Seyed Mohammad Hosseini Kasnavieh; Kehan Koukli; Mohamad Veisi; Mohammad Amerzadeh; Hossein Hosseinifar; Ali Tahmasebi
Volume 11, Issue 4 , October 2023, , Pages 178-183
Abstract
Objective: This study aimed to investigate the necessity of cervical collars in patients with neck problems.Methods: This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir andRasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was ...
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Objective: This study aimed to investigate the necessity of cervical collars in patients with neck problems.Methods: This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir andRasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was used to selectthe patients with cervical collars. According to the protocol, a cervical collar was required for individuals whohad at least one symptom. If none of these symptoms existed, the cervical collar was deemed unnecessary. Thedata were analyzed using the Chi-square test and Fisher’s exact test.Results: Of the 114 trauma patients, the cervical collar was used unnecessarily by 49 (43%) patients. Tendernesswas the most common complication in 62 patients (54.4%). The prevalence of unnecessary cervical collaruse was 37.5% in female trauma patients and 43.88% in male trauma patients, which was not statisticallysignificant (p=0.63). The prevalence of unnecessary cervical collar use in trauma patients with multiple traumawas 39.42% and 80% in patients without multiple trauma, which was statistically significant (p=0.018). Patientswith a medical history had a higher rate of unnecessary use of the cervical collar (47.96%) than those withouta history (12.5%), and this difference was statistically significant (p=0.008).Conclusion: The guidelines for using cervical collars need to be updated by the EMS. Due to the large numberof trauma patients in Iran, cervical collars for necessary conditions can help reduce healthcare expensesand injuries caused by unnecessary cervical collars.
Peyman Saberian; Arman Shafiee; Parisa Hasani-Sharamin; Hosein Rafiemanesh; Alireza Baratloo
Volume 11, Issue 3 , July 2023, , Pages 154-161
Abstract
Objective: Considering the growing use of emergency medical services (EMS), we evaluated the level ofpublic awareness of emergency situations in Iran.Methods: This cross-sectional study was conducted from August 2021 to January 2023 on Iranian residentsin Tehran, who were older than 18 years old. The ...
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Objective: Considering the growing use of emergency medical services (EMS), we evaluated the level ofpublic awareness of emergency situations in Iran.Methods: This cross-sectional study was conducted from August 2021 to January 2023 on Iranian residentsin Tehran, who were older than 18 years old. The participants were directed to a URL for an online surveylink and asked to select their preferred options for the predetermined scenarios. We divided the participantsinto three groups: abuse, misuse, and non-use. At least 12 correct answers were required to qualify asacceptable knowledge and practice responses (KP score). Then, the relationship between participants’ baselinecharacteristics and their level of awareness was investigated.Results: Totally, 3864 people participated in the study, of whom 50.5% were men. The participants’ agesranged from 18 to 90 years old, with a mean age of 40.01±11.30 years. In general, the rate of abuse, misuse,and not-use in at least one scenario was 74.5%, 64%, and 70.4%, respectively. The results of the multivariableregression analysis indicated that female sex (OR=1.29), a higher education level (OR=3.36), a higher incomelevel (OR=1.64), and Turkish ethnicity (OR=1.20) were significantly associated with the correct KP score.Conclusion: The degree of inappropriate utilization of EMS services in Iran was significant. We found thatthe proper knowledge regarding the appropriate use of EMS was significantly associated with the participant’slevel of education, academic field, job, and income.
Navid Kalani; Naser Hatami; Sajed Ali; Neema John Mehramiz; Fatemeh Rahmanian; Esmaeel Raeyat doost; Marzieh Haghbeen; Samaneh Abiri; Mahdi Foroughian; Mohsen Ebrahimi
Volume 10, Issue 1 , January 2022, , Pages 21-26
Abstract
Objective: To compare the characteristics of the emergency medical services (EMS) brought COVID-19 patients versus self-referred walk-in patients. Methods: This was a Cross-sectional study of COVID-19 infected cases in Jahrom, south of Iran. Age, sex, the symptoms of beginning days’ passing, ...
