Gilberto Cristofoletti , Autore dell’articolo                             

Coronavirus: montaggio della tenda al pronto soccorso e ...
Dalla fine del mese di febbraio u.s. l’emergenza COVID-19 ha impegnato i medici e tutti gli operatori sanitari che lavorano nelle aziende sanitarie delle zone più colpite in una straordinaria attività ed i media hanno raccontato questa emergenza sanitaria evidenziando le necessità strutturali, impiantistiche e di apparecchiature medicali correlate al lavoro dei clinici.

È stato evidente come oltre al bisogno di medici ed infermieri, si è presentata la necessità di aumentare enormemente il numero di posti letto di rianimazione, posti letto di degenze di malattie infettive e di pneumologia e quindi di tutte le apparecchiature elettromedicali a corredo (ventilatori polmonari, monitoraggi dei parametri vitali, pompe infusionali, sistemi di ventilazione assistita non invasiva, carrelli di emergenza, ecc.).

Anche nelle regioni meno colpite dal virus, come la Toscana, è scattata da subito una corsa per definire una strategia per fronteggiare l’emergenza COVID-19 e, già prima di conoscere esattamente la strategia ed il fabbisogno, è scattata la corsa all’approvvigionamento delle apparecchiature elettromedicali.

La USL Toscana Sudest, dopo un comprensibile momento iniziale di confusione ed incertezza, ha deciso di dedicare al trattamento dei pazienti COVID i suoi 2 ospedali maggiori: l’Ospedale San Donato di Arezzo e l’Ospedale Misericordia di Grosseto.

Trasformare l’Ospedale di Arezzo e quello di Grosseto in “ospedali Covid”, significava allestire in questi ospedali nuovi posti di rianimazione e trovare nuova collocazione alle attività sanitarie che venivano spostate altrove. Per esempio il trasferimento dell’attività chirurgica (sale operatorie) al Centro Chirurgico Toscano ha richiesto il trasferimento del robot e di altre attrezzature con tutte le complicazioni manutentive che ne conseguono.

Insieme all’approvvigionamento dei dispositivi di protezione individuale (DPI) quali mascherine, camici, copricalzari ecc., è partita una ricerca spasmodica di ventilatori polmonari ed altre apparecchiature che già dai primi giorni di marzo sembravano introvabili.

Il Governo ha affidato il coordinamento della gestione dell’emergenza alla Protezione Civile che ha annullato e dirottato ordini fatti dalle singole Aziende Sanitarie per cui anche ordini da me firmati per la USL Toscana Sudest non hanno potuto essere consegnati come concordato con le ditte fornitrici. La Protezione Civile ha fornito apparecchiature in comodato d’uso, ma non sono mai state chiare le procedure di azione della Protezione Civile nei confronti delle Aziende Sanitarie Locali.

Ci sono stati giorni complicati di grande confusione; non si conosceva l’evoluzione del virus e quindi non si riusciva a capire l’effettivo bisogno di apparecchiature; non si capiva quante apparecchiature avrebbe potuto fornire la Protezione Civile; soprattutto all’inizio non era facile per i clinici capire le strategie sanitarie da adottare di fronte ad un virus nuovo e sconosciuto. Tutto questo in un clima di paura collettiva con forti pressioni mediatiche.

Alle difficoltà sopra elencate si è aggiunto il problema della logistica: il trasporto e la consegna di apparecchiature era complicato dalla chiusura delle frontiere, dalla difficoltà di movimento dei mezzi. Era complicato far muovere i tecnici per le attività di installazione e collaudo (abbiamo avuto difficoltà anche per trovare l’albergo ad un tecnico fatto venire da Milano per un collaudo) ed è stato complicato trovare il modo di eseguire tutte le attività nel rispetto delle norme di distanziamento sociale.

Le attività di approvvigionamento dei dispositivi di protezione individuale e delle apparecchiature necessarie a contrastare l’emergenza sono proseguite senza soluzione di continuità: i posti letto in terapia intensiva, che nell’Ospedale San Donato di Arezzo erano 12 all’inizio dell’emergenza (tutti nel reparto di rianimazione), sono diventati 53 occupando le aree destinate alla sub intensiva e le sale operatorie: oltre quattro volte di più. Quelli nei reparti di malattia infettiva e pneumologia sono triplicati. È stato fatto uno sforzo gigantesco. Il tutto realizzato in pochissimo tempo.

Ultime notizie Coronavirus: dalla Protezione Civile la raccolta e ...
Abbiamo complessivamente acquisito oltre 4 milioni di apparecchiature e dispositivi ed ogni apparecchiatura è stata collaudata ed inventariata.

Abbiamo acquisito ed installato nella USL Toscana Sudest circa 100 letti di rianimazione, 85 ventilatori per la terapia intensiva e sub-intensiva, 130 monitor multi-parametrici, oltre a carrelli di emergenza, pompe infusionali, barelle di biocontenimento, apparecchiature diagnostiche ed altro ancora.

Mentre cercavamo di approvvigionare le apparecchiature ritenute necessarie, eravamo impegnati a valutare nuove soluzioni impiantistiche ed apparecchiature che non avevamo mai valutato e che ci venivano proposte da operatori privati e cittadini (produttori di ossigeno; stampanti 3D per produrre accessori, per esempio per le maschere della Decathlon; robot di sanificazione; termoscanner).

Merita di essere rammentata anche tutta l’attività svolta per consentire ai laboratori di analisi di Arezzo e di Grosseto di svolgere l’attività di screening sia sierologico che tramite i tamponi, allestendo idonei posti di lavoro con apparecchiature e sistemi di sicurezza dedicati.

Non so come andrà a finire e se andrà veramente tutto bene o se ci rimarranno problemi e quanto peggiorerà la nostra qualità di vita, ma sicuramente è stato un periodo sconvolgente.

*

Presidente Eletto 2020-2021

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