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BACKGROUND: Time indices are key elements in prehospital medical emergencies. The number of calls to Emergency Medical Services (EMS) and the number of missions they have undertaken have been impacted by the COVID-19 epidemic. OBJECTIVES: This study's goal was to evaluate prehospital EMS time indices at the apex of the COVID-19 outbreak. METHODS: Data were extracted retrospectively from the Asayar Automation System, which records details on all emergency medical calls resulting in patient transport. The study period was from March 2018 to March 2021, covering the pre-COVID period and the first through sixth peaks of the pandemic in Iran. Standardized data extraction procedures were used to minimize bias in this retrospective review. RESULTS: In this study, most transport missions occurred during the fifth peak (n = 2811). In addition, the most missions were related to the age group above 60 years (31.1%), and the highest rate of patient transport (65.9%) was observed in male patients. Traumatic events, cardiac emergencies, impaired consciousness, and psychiatric disorders were, respectively, the main causes of patient transport. Moreover, a significant difference was observed between time indices of various COVID-19 peaks (p < 0.001). CONCLUSIONS: Even though the structure of Iran's emergency system is based on the American-Anglo model, and rapid patient transfers to medical facilities are prioritized, the COVID-19 epidemic resulted in increased calls and missions and affected time indices. Therefore, it is suggested that the method and type of service provision be modified during similar crises.
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This research examines the impact of an aging population in Eastern Iran on prehospital emergency medical services (EMS), with a focus on changes before and during the COVID-19 pandemic. A descriptive cross-sectional analysis was performed on data from 10,264 elderly individuals using EMS in Torbat-e Heydarieh County from March 2019 to March 2022. Statistical analyses, including t-tests and Chi-square tests, were conducted using SPSS software. Findings indicate that 30% of the 33,847 EMS calls received were from older adults. The nature of emergencies evolved from cardiovascular issues pre-pandemic to predominantly impaired consciousness during COVID-19, a statistically significant shift (p < .001). The study concludes with a call for research targeted at this demographic and suggests setting up dedicated EMS response units to cater to the elderly, responding to the increase in elderly-related EMS needs.
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INTRODUCTION: The ever-increasing human life expectancy has currently resulted in a noticeable rise in the world's older population. Addressing the healthcare needs of the older people has become a significant concern for many countries. Moreover, the older people are particularly vulnerable to traumatic events. This study aimed to examine the impact of the COVID-19 pandemic on prehospital care provided by Emergency Medical Services (EMS) for trauma-related cases among the older people in Iran. METHODS: This retrospective cohort study involved analyzing the medical records of 1,111 older people aged above 60 who experienced traumatic injuries and received pre-hospital emergency services from March 2018 to March 2022. In order to collect the data, the checklist made by the researcher was used and data analysis in SPSS16 was done using the Chi-square test and Fisher's exact test. RESULTS: The age group of 60-74 received the highest number of services both before and after the COVID-19 pandemic. The older men experienced more traumatic events compared to women throughout the study period. The majority of the traumatic events occurred between 8 a.m. and 12 p.m. both before and after the COVID-19 pandemic. CONCLUSIONS: The high prevalence rate of geriatric traumas can be primarily attributed to their physical problems and no control over movements caused by old age, as well as unsafe living conditions. To address these issues, it is suggested that facilities be provided to assist with mobility problems. Moreover, constructing suitable pedestrian bridges and regularly checking neighborhoods and surroundings to identify potential risk factors should be prioritized. Once these risk factors are identified, efforts can be made to adjust and eliminate them, thereby minimizing traumatic events and enhancing a safe and friendly environment for the older people.
