Emergency Medical Services
Afsaneh Esmaeili Ranjbar; Masoud Mayel; Mitra Movahedi; Faezeh Emaeili Ranjbar; Amirhossein Mirafzal
Volume 2, Issue 2 , July 2016, , Pages 37-41
Abstract
Objective: Most previous retrospective studies failed to show a consistent association between pre-hospital time intervals and mortality in trauma patients, bringing the recommendation of “transport fast to increase survival” under question. The aim of this study was to evaluate the association ...
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Objective: Most previous retrospective studies failed to show a consistent association between pre-hospital time intervals and mortality in trauma patients, bringing the recommendation of “transport fast to increase survival” under question. The aim of this study was to evaluate the association of response time, scene time, and transport time with 24-hour in-hospital mortality.Methods: In this cross-sectional study data were collected In the emergency department (ED). Time intervals were obtained from emergency medical service (EMS) central system. All traumatized patients presented to an urban academic hospital by EMS with Emergency Severity Index (ESI) levels 1 or 2 were included in the study. Exclusion criteria were age under 16 or above 65, being transported from outside of the city, severe underlying medical illness, life threatening intoxications, and randomized trauma score (RTS) of more than 10. Patients were followed in the hospital for 24-hour mortality.Results: A total of 2884 patients were enrolled in the study. Response time, scene time, transport time, and total out of hospital time were all associated with mortality in univariate analysis (P = 0.02, 0.01, <0.001, and 0.001, respectively). In multivariate regression analysis, transport time was associated with 24-hour mortality (P < 0.001, OR [95% CI]: 1.20 [1.16-1.24]).Conclusion: Although time intervals in most previous studies did not show association with mortality, there is no recommendation such as “pre-hospital time intervals in traumatized patients should not be limited,” since limiting time intervals for taking a traumatized patient to the hospital still seems to be prudent. Our findings support the recommendation of decreasing the transportation and total out of hospital time in the present condition in Kerman city EMS system.
Trauma
Maryam Ziaee; Amirhossein Mirafzal
Volume 2, Issue 2 , July 2016, , Pages 50-54
Abstract
Objective: To evaluate the association of base deficit (BD) with mortality in traumatized children, and to assess this association in a subgroup of patients with traumatic brain injury (TBI). Methods: In this cross-sectional study performed prospectively on a convenience sample of patients ...
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Objective: To evaluate the association of base deficit (BD) with mortality in traumatized children, and to assess this association in a subgroup of patients with traumatic brain injury (TBI). Methods: In this cross-sectional study performed prospectively on a convenience sample of patients under 16 years of age with trauma presenting to an academic level ІІ trauma center, we obtained venous BD values initially and followed the patients for in-hospital mortality. Initial vital signs were measured and injury severity score (ISS), randomized trauma score (RTS), and pediatric trauma score (PTS) were calculated. Results: A total of 102 patients were included, with 48 patients diagnosed with TBI. Nine patients (8.8%) died during admission, of which 6 were diagnosed with TBI. Based on the univariate analysis, BD was associated with mortality in the whole group (P = 0.01), but not in the TBI subgroup (P = 0.08). In multivariable analysis, RTS was the only variable independently associated with mortality (P = 0.001, odds ratio [OR] = 0.197). Linear regression model showed that BD was predictive of ISS, RTS, and PTS. Receiver operating characteristics (ROC) curve showed a cutoff point of -7 mmol/L for BD, below which there is a 12 fold increased risk for mortality. Conclusion: BD is a useful parameter in mortality prediction in pediatric trauma like in adult age group, but this predictive role in TBI patients is not supported by our results.
Trauma
Hafez Mohammadhassanzadeh; Amin Beigzadeh; Mehrdad Nazarieh
Volume 2, Issue 1 , January 2016, , Pages 1-2
Abstract
Every journal finds its fundamentals in the course of time by the validity and originality of its published literature. This is validated if authors keep diligence and honesty when they conduct their research and submit their work in a journal. But at times what comes out of a scientific research is ...
