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Covid emergency rewrites Lombard’s hospital network. With organizational level 3, the main parties involved in the treatment of “time-dependent” pathologies and cases were decided.
In reorganization Asst Sette Laghi loses CTS “trauma center” (highly specialized trauma center) the emergency offer in trauma that offers along with 5 other Lombard garnishes (Civil Hospitals of Brescia, United Hospitals of Bergamo, San Matteo Polyclinic of Pavía, Niguarda and San Gerardo de Monza Hospital). The activities of the Varese presidium were transferred to the Galeazzi in Milan, a purely orthopedic institute.
Lombard’s choice took Varese hospital by surprise: in fact, several specialties collaborate within a trauma center that are not currently present in the orthopedic institute of Milan. The fundamental components of a SIAT are: the General Intensive Care and Neuroreanimation, the Angiography Room h24, the Hemodynamic Room h24, the multilayer CT, the Active Emergency Laboratory h24, the heliport that can also be used at night, the Operating Rooms dedicated to emergencies, an MRI and emergency physicians, surgeons, anesthetists, cardiac surgeons, neurosurgeons, hand surgeons, orthopedists, gynecologists, cardiologists, interventional cardiologists, radiologists, neuroradiologists, plastic surgeons and thoracic surgeons, urologists, endoscopists.
The new regional resolution establishes that the activation of level 3 of the Employee Time Networks and High SpecializationFor each type of network, the corporate Departments of the Centers that temporarily suspend their activity must contact the Directorates of the Centers that remain fully operational, to define the methods of management of urgent procedures and a reorganization based on resources available. thus, the direct transfer of the patient but also the possibility that the teams of the Center that temporarily suspend the activity carry out the procedures in the active Center where the patient will later continue the intensive / sub-intensive hospitalization.
Varese, therefore, sacrifices his trauma center with related neurosurgical activity to “allow immediate expansion of the intensive accommodation.”
In the Lombardy region we work to expanding the availability of accommodation for COVID patients. The growth of the contagion curve suggests that a increase of around 200 IT beds to dedicate to COVID patients (mainly within the 18 COVID HUBS) and about 2,200 acute beds (including 10-15% of beds with the possibility of non-invasive ventilatory assistance) to distribute in HUB and non-HUB hospitals, in addition to an increase of around 1,000 beds for subacute and community / surveillance patients, mainly in basic health establishments. In summary, ” it is a priority to reach the expected level of around 4,000 ordinary beds and around 450 IT beds by Wednesday 10/28/20After this execution phase, it will be possible to evaluate any other indication related to the planned activity “.
The new emergency network identifies the hospitals that act as regional benchmarks according to the pathology:
For the STEMI network, the identification of the San Paolo to replace the San Carlo, the suspension of STEMI activity at the Presidium S. Fermo di Como and the inclusion of the San Donato Polyclinic
For the STROKE network, the inclusion of San Carlo, former CTZ reference with NCH, and the suspension of the STROKE activity in the Presidium Manzoni di Lecco,
For the Cardiac Surgery network, the inclusion of the San Donato Polyclinic,
· For the Trauma network, the insertion of the Galeazzi Institute and the deactivation of the CTS with simultaneous temporary suspension of the NCH activity of the Hospital Circolo di Varese to allow the immediate expansion of the intensive accommodation.
The new decision recognizes that the emergency is mainly concentrated in the Lombard capital and its surroundings. Hence the acceleration for the opening of the hospital at the Milan Fair on the one hand and that of the Bergamo fair on the other.
All COVID HUB hospitals identified with DGR 3264 of 6/16/2020 are directly involved in the management of the modules and these HUBs, after identifying their own medical contact person and a contact person for the health professions, with responsibility clinical, care and management. The human and instrumental resources related to the Module will be in charge of organizing the presence of H24 of a medical, nursing and support team for the care needs of hospitalized patients in the corresponding “Module”. For this reason, the Varese hospitals are also called upon to do their part.
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