protective equipment both from body fluids and from being hit by a car. Due to this it's mandatory to wear long sleeve during patient care.
> ...


 
That's sweet.B)
Too bad we cannot flat out refuse transport on the BS calls.:beerchug:


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## seanm028 (Jan 12, 2009)

Do the firefighters have any medical training?  EMT, first responder, first aid/CPR, etc.?


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## Jac [ITA] (Jan 14, 2009)

seanm028 said:


> Do the firefighters have any medical training?  EMT, first responder, first aid/CPR, etc.?



They all have a generic first aid CPR training, but they can certify "TPSS" that is "Tecniche primo soccorso sanitario" (literary translated: first aid technique) that is more or less EMT-B. The TPSS cert is not mandatory for all firefighter, only some are certified.


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