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Every journal finds its fundamentals in the course of time by the validity and originality of its published literature. This is validated if authors keep diligence and honesty when they conduct their research and submit their work in a journal. But at times what comes out of a scientific research is not always valid and reliable because there has not been an appropriate control on the work or researchers did not thoroughly conduct and report the results. Thus, it is very important that journals keep an increasingly close eye for the detection of scientific misconduct.
Trauma
payman Asadi; Vahid Monsef Kasmaei; Seyyed Mahdi Zia Ziabari; Behzad Zohrevandi
Volume 2, Issue 1 , January 2016, , Pages 11-15
Abstract
Objective: Low back pain is the most common skeletal disorder worldwide that 50% to 80% of people experience it at least once in their lifetime. Physical and psychological factors in the work environment can relatively contribute to low back pain. In this study, we examined the prevalence of low back ...
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Objective: Low back pain is the most common skeletal disorder worldwide that 50% to 80% of people experience it at least once in their lifetime. Physical and psychological factors in the work environment can relatively contribute to low back pain. In this study, we examined the prevalence of low back pain and influential factors in its development among nursing staff. Methods: In this cross-sectional study we assessed the prevalence of low back pain among nurses working in Poursina hospital, Rasht, Iran, during March and April 2012. Demographic data and information on the status of skeletal pain, as well as, associated factors were collected using a pre-designed check list. Data were analyzed using SPSS version 16. Results: A total of 350 nurses with a mean age of 32.00 ± 8.24 years (minimum 22 and maximum 56 years) were studied (90.3% female). 246 participants (70.3%) had a history of low back pain. There was no significant difference between gender and the incidence of low back pain, (P = 0.286). 96 participants (27.4%) aged 27 to 31 had the highest rate of low back pain and 11 participants (3.1%) aged 52 to 56 were the least frequent age group. Low back pain significantly differed by age (P = 0.001), body mass index (BMI) (P = 0.222), and physical activity (P = 0.050). Conclusion: The results of this study showed a prevalence of 70% for low back pain among nurses working in Poursina hospital in Rasht, in Gilan province. Age, BMI, and physical activity were significantly associated with the prevalence of low back pain. However, gender, occupation, marital status, smoking, family history, frequency of lifting heavy things, work experience, and workplace did not show a significant relationship
Trauma
Maryam Eshghi; Farzad Rahmani; Behjat Derakhti; Fariba Abdollahi; Shahrad Tajoddini
Volume 2, Issue 1 , January 2016, , Pages 15-20
Abstract
Objective: Patient satisfaction is one of the most important indicators for measuring the quality of emergency services and health care. The purpose of this study was to evaluate the patients’ satisfaction in the emergency department (ED) of Sina hospital. Methods: This descriptive, cross-sectional ...
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Objective: Patient satisfaction is one of the most important indicators for measuring the quality of emergency services and health care. The purpose of this study was to evaluate the patients’ satisfaction in the emergency department (ED) of Sina hospital. Methods: This descriptive, cross-sectional study was performed during one month in Sina hospital in 2014. Data were collected by a questionnaire which its validity and reliability were confirmed in previous studies. The questionnaire consisted of 2 parts. Part 1 included the demographic characteristics and part 2 encompassed the scales of satisfactory. Data analysis was conducted by SPSS version 15. Results: Totally, 425 patients participated in this study. The mean age of patients was 41.6±17.6 years. The mean total score of patient satisfaction was 17.43±1.56. The maximum satisfaction was related to the knowledge of physicians and the minimum satisfaction was related to the remaining period in the ED. Additionally, there was a desirable satisfaction for nurses’ performances. In terms of satisfaction regarding the physical environment and the workflow of the ED, the results were moderate. There was a significant statistical difference regarding nurses and physicians behavior in the ED during different working shifts, vacation days, and workdays. Conclusion: Based on the results obtained, patients had good satisfaction for the received services in the ED. It is necessary to develop physical spaces and improve the workflow of patients in the ED.
