EMS Around the World: The Volunteers of Italy`s Red Cross

“Next to creating a life, the finest thing a man can do is save one.” This quote from Abraham Lincoln is perhaps the best way to describe the spirit that moves the volunteer EMS providers of Italy.  

As in other countries, EMS in Italy is provided by various services (public and private) that work together to serve their communities. All their services are coordinated by a main dispatcher; emergency calls are received and assigned by the unique number 1-1-2, the equivalent of America’s 9-1-1. But while care protocols are national, the Italian emergency system is not exactly the same nationwide.

Emergency medical services in Italy are controlled regionally under local public health authorities. Their delivery differs by location: In some places EMS is the responsibility of a local hospital; elsewhere it’s driven by volunteer organizations. One of the most historical of these volunteer groups is the Italian Red Cross. The Italian Red Cross (like other worldwide Red Cross and Red Crescent societies) prevents and alleviates human suffering in the face of emergencies by mobilizing the power of volunteers.

I’m a proud Italian EMT and have volunteered with the Italian Red Cross since 1988. I’ve been an NAEMT member since 2001. I’m also an EMT volunteer instructor, AED and infant choke technique instructor, PTSD support team member, PHTLS instructor, public access defibrillation (PAD) instructor, 12-lead ECG operator, and an ambulance driver. I’m also studying to pass the NREMT exam.

We are a group of volunteers dedicated to serving our rural community through the provision of professional first aid services and disaster assistance. My local committee in Lomazzo, a small town near Lake Como, was first formed in 1992. Our local committee is a section of the Italian National Red Cross Society. We can count on a total of 162,000 Red Cross members across Italy. 

We are in the north of Italy, about 15 miles from Milan. We cover, together with some other ambulance services, a very large territory that ranges between different provinces. We provide lots of services; we have emergency rigs with skilled crews and specific teams that handle specific topics such as disaster relief, civil protection, telecommunications, fund-raising, CPR and AED training, PAD courses, care of the elderly, organ transport for transplants, and bike patrolling.

All our activities are 100% compliant with the seven universal principles of the International Red Cross movement: humanity, impartiality, neutrality, independence, voluntary service, unity, and universality. As a result we participate not only in emergency prehospital medical care but also in the planning and delivery of community services and interactions with clients and patients. 

Nationally certified instructors like me teach public first aid and CPR that are the recognized standard in health and safety training. We also have a nationwide public access defibrillation program and inform citizens how to use public AEDs. Another typical activity is assisting homeless people through the “street unit,” a specialized group of volunteers. Their mission is to reach out to people living in public spaces and provide moral support and material aid if needed. 

Training and Skills

Volunteers can upgrade their skills through training and workshops in their areas of interest—e.g., volunteer administration, casualty simulation, or disaster assistance. Over the years the Italian Red Cross has developed many courses for training volunteers, and every year there is mandatory retraining for all volunteers, first responders, and professionals. This helps ensure solid service to the community. 

Our course offerings include emergency and standard-level first aid and CPR/BLS for adults, infants, and children. Our volunteers learn how to:

• Conduct a first patient assessment;
• Deliver basic care;
• Perform nonemergency transports;
• Work as part of a team;
• Communicate with dispatchers;
• Manage scenes (even natural disasters);
• Support elderly patients and others affected;
• Transport obese patients;
• Use AEDs;
• Use portable 12-lead ECG devices;
• Administer oxygen therapy (setup and delivery);
• Remove choking obstructions;
• Respond to crime scenes;
• Treat hypothermia ;
• Stop heavy bleeding;
• Deliver PHTLS treatment.

Even first responders can deliver basic care and use AEDs. Obviously, there are different learning programs for first responders and volunteers. A normal volunteer course takes up to six months. We teach to AHA CPR standards, but we also teach community CPR according to ERC (European Resuscitation Council) standards. Over the past five years, we have activated a national team dedicated to PTSD care and psychosocial support in complex emergencies (e.g., earthquakes). It consists of psychologists and specialized operators (like me).

Our Numbers

Our service operates 24 hours a day, 365 days a year. We have on duty six rigs, one dedicated rig to transport obese patients, 10 vehicles for the transport of disabled people, five service cars, and two special vehicles to transport organs for transplants. In 2018 our vehicles traveled more than 352,000 miles. 

We can count on up to 180 volunteers. They come from a wide range of backgrounds: high school students, teachers, university students, firefighters, and nurses. We also have on duty 16 professionals, and my local committee has a team of six instructors/trainers for training activities for schools and companies.

Our “youth group” has lots of activities for young people, like sex education and education on prevention of sexually transmitted diseases; road safety education; promotion of the seven principles and a culture of nonviolence and peace; health education and the promotion of healthy lifestyles; promotion of voluntary donation of blood, organs, and tissues; and cooperative activities and international youth exchanges. 

Our equipment is always up to date. Every year we check all inventory and evaluate the purchase of new tools. Some of our preferred brands are Ferno, especially for scoop stretchers, backboards, and immobilization and extrication tools; and Stryker Performance-PRO XT ambulance cots and Stair-PRO stair chairs. One of our most used mottos is “continuing education,” which in this case represents the Italian Red Cross’ goal to maintain a high-quality standard in the use of equipment.

Because of their commitment and training, EMS professionals in Italy perform a high-quality community service. 

Alessandro Borgonovo is a volunteer EMT instructor, AED trainer, 12-lead ECG operator, infant choke technique instructor, PTSD support team member, PHTLS instructor, and public access defibrillation instructor in Italy. Reach him at alessandro.borgonovo@crilomazzo.org.