Behrouz Samei; Javad Babaie; Jafar Sadegh Tabrizi; Homayoun Sadeghi-bazargani; Saber Azami-Aghdash; Naser Derakhshani; Ramin Rezapour
Volume 11, Issue 3 , July 2023, , Pages 109-118
Abstract
Objective: This study aimed to comprehensively determine the factors that affect the hospitals’ functionalpreparedness in response to disasters.Methods: A systematic review of studies published in English and Persian up to the end of 2022 was performedby searching PubMed Central, Web of Science, ...
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Objective: This study aimed to comprehensively determine the factors that affect the hospitals’ functionalpreparedness in response to disasters.Methods: A systematic review of studies published in English and Persian up to the end of 2022 was performedby searching PubMed Central, Web of Science, Scopus, ProQuest, SID, and Elmnet databases. Articles thatassessed hospitals’ functional preparedness were searched by using a combination of medical subject headingterms and keywords including disaster, emergency, preparedness, hospital preparedness, health care facilitiespreparedness, hospital functional preparedness, health care facilities functional preparedness, readiness, andeffective factors. Additionally, journals and gray literature were manually searched. Two independent reviewersscreened the eligible papers. The inclusion criteria were the full text should be published up to the end of 2022,in both Persian and English, and focus on hospital preparedness. The extracted data were manually analyzed,summarized, and reported using the content analysis method.Results: Of the 3465 articles, 105 studies were eventually included in the final analysis. Eighty-two influentialfactors were identified and classified into seven categories: government, coordination, control, and commanding(7 factors), existing guidelines and preparedness plans (12 factors), regulations (6 factors), supplying of resources(37 factors), education and training (8 factors), multi-layered information management and communicationsystems (8 factors), and contextual factors (4 factors).Conclusion: There are different dimensions of hospital preparedness for disasters, each of which is influencedby several independent factors. Addressing these factors will enhance the actual functional preparedness ofhospitals encountering disasters.
Farhad Heydari; Alireza Gholamian; Majid Zamani; Saeed Majidinejad
Volume 6, Issue 4 , October 2018, , Pages 292-299
Abstract
Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. ...
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Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. Patients were randomly assigned to receive intramuscular (IM) haloperidol (5 mg) or IM ketamine (4 mg/kg). The primary outcome was time to adequate sedation (AMSS ≤ +1). Secondary outcomes included the need for additional sedatives, required intubation, duration of hospitalization, and side effects. Results: The 90 agitated patients were enrolled. The mean age was 30.37±7.36 years (range 18–56); 74% (67/90) were men. The mean time to adequate sedation in ketamine group (7.73 ± 4.71 minutes) was significantly lower than haloperidol group (11.42 ± 7.20 minutes) (p= 0.005). 15 minutes after intervention, the sedation score did not differ significantly in both groups (Ketamine:0.14 ± 0.59 vs. Haloperidol: 0.30 ± 0.60; p=0.167). The incidence of complications was not significantly different between groups. The physician's satisfaction from the patients’ aggression control was significantly higher in ketamine group.Conclusion: These data suggest ketamine may be used for short-term control of agitated patients, additional studies are needed to confirm if ketamine is safe in this patient population. Given rapid effective sedation and the higher physician satisfaction of ketamine in comparison to haloperidol, it may be considered as a safe and appropriate alternative to haloperidol.IRCT Code: IRCT20180129038549N5
Mahsa Dehghani; Nazila Moftian; Peyman Rezaei-hachesu; Taha Samad-soltani
Volume 5, Issue 2 , April 2017, , Pages 79-89
Abstract
Objective: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department.Methods: For the purpose of collecting the data, PubMed and ACM databases were used ...
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Objective: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department.Methods: For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases. Subsequently, 11 articles were selected for further analysis.Results: The studies focused on the reduction of waiting time and patient stay, optimization of resources allocation, creation of crisis and maximum demand scenarios, identification of overcrowding bottlenecks, investigation of the impact of other systems on the existing system, and improvement of the system operations and functions. Subsequently, 15 simulation steps were derived from the relevant studies after an expert’s evaluation.Conclusion: The 10-steps approach proposed on the basis of the selected studies provides simulation and planning specialists with a structured method for both analyzing problems and choosing best-case scenarios. Moreover, following this framework systematically enables the development of design processes as well as software implementation of simulation problems.
Amir Khorram-Manesh; Johan Berlin; Eric Carlström
Volume 4, Issue 4 , October 2016, , Pages 186-196
Abstract
The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, ...
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The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.
