Caldo, the internists: “We need long-term structural interventions”
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To counter the heat it would be necessary “that we start working not only in an emergency perspective, but with structural interventions”. This is the appeal of the Fadoi internist doctors who recognize the importance of the measures adopted by the Ministry of Health, from the heat code in the emergency rooms, to the strengthening of medical guards, to the territorial outpatient clinics operating 7 days a day, to the reactivation of the Uscars (special regional continuity of care units born against Covid), but who recall how much a long-term perspective would also be needed “.
Francesco Dentalipresident of the Fadoi internal medicine doctors and director of the Medical Area Department of the Asst Sette Laghi of Varese, in fact reports that we will find ourselves in the same situation again next summer
The heat code
“The Heat Code is certainly a good idea,” analyzes the number one of the Federation of Hospital Internists’ Associations. “For the rest – explains Dentali – in a short time it is not easy to reactivate the Oscars, rather than organizing clinics in the area”.
Infernal heat: a “heat code” in the emergency room and the Covid mobile units in the field
4 million non self-sufficient people
The Oscars themselves, special regional continuity of care units born against Covid, already in the pandemic “took weeks to get up to speed. In addition to reacting to emergencies, we should try to be proactive”, urges Dentali. “There are many measures which, especially with the new government, have been put in place”, adds the specialist. However, in a country with “4 million people who are absolutely not self-sufficient”, he points out, “we really need to completely change the perspective, especially for assistance to these very fragile people, trying to adopt a whole series of measures that are structural, not tied to the moment. Then there will always be some that in their improvisation will make sense and that it will be right to adopt. But it is one thing to say ‘let’s put on an Oscar’, another is to actually do it”.
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Emergency room access boom
In an Italy gripped by the heat “accesses to the emergency room are certainly on the increase, I would still say by 10-20%, which varies from situation to situation. The pressure on hospitalizations is also growing, but not so much due to illnesses directly related to the heat, but rather due to the worsening of fragile patients with various underlying pathologies”. In these hours, the management of ‘trench’ hospital wards weighs on “multi-pathological patients: very, very delicate patients with an unstable balance – underlines the number one of the Federation of Associations of Internal Medicine Hospital Managers – who in this situation easily decompensate”.
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Fragile patients
In other words, the heat has something to do with it, but “these patients come to the hospital for their underlying pathology. To give an example, a patient suffering from heart failure comes to the hospital for that – explains Dentali – because the heat compromises the already precarious balance of his body, not due to a direct illness”. The same goes for “all the most delicate patients” who are many: “Since there are now 4 million absolutely non self-sufficient people in Italy – recalls the specialist – the impact” of the heat emergency on the country’s hospitals “is actually there”, albeit indirect. So “we are witnessing an increase in the pressure on hospitalizations which, however, at a first reading – reiterates Dentali – would not seem to be directly linked to heat-sickness, but to the worsening of the basic conditions of the most fragile patients”.
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