A critical challenge for the 118 emergency system in Italy

Inadequate Ambulances and Shortage of Medical Personnel: A Concerning Situation

The Need for Ambulances with Physicians on Board

In Italy, the emergency healthcare system 118 is facing a critical challenge to ensure adequate and timely coverage across the country. According to estimates from Mario Balzanelli, the national president of the Emergency Urgency System 118, only one out of three provinces is currently capable of providing ambulances with physicians on board that respond within the expected timeframe. This implies that an additional 716 ambulances would be required nationwide to meet the desired standards.

Detailed Analysis of the System’s Needs

A recent study examined all Italian provinces, taking into account various factors such as population, territorial extension, population density, and the number of municipalities. The goal was to establish a suitable organic staffing level for healthcare personnel in the territorial emergency 118 system in a realistic and effective manner. Initially, the plan was to provide each province with one ambulance with a physician on board for every 60,000 inhabitants and one ambulance with nurses on board for every 30,000 inhabitants.

Considering the necessity of maintaining a 24/7 operational service, it was concluded that a total of 1,028 ambulances with physicians on board and 2,017 ambulances with nurses on board would be needed. To maintain this service level, 6 doctors and 6 nurses would be required for ambulances with physicians on board, and 6 nurses for the others. This would result in a minimum organic staffing level of 6,168 doctors and 18,270 nurses in Italy.

Response Times and Territorial Coverage: An Urgent Issue

Furthermore, a maximum limit of 8 minutes has been set for the time between the call and the arrival for red and yellow codes, with an average travel speed of 60 kilometers per hour. However, only 33% of Italian provinces currently have adequate coverage by a medical team within these timeframes, while only 67% would meet the legislated response times with a nurse-staffed team.

The Necessary Increase in Ambulances and Healthcare Personnel to Improve Emergency Response

As a result, to ensure correct and timely emergency response, an increase of 716 ambulances with physicians on board would be necessary, bringing the total to 1,744, and an increase of 354 ambulances with nurses on board, reaching a total of 2,371. Additionally, the medical staff would need to be increased to 10,464, and the nursing staff to 24,690 to meet these critical emergency healthcare needs in Italy. These efforts are essential to guarantee efficient and timely emergency assistance throughout the country.

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