Niguarda has the following services in its Emergency Department: • Headquarters of the 118 Service for Milan and its provinces • Heliotransport service and a Trauma Center • Poison Control Center • Burn Unit • Mobile Unit for the management of major emergencies.
The Emergency Room ( ER) is active 24 hours a day every day for every area of specialization.
There is also a separate Pediatric Emergency Room, and the Dental Clinic is open from Monday through Saturday from 8:00 a.m. to 8:00 p.m.

Questions? Niguarda answers.

> What is the Emergency Room (ER)? The ER is a department of the hospital dedicated to patients who arrive in critical conditions.

> Is the ER available for foreigners?
ER assistance is guaranteed for everybody. If needed, you can ask for an interpreter or cultural mediator.

> What do I do in case of an emergency requiring immediate medical intervention?
In life-threatening or emergency situations, dial 118. In all other cases, when there is an unforeseen need for medical attention, you can go directly to the emergency room.

> What is service 118?
118 is a telephone number reserved for the request of urgent medical assistance. It is a toll free number from all fixed and mobile phones. A trained operator answers the call and asks questions to determine the severity of patient condition. When appropriate, he/she despatches an ambulance, and when needed, sends a doctor with the rescue squad.

> What do I need to bring to the emergency room?
Even if it is not necessary for access to care, it is useful to bring your photo identification card and your Regional Card of Services (Carta Regionale dei Servizi) or your health card (Tessera Sanitaria) and your Social Security Card (Codice Fiscale). If the situation does not require immediate medical intervention, the admission personnel will ask for a brief description of symptoms.

> Who is the first person I come in contact with in the ER?
A specialized professional nurse is responsible for patient identification and initial evaluation, attributing to each patient a priority code (triage).

> Why at times is the wait so long in the ER?
Admission to the ER and treatment is not regulated only by the order of arrival, but by the seriousness of the problem. An international Priority Code determines the order of care given.

> What is the Priority Code?
It is a four colour code to classify patient severity on ER admittance.

- Code red: absolute priority, life-threatening situation. The patient is admitted and stabilized. Other patients are informed of the resulting prolonged waiting time.
- Code yellow: serious condition. The patient will be visited as soon as possible.
- Code green; treatment can wait. Patients with this code will be seen after the more serious cases.
- Code white: non-emergency situations that could be treated by the family doctor. Patients with this code will be seen only after all the other patients have been treated. If the code white status is confirmed by the visiting physician, all ER services (including diagnostic studies) are subject to an established fee, except in cases of exemption

> And During the Weekend?
For non-emergency medical assistance, the Local Health Care Agency (ASL) of Milan has openned experimental clinics for general medicine and pediatrics, available to residents of Milan and to those who pass a good part of the day in Milan for school, work, tourism or other reasons.
For information www.asl.milano.it

> Can the priority code change?
Triage personnel monitor waiting patients and may review the priority code according to changes in the clinical status. All triage codes are confirmed or changed based on the ER doctor’s visit.

> Do I have to pay for ER services?
No, unless you have been classified as code white.

> Who is exempt from paying the fees?
Children under age 14 and adults over 65.

> What happens when I go home?
Once the necessary diagnostic and therapeutic procedures are completed, the doctor may discharge you with prescriptions and, possibly, follow up visits to be scheduled then. The doctor may decide, however that it is advisable to keep you hospitalised for further studies or therapy. If so, you will be admitted to the appropriate department directly from the emergency room.

> What is needed for the follow-up visit in the ambulatory care clinic?
If the doctor orders a follow-up visit, an exam, wound treatment or dressing changes, he/she will fill out the pink sheet which is the regional prescription form. An appointment for these services can be made at the walk up window of the ER or in the other offices for appointments.

> How can I have a copy of results from exams done in the ER?
Laboratory tests as well as x-ray, CT scan, MRI and sonogram findings are included in the discharge report, which will be given to you when you leave the ER. For a copy of radiological images contact:
Clinical Chart Archives (Ufficio Cartelle Cliniche)
Entrance area (pavillon 1)
tel. 02 6444.2212 - fax. 02 6444.3128 Monday through Friday 8 a.m. to 1 p.m., 2 p.m. to 4 p.m.
Walk up window Monday through Friday 9 a.m. to 1 p.m.
certificazionisanitarie@ospedaleniguarda.it

There is a set fee for these copies, except if you were classified as code white. In that case the cost of the copies of the exams is already included in the fee for ER services.

> What if I bring a child to the ER?
A special pediatric waiting room with toys has been created for young patients. The child will be accompanied to the pediatric department and visited by a pediatrician.

> Information for the foreigners
Emergency Room assistance is guaranteed to everybody. Foreigner citizens without the Italian Health Insurance Card must pay for the entire cost of the health services given. To foreigner citizens which signed a declaration of indigence had been assigned a Regional Code called S.T.P. (Foreigner Temporary Present), in this case health benefits will be guaranteed in Emergency Room, for pregnant, for underage and for the treatment of infectious diseases.
In case of need it is possible to ask for an interpreter or for a cultural mediator.