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That's because the embassies are for governmental negotiations. U.S. consulates—not embassies—are the entities responsible for helping citizens aboard. (Consulates' other main job is helping people in the country in which they are located visit their own country, so expect to see a lot of Italians lined up to fill out paperwork for visas to visit your homeland.)
Whenever you get in serious trouble abroad—like losing a passport—you head for the nearest U.S. Consulate—not the embassy. That said, the main consular office for most countries is often inside, or next to, the embassy—though not always.
All foreign countries have their embassies in Rome. (A few even have a second embassy just to the Vatican, but that's just a curiosity.)
Many also have a second consular office in Milan (including Australia, Ireland, New Zealand, South Africa, the U.S., the U.K.).
A few—like the U.S. and the U.K.—have more consulates or consular agencies in other major Italian cities. (Canada, oddly, doesn't have on in Milan, but does in Naples and Padova.)
I've put a list of all the U.S. consulates in Italy on the right, because most of my readers are Yanks.
To my beloved Canadian neighbors, and my far-flung English-speaking cousins in Australia, the U.K., Ireland, Southern Africa, and elsewhere: I love you guys, but trying to maintain up-to-date lists of everyone's consulates in every Italian city would be crazy, Instead, I direct you to the most excellent list of resources below where you can find updated info on your home country's consulates in Italy:
Embassy World (www.embassyworld.com) - A nifty little Web site that links you to every embassy and consulate Web site out there, so an Aussie can find not only the Australian consulate in Rome, Italy, but also Italy's consulate in Canberra so he can ring up about visa requirements.
US State Department (travel.state.gov) - This Web site is the best thing the government has ever done for travelers. You can download passport applications, research potential visa requirements, read consular fact sheets and travel warnings on the countries you wish to visit, and find out all about the services available to US citizens abroad. Great set of links to other governmental and non-governmental travel sites, too.
U.S. Embassies (usembassy.state.gov) - Direct links to individual US Embassy Web sites around the globe, such as the one in Rome: rome.usembassy.gov.
Australian Government's Department of Foreign Affairs & Trade (www.smarttraveller.gov.au) - The direct link to the Australian embassy in Italy is www.italy.embassy.gov.au.
Canadian Government's Department of Foreign Affairs & International Trade (www.voyage.gc.ca). The direct link to the consular affairs department of the Canadian embassy in Rome is www.Italy.gc.ca.
Ireland Department of Foreign Affairs (www.dfa.ie/home/index.aspx?id=275) - The direct link to the Irish embassy in Italy is www.embassyofireland.it.
New Zealand Ministry of Foreign Affairs and Trade (www.safetravel.govt.nz) - The direct link to the New Zealand embassy in Italy is www.nzembassy.com/italy.
South African Department of International Relations and Cooperation (www.dfa.gov.za). The direct link to the South African embassy in Italy is www.sudafrica.it.
British Foreign & Commonwealth Office (www.fco.gov.uk) - The direct link to the British embassy in Italy is ukinitaly.fco.gov.uk.
U.S. consulates in Italy
Rome
Via Vittorio Veneto 121, 00187 Roma
tel. +39-06-46741
uscitizensrome@state.gov
rome.usembassy.gov
Walk-in hours: Mon–Fri 8:30am–12:30pm
Florence
Lungarno Vespucci 38, 50123 Firenze
tel. +39-055-266-951
uscitizensflorence@state.gov
florence.usconsulate.gov
Walk-in hours: Mon–Fri 8:30am–12:30pm
Milan
Via Principe Amadeo 2/10, 20121 Milano
tel. +39-02-290-351
uscitizensmilan@state.gov
milan.usconsulate.gov
Walk-in hours: Mon–Fri 8:30am–noon
Naples
Piazza della Repubblica , 80122 Napoli
tel. +39-081-583-8111
uscitizensnaples@state.gov
naples.usconsulate.gov
Walk-in hours: Mon–Fri 8am–noon
Venice (Consular agency)
Venice Marco Polo Airport
General Aviation Terminal
Viale Galileo Galilei 30, 30030 Tesserra (VE)
tel. +39-041-541-5944
veniceconsularagent@libero.it
Open: by appointment only
Palermo (Consular agency)
Via Vaccarini 1, 90143 Palermo
tel. +39-091-305-857
uscitizenspalermo@state.gov
Open: by appointment only Mon–Fri 9am–12:30pm
Genoa (Consular agency)
Via Dante 2, 16121 Genova
tel. +39-010-584-492
usconsge@libero.it
Open: Mon–Thurs 11am–3pm
For more info: usembassy.state.gov
This is vital, because you must leave large bags and any electronic devices—cellphone, iPod, cameras, etc.—at your hotel. None of these things are allowed inside embassy and consular buildings, and most consulates do not have a place where you can check them. I'd hate for you to wait in line for an hour only to be turned back for having an iPhone in your hip pocket.
Bring along every single piece of identification you still have. If you were smart and made a photocopied backup info sheet, bring that. Also bring two passport-sized photos of yourself. Also, bring a whole lot of patience (and something to read).
(a) you can get a list of English-speaking lawyers from the nearest U.S. consulate, and (b) good luck.
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U.S. consulates in Italy
Rome
Via Vittorio Veneto 121, 00187 Roma
tel. +39-06-46741
uscitizensrome@state.gov
rome.usembassy.gov
Walk-in hours: Mon–Fri 8:30am–12:30pm
Florence
Lungarno Vespucci 38, 50123 Firenze
tel. +39-055-266-951
uscitizensflorence@state.gov
florence.usconsulate.gov
Walk-in hours: Mon–Fri 8:30am–12:30pm
Milan
Via Principe Amadeo 2/10, 20121 Milano
tel. +39-02-290-351
uscitizensmilan@state.gov
milan.usconsulate.gov
Walk-in hours: Mon–Fri 8:30am–noon
Naples
Piazza della Repubblica , 80122 Napoli
tel. +39-081-583-8111
uscitizensnaples@state.gov
naples.usconsulate.gov
Walk-in hours: Mon–Fri 8am–noon
Venice (Consular agency)
Venice Marco Polo Airport
General Aviation Terminal
Viale Galileo Galilei 30, 30030 Tesserra (VE)
tel. +39-041-541-5944
veniceconsularagent@libero.it
Open: by appointment only
Palermo (Consular agency)
Via Vaccarini 1, 90143 Palermo
tel. +39-091-305-857
uscitizenspalermo@state.gov
Open: by appointment only Mon–Fri 9am–12:30pm
Genoa (Consular agency)
Via Dante 2, 16121 Genova
tel. +39-010-584-492
usconsge@libero.it
Open: Mon–Thurs 11am–3pm
For more info: usembassy.state.gov