The Coronavirus Disease 2019 (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.

Due to factors that still remain under debate, both social and virological, the COVID-19 pandemic has continued to flare up in India, particularly in northern and western areas. This has led to an incidence of approximately 350,000 cases per day and a daily death toll of around 4,000 in the weeks between the 1st and 14th May 2021. The current pandemic is testing the adaptability of the oxygen distribution and consumption. Following India’s request for support, the EU Civil Protection Mechanism coordinated the response agreed by EU Member States providing shipments of oxygen and equipment. In this scenario, our Emergency Medical Team (EMT)-2, based in Italy, organized a cargo and a twelve member team of technicians and medical professionals with the main objective of installing a novel source of oxygen. The installation of a PSA oxygen plant provided the ITBP hospital in Greater Noida, India, with a sustainable solution to combat oxygen shortage in less than 48 hours. The supply of oxygen could not be deemed a successful intervention without a proper plan to guarantee the rational use of the source so additional training was carried out. Our EMT were among the first responders in mitigating this public health crisis.

On March 15, 2019, Cyclone Idai made landfall near the port city of Beira in central Mozambique causing significant casualties and serious damage to infrastructure. The Emergency Medical Team Type 2 – Italy Regione Piemonte (EMT2-ITA) was deployed approximately two weeks after the disaster to support the country in need, providing essential medical and surgical care. The EMT2-ITA staff was composed of 77 team members including two rotations and integrating local staff. A total of 1,121 patients (1,183 triage admissions) were treated during the 27 days of field hospital activity; among all the admissions, only few cases (17; 1%) were directly or indirectly attributed to the disaster event. Only three cases of cholera were confirmed and transferred to one of the treatment centers set up in Beira. The EMT2-ITA performed a total of 62 surgical operations (orthopedic, gynecological, general, and plastic surgery), of which more than one-half were elective procedures. The objective of this manuscript is to report the mission of the EMT2-ITA in Mozambique, raising interesting points of discussion regarding the impact of timing on the mission outcomes, the operational and clinical activities in the field hospital, and the great importance to integrate local staff into the team.

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.

Background/Introduction:The World Health Organization (WHO) declared climate change a defining issue in the 21st century with more intense heatwaves, higher risks of flooding and damaging storms, and a changing pattern of emerging infectious diseases. In this scenario, the response of Emergency Medical Teams (EMTs) to disasters represents a fundamental resource.Objectives:To expand EMT2-ITA-Regione Piemonte operational independence and to minimize its environmental footprint.Method/Description:A multiphasic and prospective project is planned in order to:(1) Reduce water consumption: use of a sterilizer designed with a set of high-efficiency heat exchangers enabling a substantial saving in water consumption by the vacuum pump and a significant reduction of total water usage through a recirculation system.(2) Reduce demand for diesel: photovoltaic (PV) system to integrate the current energy production system based on diesel generators.(3) Reduce paper consumption: use of sterilization management and traceability system and computerized medical record in order to be paperless.(4) Improve staff awareness and education on greening practices: educational program for the staff focused on waste segregation/management and energy and water saving both in the hospital and in the Base of Operation (BoO).Results/Outcomes:EMT2-ITA-Regione Piemonte aims to reduce energy and water consumption by 30% and to become paperless.Conclusion:Advances in greening initiatives offer to EMT2-ITA-Regione Piemonte the potential to improve its disaster medical response capabilities and to reduce its ecological footprint.