118 (Italy)

118 (Italy)
Name	118
Native name	Numero 118
Country	Italy
Service	Emergency medical services
Established	1990s
Headquarters	Rome

118 (Italy) is the national emergency telephone number used to access pre-hospital emergency medical care in the Republic of Italy. The 118 system interfaces with regional health authorities such as Regione Lazio, Regione Lombardia, Regione Campania, Regione Piemonte and national institutions including the Ministero della Salute, the Istituto Superiore di Sanità and the Protezione Civile. It operates alongside other European emergency systems such as 112 (emergency number) and coordinates with services including the Polizia di Stato, the Carabinieri, the Vigili del Fuoco, and municipal administrations in cities like Roma, Milano, Napoli, Torino and Palermo.

History

The modern 118 service emerged during reforms influenced by models from France, United Kingdom, and United States emergency medical systems and legislative acts such as Italian regional health reorganizations in the 1990s and the national Legge 833/1978 framework. Early implementations were piloted in metropolitan areas including Roma, Milano, Bologna and Firenze with involvement from institutions like the Azienda Sanitaria Locale networks and university hospitals such as Policlinico Gemelli, Ospedale San Raffaele, Ospedale Maggiore Policlinico, and Ospedale Careggi. Coordination with the Croce Rossa Italiana and volunteer organizations including ANPAS and Misericordie expanded capacity, while technological integration referenced standards from European Resuscitation Council and training guidelines influenced by the World Health Organization and International Liaison Committee on Resuscitation.

Emergency Medical Services Structure

The 118 system is organized through regional Aziende Sanitarie Locali such as ASL Roma 1, ASL Milano, ASL Napoli 1 Centro and interacts with specialty centers like Istituto Nazionale Tumori and trauma hubs including Niguarda Hospital and Ospedale Sant'Orsola-Malpighi. Dispatch and clinical oversight involve medical directors often affiliated with universities such as Università degli Studi di Roma "La Sapienza", Università degli Studi di Milano, Università degli Studi di Napoli Federico II and regulatory bodies like the Ministero della Salute and the Agenzia Italiana del Farmaco. Collaboration occurs with emergency departments at Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola and regional emergency coordination centers that liaise with police forces including Polizia Locale and national responders like Guardia di Finanza.

Operations and Response Protocols

Protocols follow clinical pathways developed with input from the European Resuscitation Council, Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva, Società Italiana di Medicina d'Emergenza ed Urgenza, and guidance from Istituto Superiore di Sanità. Call triage uses criteria compatible with international models such as the Manchester Triage System and integrates with 112/Europe-wide initiatives like the eCall project. Responses range from basic life support by volunteers from Croce Rossa Italiana and ANPAS to advanced life support by physician-staffed units often trained at centers like Humanitas Research Hospital and Ospedale San Camillo-Forlanini. Major incident protocols reference frameworks used in events like the G8 Summit (2001) and disaster responses such as the L'Aquila earthquake and coordination with the Protezione Civile.

Training and Personnel

Personnel include volunteer responders from organizations such as Misericordie, Volontari della Croce Rossa Italiana, and professional staff from Aziende Ospedaliere and private providers like Misericordia di Firenze and private ambulance companies. Training pathways often involve institutions such as Istituto Nazionale per la Formazione, university departments at Università Cattolica del Sacro Cuore, and simulation centers affiliated with European Resuscitation Council certified instructors. Certification standards reference curricula by the Società Italiana di Medicina d'Emergenza ed Urgenza, continuing education from the Ministero della Salute, and collaborations with international programs including Red Cross Red Crescent training and exchanges with National Health Service (England) emergency medicine departments.

Equipment and Vehicles

Ambulance fleets use models from manufacturers such as Fiat, Iveco, Mercedes-Benz, Renault, and medical equipment brands including Philips (company), Zoll Medical Corporation, Laerdal and Drägerwerk. Advanced vehicles include physician-staffed ambulances, intensive care transport units and helicopter emergency medical services operating from bases near hospitals like Pisa Aeroporto and in collaboration with aeronautical units such as Aeronautica Militare and private operators used in regions such as Sardegna and Sicilia. Standardization efforts reference European Union directives and interoperability with systems used by Ambulance Victoria and SAMU (France).

Regional Organization and Dispatch Centers

Dispatch centers are managed by regional health authorities like Regione Veneto, Regione Toscana, Regione Sicilia and metropolitan agencies including Città Metropolitana di Roma Capitale. Notable dispatch centers operate in hubs linked to hospitals such as Ospedale Niguarda, Policlinico di Milano, Ospedale Cardarelli and Azienda Ospedaliera Papa Giovanni XXIII. Inter-regional coordination has been tested during pandemics referenced by institutions like Istituto Superiore di Sanità and in large-scale events such as the Expo 2015 and UEFA tournaments hosted in Italy where collaboration with Fédération Internationale de Football Association event medical teams occurred.

Controversies and Public Perception

Controversies have involved debates over centralization versus regional autonomy, highlighted in disputes between Regione Lombardia and national bodies like the Ministero della Salute, budgetary controversies involving Azienda Sanitaria Locale spending, and publicized cases that reached media outlets such as RAI, Mediaset and La Repubblica. High-profile incidents during disasters like the Amatrice earthquake prompted scrutiny from parliamentary committees and NGOs including Emergency (NGO), while advocacy groups and unions such as CGIL and USB have campaigned on working conditions, staffing levels, and procurement practices that engaged constitutional discussions in the Corte Costituzionale.

Category:Emergency medical services in Italy