[The Department of Emergency in the Italian National Health Service: a critical analysis]

The Emergency Medical Service in Italy is based on operating exchanges, distributed on all the national territory. The operating exchange coordinates the help means sending in relation to the event severity. The telephone calls of request for help are sent to the operating exchange through a single telephone number (118). The helps (ambulances, helicopter) are sent later to the hospital more suitable help Center. Hospitals are inserted in an organizational net and differentiated for service level. All this to assure homogeneity of care and different care levels in the emergency situations. In the April 1996 the National Guide Lines, which provide the information on the organizational and functional emergency requirements, have been given off. Requirements have been furthermore identified for the Emergency Departments of first and second level. After ten years from the Emergency Department activation, the main critical states are represented by the heterogeneous organization on the national territory and medical and nursing staff's formation.