In relation to the letter signed by the PP (“Eight hours of waiting in the emergency room because on Sundays there was only one cardiologist in the hospital”) published on 1 March 2023, we believe some clarifications are necessary.
On Sunday 26 February, two cardiologists were present in Cardiology, as on all weekends (and not one as reported in the letter), and they remained on duty throughout the day, furthermore a third cardiologist was available on call (on call) in case there was a need to intervene on patients with acute myocardial infarction.
The different distribution of the workforce between weekdays and weekends is linked to the programmed activity of Cardiology which, on weekdays, adds up to the urgency and emergency activities.
In the DEA, however, the patient is always taken care of in the diagnostic-therapeutic management by the emergency medicine specialist, who has multidisciplinary skills that allow him to promptly undertake any therapies. The process is complex and the management time is strictly necessary to allow for a better clinical assessment of the patient; in particular the Guidelines recommend an adequate time interval between the determinations of myocardial damage markers, which cannot be reduced, otherwise the diagnosis will be ineffective. Furthermore, the necessary diuretic treatment was started immediately on the patient.
The processing time and output of the result is on average 40-50 minutes. Therefore these expectations are not reducible, because they depend on biological factors and the technical processing times of the exams. After having had the second troponin value available, cardiological consultancy was started, because only then were all the elements necessary for a correct clinical classification available to allow safe hospitalization in the most appropriate treatment setting.
Therefore, a significant part of the time spent in the emergency room by the patient was dedicated to the diagnostic process which is in no way compressible.
Throughout the stay, despite the high flow and turnover of patients in the ED, the staff ensured adequate management and surveillance of the patient. Emergency doctors possess and guarantee 24/7 the skills and knowledge necessary for the management of the patients entrusted to them.
It should be noted that during the waiting period, despite the continuous need of the staff to deal with the new patients arriving, the Emergency Medicine doctor on duty correctly and fully informed the patient and relatives of the procedure in progress and of the need to check the tests, as well as the therapy undertaken.
In this hospital, the medical staff interested in illustrating the process and meeting the patient’s family members are available for any further clarifications.
The Director of the Emergency and Critical Areas Department dr. Joseph Colletta
The Medical Director of the Presidio ff dr. Alexander Garibaldi