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Objective: To compare the characteristics of the emergency medical services (EMS) brought COVID-19 patients versus self-referred walk-in patients. Methods: This was a Cross-sectional study of COVID-19 infected cases in Jahrom, south of Iran. Age, sex, the symptoms of beginning days’ passing, respiratory distress, PO2 at arrival, admission length and inhospital death were retrieved for confirming COVID-19 cases in the whole 2020 year. Respiratory distress was considered as the sign that agitates the patient to call EMS care. Survival analysis was used to evaluate the possible difference of the hospitalization outcome in EMS brought or Self-referred walk-in (SRW) patients. Results: There was 704 (27.1%) registries patients transfer to the hospital by EMS and 1895 (72.9%) cases with SRW referred to the hospital. The survival distributions for the EMS group were statistically significant and lower than SRW group (p <0.05). Despite the SRW patients, respiratory distress was associated with lower survival in EMS group (p <0.05). Days passing the symptom’s beginning was significantly different between EMS group (6.1±5.3 days) and SRW group (6.9±4.6 days). Cox regression showed higher mortality rate in patients higher than 75 years old in both groups (p <0.05). Higher PO2 at arrival was associated with lower mortality rate of Hazard Ratio of 0.959 (p <0.001) and 0.903 (p <0.001) in EMS and SRW groups, respectively. The history of heart disease and hypertension were associated with 1.011 and 1.088 times more than mortality risk in EMS group; while cancer history was associated with 2.74 times more of mortality risk in SRW group. Conclusion: It seems that severe acute respiratory syndrome occurs soon in some patients that lead to the need for an ambulance to transfer the patient to the hospital. Therefore, EMS transfer patients should be considered for more risk of severe COVID-19; considering comorbidities of heart disease and hypertension as red flags.
Seyed Mahmoudreza Sajjadi; Fatemeh Rahmanian; Razieh Sadat Mousavi-Roknabadi; Faramarz Farahmand; Afsaneh Dehbozorgi; Hadid Hamrah; Mohamad Javad Moradian
Volume 9, Issue 1 , January 2021, , Pages 21-27
Abstract
Objective: To investigate the patients transferred by helicopters, as well as an emergent medical services that were performed for them.Methods: In this retrospective cross-sectional study, all patients who were transferred by Fars province of Helicopter Emergency Medical Services (HEMS) to ...
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Objective: To investigate the patients transferred by helicopters, as well as an emergent medical services that were performed for them.Methods: In this retrospective cross-sectional study, all patients who were transferred by Fars province of Helicopter Emergency Medical Services (HEMS) to Shiraz hospitals, southern Iran (March 2017-March 2019) were investigated. Patients’ information was collected and analyzed includes age, gender, dispatch reason, trauma mechanisms, take hold of emergent medical services, as well as the air transportation time, time between dispatch from the origin hospital and starting the procedures, and patients’ outcome.Results: Eighty-three patients were enrolled with the mean±SD age of 36.9±19.47 years that 75.9% had trauma (p <0.0001). Mental status deterioration (25.3%) was the most dispatched indications. The mortality rate was 13.25% totally (11.11% in traumatic vs. 10% in non-traumatic). The mean±SD of air transportation time was significantly lower than ground transportation in both traumatic (p=0.0013) and non-traumatic (p <0.0001) patients. Also, the mean±SD of time between dispatch from the origin hospital and starting the procedures wasstatistically lower in air transportation in both traumatic (p=0.0028) and non-traumatic (p=0.0017) patients.Conclusion: Most of the patients transferred by HEMS were traumatic. The air transportation time as well as the time between dispatches from the origin hospital to the starting of the procedures were significantly lower in HEMS in comparison with ground transportation for both traumatic and non-traumatic patients.
Reza Safdari; Jaleh Shoshtarian Malak; Niloofar Mohammadzadeh; Azimeh Danesh Shahraki
Volume 5, Issue 3 , July 2017, , Pages 171-178
Abstract
Objective: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity.Methods: Prehospital emergency process were analyzed using existing prehospital management ...
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Objective: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity.Methods: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Results: Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities. The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent.Conclusion: In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement.
Amir Mirhaghi; Hojjat Shafaee; Javad Malekzadeh; Farzaneh Hasanzadeh
Volume 5, Issue 2 , April 2017, , Pages 104-109
Abstract
Objective: To develop decision-support tools to identify patients experiencing sudden cardiac arrest (SCA).Methods: Eighty calls related to SCA were content analyzed, and the contextual patterns that emerged were organized into a checklist. Two researchers independently analyzed the recorded calls and ...
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Objective: To develop decision-support tools to identify patients experiencing sudden cardiac arrest (SCA).Methods: Eighty calls related to SCA were content analyzed, and the contextual patterns that emerged were organized into a checklist. Two researchers independently analyzed the recorded calls and compared their findings. Eighteen dispatchers scored 20 cases (which included SCA and non-SCA cases) both with and without the checklist. Correct responses for each case and agreement among dispatchers have been reported.Results: Eighty audio files (total time, 96 min) were analyzed, and a total of 602 codes were extracted from the text and recordings. The caller’s tone of voice and presence or absence of background voices, calling for an ambulance and giving the dispatcher the address promptly, and description of the primary complaint and respirations accounted for 38%, 39%, and 23% of all codes, respectively. A 15-item complementary checklist has been developed. The mean percentages of correct responses were 66.9%+27.96% prior to the use of checklist and 80.05%+10.84% afterwards. Results of the independent t test for checklist scores showed that statistically significant differences were present between the SCA and non-SCA cases (t=5.88, df=18, p=0.000).Conclusion: Decision support tools can potentially increase the recognition rate of SCA cases, and therefore produce a higher rate of dispatcher-directed CPR.