Trauma
Alireza Baratloo; Marzieh Maleki
Volume 1, Issue 2 , July 2015, , Pages 39-39
Abstract
Today, overcrowding in emergencies has turned out to be one of the biggest problems in health systems around the world. In this case, a short and an accessible solution could not be reached. In fact, several basic reasons play a role in such a problem, and eliminating each of them would require long-term ...
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Today, overcrowding in emergencies has turned out to be one of the biggest problems in health systems around the world. In this case, a short and an accessible solution could not be reached. In fact, several basic reasons play a role in such a problem, and eliminating each of them would require long-term planning. This issue not only has a negative effect on the quality of services presented to the patients, but also produces both psychological and physical effects on the emergency staff such as physicians and nurses. In addition, it also causes increased dissatisfaction among referees as well as imposing excessive exhaustion on medical staff.
Emergency Medical Services
Davood Soroush; Morteza Talebi Deloei; Hamidreza Reihani; Vida Vakili; Azadeh Mahmoodi Gharaee; Azadeh Tafakori; Reza Farahmand Rad; Elham Pishbin
Volume 1, Issue 2 , July 2015, , Pages 48-51
Abstract
Objective: Road traffic injuries (RTIs) are the second leading causes of death in Iran. One of the most important steps in the prevention of traffic-related trauma and its consequences is gaining insight into the epidemiology of injuries. We conducted this study to describe the characteristics of RTIs ...
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Objective: Road traffic injuries (RTIs) are the second leading causes of death in Iran. One of the most important steps in the prevention of traffic-related trauma and its consequences is gaining insight into the epidemiology of injuries. We conducted this study to describe the characteristics of RTIs and to find strategies for its prevention.
Methods: This was a prospective cross-sectional study on consecutive road traffic trauma patients admitted to the emergency department (ED) of the second largest trauma center in the northeast of Iran, during July to September 2013. Demographic characteristics, type of vehicle, and injured area of the body were documented for each patient.
Results: Of 666 included patients, 562 (84.4%) were male and 104 (15.6%) were female, with a mean age of 28.89 ± 16.62 years. Most of the patients were uneducated. The highest frequency of RTIs was related to motorcyclists with an attributed risk of RTIs for motorcycles at 75.8%. The most common traumatized area was head, face, and lower extremities.
Conclusion: The largest number of traumatized patients was among motorcyclists and uneducated population underscores the importance of public training about motorcycle usage and security and increase social awareness about reasons behind traffic law.
emergency nursing
Ramin Azhough; Samad Shams Vahdati; Fariba Faraji; Malihe Faraji; Maryam Ghorbanian; Ali Ramouz; Shahrad Tajoddini
Volume 1, Issue 2 , July 2015, , Pages 52-55
Abstract
Objective: Triage procedure is one of the most important aspects of emergency departments as it has an undeniable role on the management of patients. It includes 5 categories based on the Emergency Severity Index (ESI) according to the condition of severity. For better decision making and management, ...
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Objective: Triage procedure is one of the most important aspects of emergency departments as it has an undeniable role on the management of patients. It includes 5 categories based on the Emergency Severity Index (ESI) according to the condition of severity. For better decision making and management, it is important to have skillful and experienced nursing staff. In the current study, we aimed to investigate the effectiveness of a one-day workshop on participants in terms of their triage knowledge improvement.
Methods: This is a pre- and post-test trial study. In this study all the nursing staff of Sina hospital participated. The workshop was conducted in a single day for 6 hours. During the one-day workshop, topics such as emergency triage and hospital triage were covered according to START and ESI. In order to evaluate triage knowledge, each participant completed a pre-test before the workshop, and a post-test after the workshop (15 questions). Data were analyzed with SPSS 15.0. Paired t test was applied for data analysis.
Results: Fifty-five nurses with the mean age of 35.72 ± 7.35 participated in the workshop. The analysis of the data, using paired t test based on the pre-test and post-test results, did not show any significant differences (P > 0.05).
Conclusion: This study suggests that a one-day workshop is not really effective and reliable for triage knowledge improvement. We propose longer planned workshops in order to train more skillful staff.