Inside the Ambulance Service

The Story of Andrea Bigi

The world of emergency healthcare is made up of speed, complex decisions and great humanity. Andrea Bigi tells us about it. Today he is Head of Operations of the Mendrisiotto Ambulance Service (SAM), and for over twenty years he has lived the reality of rescue work every day.

Every intervention begins with a call

In pre-hospital emergency care, nothing is ever truly routine. Bigi reminds us of this when he says:

“Typical is a bit of a strange word because all our missions are different”.

Everything starts with a phone call to 144, when someone reports an illness or a critical situation. The operator assesses the urgency and activates the necessary resources: ambulance, emergency physician vehicle or other support. From that moment on, a real race against time begins, with one clear rule:

“In case of urgency, our rescuers must leave within 120 seconds”.

A mobile intensive care unit in the territory

When the crew reaches the scene, patient care begins. Andrea Bigi describes the ambulance as:

“A small intensive care unit that moves to the patient”.

Here, delegated medical procedures are performed, therapy is started and the most appropriate destination is determined: an emergency department, a specialist center or, in some cases, no transport at all.

The work continues during transport and ends with the handover at the hospital, the documentation of the intervention and the full restoration of the vehicle.

Analysis, procedures and continuous improvement

The quality of rescue does not end with the intervention itself. In particular situations, a structured discussion is organized with the entire team involved:

“We conduct a debriefing using a tool called after action review”.

This makes it possible to highlight strengths, critical issues and potential improvements, keeping service standards high.

The role of the head of operations

As Head of Operations, Bigi coordinates processes, procedures, response times and service management. It is a role that requires vision, organization and decision-making skills. At the same time, the connection with the field remains strong, especially in his role as regional incident commander, where tactical management also comes into play:

“The patient is always at the center of our plan, of our activity”.

A guiding principle that remains constant even in the most difficult conditions: night operations, rain, snow or complex scenarios.

A calling born at 15

His love for rescue work began early, during an internship at Croce Verde Lugano. From there, Andrea Bigi entered the first Swiss training program for professional rescuers and then joined SAM in 2001. Years of activity led him first into training, then into the management of vehicles, equipment and operational organization.

In 2019, he won the competition that appointed him Head of Operations. He took on the role shortly before the arrival of Covid, a period he describes as follows:

“We were forced to grow up very fast… we were toughened”.

Since then, his work has focused on management, supervision of complex interventions and continuous training.

A career built on passion and responsibility

Andrea Bigi’s career tells the story of a world in which professionalism, speed and adaptability merge with a deep sense of service. A vision reflected in every choice, every procedure and every intervention.

A constant reminder of what truly matters: the person who needs help.