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COVID-19 , Servicios Médicos de Urgencia , Masculino , Humanos , Femenino , Anciano , Persona de Mediana Edad , COVID-19/epidemiología , Pandemias , Estudios Retrospectivos , Servicio de Urgencia en HospitalRESUMEN
INTRODUCTION: Following the significant changes in healthcare systems over the last century, the role of pre-hospital emergency medical services (EMS) has been drawn against numerous challenges. In view of this, the present study aims to reflect on the trend of change in the role of pre-hospital EMS to meet new situations and needs, thereby providing a clear picture of this process. METHODS: Respecting the intricate concept of development and the major changes in Iran's healthcare system, this study was fulfilled using situational analysis (SA), developed by Clarke (2018), in Iran within 2022-2023. For this purpose, the data were collected through semi-structured, in-depth individual interviews with four faculty members, two managers involved in EMS, and six highly skilled EMS personnel in various positions. Moreover, the relevant articles published from 1950 to 2023 were reviewed. The data analysis was then performed via SA in the form of open coding as well as simultaneous analysis through three types of maps, viz., situational, social worlds/arenas, and positional maps, along with constant comparative analysis. RESULTS: Pre-hospital EMS in Iran has thus far had two turning points from 1970 to 2023, wherein academic components, need for equipment and resources, in conjunction with basic needs in the modern society, have been the main propellers. As well, the complexity of care for non-communicable diseases (NCDs), demand for managed care, and technological advancement has gradually resulted in further development in EMS. This trend describes the EMS situation in Iran from 1973 to 2023, as well as the EMS emergence stages, quantitative growth and infrastructure, and clinical education development in 2002-2023, indicating the lack of funding and inadequate scientific infrastructure in proportion to the population receiving such services. CONCLUSION: Considering the trend of change in the approaches adopted by healthcare systems across the world, and given the breakthroughs in nursing and medicine, along the education of professionals during the last thirty years, the descriptions of duties and performance in EMS have moved from primary care and patient transfer to specialized services and outpatient care. In addition, the cultural context specific to Iran, the challenges of women working in EMS centers, the disconnection of service providers, namely, the Iranian Red Crescent Society (IRCS) Relief and Rescue Organization (R&RO), Iran's National Police Force (INPF), and Iran's National Medical Emergency Organization (INMEO), as well as lack of resources and equipment, and the geographical distribution of human resources (HRs) based on population dispersion, are thus among the significant issues facing pre-hospital EMS in this country.
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Atención a la Salud , Servicio de Urgencia en Hospital , Humanos , Femenino , Irán , Escolaridad , HospitalesRESUMEN
BACKGROUND: The COVID-19 pandemic resulted in many changes in pre-hospital emergency medical services (EMS), including wearing full-body protective suits and well-fitted face masks, which can influence time indices in the course of service delivery. The present study aimed to compare the time indices of pre-hospital EMS missions before and during the COVID-19 pandemic in Iran. METHODS: This descriptive cross-sectional study used census sampling to select 17,860 emergency calls that caused patient transfer to medical facilities from March 2018 to March 2021 and then examined the time indices of pre-hospital EMS missions during the COVID-19 pandemic. The data collection tool was a two-part checklist: patients' individual characteristics and pre-hospital EMS mission time indices. The data were further analyzed using the SPSS16 and independent samples t-test. RESULTS: Out of the patients transferred by the EMS, 11,773 cases (65.9%) were male and 6,087 (34.1%) were female. The most common reason for the emergency calls was accidents (28.0%). Moreover, response time (P < 0.001), on-scene time (P < 0.001), transfer time (P < 0.001), total run time (P < 0.001), and round trip time (P < 0.001) increased significantly during the COVID-19 pandemic. CONCLUSIONS: We concluded that the EMS time indices elevated following the COVID-19 pandemic. Updating pre-hospital information management systems, ambulances and medical equipment, as well as holding training courses for pre-hospital EMS personnel could effectively enhance the time indices of pre-hospital EMS missions.
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COVID-19 , Servicios Médicos de Urgencia , Humanos , Masculino , Femenino , COVID-19/epidemiología , Estudios Transversales , Irán/epidemiología , Pandemias , HospitalesRESUMEN
BACKGROUND: Pre-hospital emergency medicine (PHEM) personnel are at risk of developing psychological disorders during the Covid-19 pandemic. This study aimed to investigate depression, anxiety, and stress levels of the Iranian PHEM personnel during the Covid-19 pandemic. METHODS: This descriptive cross-sectional study was performed on 544 PHEM personnel chosen by purposive sampling in North Khorasan, Khorasan-Razavi, South Khorasan, Sistan-Baluchestan, and Kerman provinces in eastern Iran from August to September 2021. Data collection tools included a demographic information questionnaire and the standardized 21-item Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed in SPSS 16 using one-way analysis of variance and linear regression. RESULTS: The mean scores of depression, anxiety, and stress were 8.7 ± 9.2, 7.0 ± 7.8, and 11.6 ± 9.2, respectively. Depression, stress, and anxiety were more prevalent in the age group of 41-55 years, people with master's and higher degrees, people with a history of underlying diseases, and people with over 10 years of work experience(p < 0.05). Depression and stress also showed a significant relationship with the type of employment. Stress alone was also significantly associated with working less than 35 hours a week and living separately from family(p < 0.05). CONCLUSIONS: PHEM personnel suffer from significant levels of depression, anxiety, and stress during the Covid-19 pandemic. Therefore, in order to improve the mental condition, it is recommended that the work schedule and services provided to these people be designed in such a way that they have more time for rest and communication with their family members. The personnel should also have easier access to the expert team in the fields of counseling and psychiatry.