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The 2019 coronavirus disease (COVID-19) pandemic has stressed the health care system in Italy as well as around the world, with hospitals implementing their surge capacity to increase the number of available beds for patients positive to the virus. At the end of March, the Piemonte (Northern Italy) Government decided to build a temporary rapid-assembly emergency hospital for the treatment of mild and moderate COVID-19 patients, converting an existing concert hall in the city of Turin. The decision was prompted not only by the urgent need of hospital beds, but also by a forward-looking approach for the months immediately after the emergency, when it will be essential for conventional hospitals to return to a normal configuration. This paper documents the temporary hospital project, describing the site, the layout and the equipment, the idea behind structural choices, and the staff involved. The aim of the work is to share the experience and to provide some practical recommendations to other professionals who are fighting the COVID-19 pandemic worldwide. [ABSTRACT FROM AUTHOR]

Introduction: A disaster involving significant casualties in a populated area demands the rapid development of a field hospital with personnel specialized in Disaster Medicine. In this scenario, the clinical response of Emergency Medical Teams should be guided by the knowledge of how the medical needs of the population change after the disaster itself. In order to reduce the loss of life and prevent long-term disability, it is essential to have the right tools to treat critical patients. In fact, disasters cause a variety of conditions ranging from minor to life-threatening injuries requiring admission to Intensive Care Unit (ICU). Method: A systematic review was carried out and electronic healthcare databases were searched using terms such as "Disaster" or "Flood" or "Storm" or "Earthquake" or "Mass Casualty Incidents" and "Intensive Care Unit" or "Intensive Care" or "Health Impact". Articles that met the search criteria, published in the last 15 years in the English language, were analyzed and summarized. The objective of the review was to identify the main health problems following disasters and, in particular, the diseases that may require intensive care in order to assess the need to include ICU in the minimum technical standard for Emergency Medical Teams type 2. Results: The review included 12 studies identified as relevant and significant for our purpose. Health problems were sorted for disaster type and severity of the injury. The review demonstrates that health problems after a disaster are different depending on disaster type, but in all the scenarios there are diseases that potentially may require timely intensive care. Conclusion: The presence of an ICU within an Emergency Medical Team type 2 (according to WHO EMT classification) is an essential part of disaster management plans as ICU plays an irreplaceable role in saving lives and in reducing the health impact of a disaster. [ABSTRACT FROM AUTHOR]

Introduction: Validation of the new MCI Triage protocol of Regione Piemonte by comparing it with the already published and internationally used START/Jump START protocol. Compare its accuracy, execution time, over and under triage indices and the influence of any rescuer characteristics in reference to adult and pediatric victims when in use in a simulated multi-casualties event setting. Method: We conducted a randomized controlled experimental study in a simulation setting. A group of 35 people involved in an incident (volunteer participants) was assessed by a population of trained and untrained healthcare professionals (nursing students and nurses). The participants were randomly divided into two homogenous groups to which the two protocols were explained separately and carried out the simulation in single-blind. Evaluation data were collected and statistically processed. The resulting items were used to compare the accuracy, over- and under-triage rates and any items related to rescuer characteristics for each triage system. Results: 74 subjects were included in the study. Of these, 56.7% were healthcare professionals in training and 43.4% were trained nurses. Compared to standard criterion definitions, the MCI triage protocol showed a higher accuracy rate than START (88.4% vs 80.4%, p<0.01). MCI triage had a significant lower rate of underestimation compared to START (8.9 vs 13.6%, p< 0.01) as well as overestimation (3.2% vs. 6.8%, p< 0.01). Time is only correlated with the performance of MCI triage, influencing its accuracy. There were no significant differences in the accuracy of diagnosis in pediatric patients. Conclusion: We found that MCI method triaged adult patients more often correctly than START method. Underestimation and overestimation were lower than in the control method, although there tended to be a significant overestimation of white codes which were not present in the START system. In the assessment of pediatric patients, the protocols are equivalent. [ABSTRACT FROM AUTHOR]

Introduction: An adequate Mass-Casualty Incident (MCI) triage system is essential to provide the best possible health care to the greatest number of affected people and to optimize the management of the available resources in the context of a MCI. Method: In February 2022, Disaster Medicine Service 118 of Regione Piemonte adopted a new 5-color code-MCI triage system and Emergency Medical System (EMS) personnel was trained through a 3-hours-distance learning course. 515 medical doctors and nurses attended the course and completed the final test (triaging of 50 computer-based simulated patients/cases). Their performance was compared to intended triage designations. We collected the data and conducted a descriptive observational study. Results: A total of 25.750 evaluations were carried out: 1.030 white cases, 6.180 green cases, 6.180 yellow cases, 9.270 red cases and 3,090 black cases. Overall triage accuracy was 89,63%. The overall errors were 2.671 (10.37%). Concerning the type of error, there were 1.415 cases under-triaged (5.5%) and 1.256 cases over- triaged (4.88%). Based on color-code, the highest rate of error was in green cases (3.48%), while black patients showed the highest accuracy rate (0.32%). Based on type, the most frequent error was under-triage of red patients, while the less frequent was over-triage of black patients. Conclusion: The results of the final test performed by EMS personnel showed the accuracy rates of triage using new 5-color code-MCI triage systems of Regione Piemonte to be in range with data reported in the literature. A study limitation is the fact that the data analyzed are derived from online testing performed in no-time limited and no-stress conditions. Another potential limitation is the distance learning which doesn't allow a discussion with the teacher or a request for clarification. For this reason, we would plan a future study defining the efficacy of the didactic methodology in comparison with face-to-face courses. [ABSTRACT FROM AUTHOR]

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Copyright of Giornale Italiano di Medicina del Lavoro ed Ergonomia is the property of Giornale Italiano di Medicina del Lavoro ed Ergonomia Editorial Board and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Many people are poisoned by carbon monoxide (CO) each year, either intentionally (e.g. suicide attempts) or by accident. In the prehospital care the early diagnosis is primary for a correct treatment with high flow of oxygen and for the appropriate hospitalization of the patient. The aim of this study is to detect the main factors associated with CO poisoning in our area and to evaluate the role of CO detector in the prehospital setting., Methods: From 1 January 2012 to 1 May 2013, all cases of carbon monoxide poisoning, recorded by the Emergency Medical Service (118) in the Province of Cuneo, were analyzed., Results: Seventy clinical cases were collected, 68.5% of poisonings occurred in the months of December, January and February. Boilers were found to be the main source of indoor CO poisoning (average CO concentration of 66.78 versus 32.92 ppm generated by other heating systems, p = 0.004). CO detector was used in 77.4% of cases. The prehospital diagnosis was properly made in 96% (48/50) of cases in which CO detector was used, versus 70% (14/20) of correct clinical assessment without its use (p = 0.005)., Conclusions: The CO detector is not only a personal protective equipment for Emergency Medical Service operators, but it contributes significantly to increase prehospital diagnosis of CO poisoning, thus suggesting its use in all emergency services in the national territory.