Italian territorial emergency medical services - 118: a type of advanced EMS vehicle in the experience of the Piedmont Region

BACKGROUND: The Emergency Medical Services (EMS) in Piedmont (Italy) are organized according to a uniform model, but with differences due to the specific territorial needs. This study analyzes the activity of an Advanced EMS Vehicle, organized by the Territorial Emergency Operations Center of the South-Eastern regional quadrant of Piedmont, consisting of a car with medical personnel on board indicated with the code A1065.METHODS: The activity of A1065 was observed for two years, from 02/01/2020 to 01/31/2022. The data necessary for the assessments were obtained from the intervention forms, recorded in the SaveOnLine® program archive. Data were processed in aggregate form and analyzed according to a descriptive methodology.RESULTS: Between 01/02/2020 and 31/01/2022, 1704 surgeries were performed by A1065. Of these, 75.9% were primary rescue interventions, understood as direct intervention on a patient at the site of onset, and only 9.6% were secondary interventions, understood as the transport of patients in continuity of care. A1065 carried out 1420 of the total 5315 cases that would have been the responsibility of A1006, the only MSA present before the introduction of A1065. For 105 operations (6.2%) an intervention form was not opened. Of the 1599 open interventions 1282 records with complete available data were analyzed and the 58% of the records had an intervention time of less than 10 minutes.CONCLUSIONS: The results of this research indicate how an organizational model based on the described dynamic system can be more effective than a system based only on the use of ambulances for transport.