Within the overall design of the hospital network it is necessary to articulate the networks for pathology that integrate the hospital activity for acute and post-acute with the territorial activity: heart attack network; stroke; traumatological; neonatal; specialist medicines; oncological; pediatric.Network for cardiological emergencies. The organizational model adopted is that of a territorial intervention network centered on the 118 emergency service, flanked by a coordinated inter-hospital Hub & Spoke network relating to a catchment area of 300,000-600,000 inhabitants urgent care san antonio.
An Integrated System for Trauma Assistance (SIAT) is activated, consisting of a network of hospital structures connected to each other on the basis of available resources and skills: First aid facilities for trauma (PST); Area trauma centers (CTZ) that guarantee 24-hour assistance; Highly specialized trauma centers (CTS) which must record volumes of activity for trauma of at least 400-500 cases / year and a share of serious trauma exceeding 60% of the entire case history treated.
In this phase, the standards of the Stoke units were defined. Two levels are envisaged: Level I Stoke unit, necessary to respond widely, at a territorial level, to the need for hospitalization and care for the majority of patients with cerebral stroke; Level II Stoke units that must treat at least 500 cases / year of stroke as well as guaranteeing the 24-hour presence of dedicated personnel, neuroradiology, neurosurgery, vascular surgery and endovascular intervention.
Network of emergency urgency
The system operates through 118 operations centers, the local emergency network and the hospital network. As regards the former, an organizational review was considered feasible, which envisages the presence of an operational center for a reference basin of approximately 0.6-1.2 million inhabitants and more.
The definition of the need for medical emergency vehicles in the region, on the other hand, was identified using a criterion based on the allocation of an advanced ambulance for every 60,000 inhabitants for the coverage of a territory not exceeding 350 square kilometers. helicopter rescue it was proposed to use a day vehicle for an average forecast of minimum interventions of 600 for each year base and a night vehicle for an average forecast of 550 interventions per year.
The First Intervention Points (PPI), those structures distributed throughout the territory with hours of activity articulated over 12 or 24 hours, will be entrusted to the territorial system 118 if they have a volume of no more than 6,000 accesses / year, otherwise, in case of of higher accesses, will refer to the reference Goddess.
The emergency rooms must have a catchment area of between 80,000 and 150,000 inhabitants; a travel time greater than one hour from the center of the town to the reference Goddess; an annual number of appropriate accesses exceeding 25,000 units. Finally, they will have to be equipped with Intensive Short Observation Beds (Obi) proportional to the catchment area and the average access.