Role of the rescue driver in EMT: the situation in Italy

The role of the rescue driver in Italy in the Emergency Medical Team (EMT) is characterized by the lack of regulations that makes it different from the rest of Europe. Where the educaton path and the professional status are harmonized. In Italy there is not a national contract but at the same time the skills and requisites are not harmonized over the country. However some recent regulations drafts underline the need for a clear definition of the professional role of the rescue driver.

The rescue driver in Italy

There are 21 regulatory systems for the rescue driver, as many as the regional health services, plus the autonomous provinces of Trento and Bolzano.

Each region standardizes and regulates the EMT regulations differently the rescue services depending on the national emergency system. With a major and minor decision power given to the volunteer, the private or public sector, based on traditions and civil engagement.
Such diversification if somehow an added value for Italy but it creates uncertainty and malfunctions that risk to affect the end user.
If the role of the doctor and nurse are regulated by a national employment contract, valid across Italy, the rescue driver’s role is regulated differently.

Employment contracts and tasks for the EMT

The rescue drivers works in two different employment scenarios: the public sector and the private sector. Both scenarios does not have yet any reference contract defining competences and tasks. Two regions, Veneto and Valle d’Aosta, have regulated the specific role of the rescue driver, but this does not apply to the rest of Italy. Recently in the Province of Vicenza, in Veneto, an emergency service provider has appointed nurses as drivers for the medical car, rising a lot critics.

Education

The education of the rescue driver varies in content and duration, inevitably resulting in a disparity in patient’s treatment. Infact they may get a different quality treatment depending on the Italian region.
In several situations, basic rescue is provided by ambulances without specialized medical staff on board (medical, rescue). Thus it is fundamental that the rescue driver has a first response education and know where and how to intervene in case of need. For instance in the proper use of anti-trauma devices in case of muscle-skeletal injury.

Regulatory initiatives of rescue drivers from the EMT

The issue of a regulatory gap is getting critical and the reference associations all urging for intervention for years:

For the time being there are two law drafts, one signed by senator Rizzotti (Forza Italia) presented in March 2018 and one signed by senator Marinello (M5S) dated March 2019.
Both are under evaluation by the close comittee of the Commissione Igiene e Sanità, with the hope that a standardized ddl can be discussed in the first months of 2022. An agreement was reached during the last legislature, when a PD senator presented the same ddl.
What is the ddl Marinello about? First of all a full recognition of the role of the rescue driver. Finding at article 1 eight points on his/her exclusive skills, learnt at the end of a dedicated professional education path giving the rescue driver a qualification certificate.

What exactly should the driver do?

Starting from driving medical emergency vehicles with acoustic warning device and flashing lights, the driver shall:

  • Check the efficiency and safety of the rescue vehicle (s)he was given;
  • Know the proper use of all medical devices on board;
  • Know how to use the radio-phone communication and the communication information systems;
  • Being trained on how to read the cartography, knowledge and use of navigation systems and global positioning systems (GPS);
  • Manage communication with the emergency operative station and other rescue vehicles with the hospital emergency points;
  • Make gesture and lighting communication with the ambulance helicopter;
  • Support the medical rescue operation in all its phases.

The education path, handled by regions, shall have a comprehensive duration of 1000 hours: 300 hours theory, 400 hours training and 300 hour internship.

A transition law provides for the exoneration from the education path for those operators who have been drivers for at least 2000 hours at the moment when the law comes into force.

To find out more about the Ambulances and the standard EN 1789: the applicable standards in Europe updated to 2020, visit The Ems Blog!

A high profile professional rescue role, an important asset for the EMT

It should be the recognition of a high profile professional rescue role, in charge for not only driving in emergency, but also coordinating the transport and being responsible of the ambulance and crew.

The rescue driver shall have complete knowledge of the medical devices on board the ambulance and will be definitely a support to the medical staff. Read more about it the maintenance of the medical devices HERE, on The Ems Blog!
This is a role that many drivers already have, although they will have a valid recognition and eliminating the risk to let the personnel without a proper training drive.