مجله طب اورژانس ایران
سال سوم شماره 2 (بهار 1395)

Triage is a part of the organizational process in emergency departments that affects their functional outcome. Each emergency department has its own special strategic state that may require adjustments to its triage system for localizing the process. Therefore, sufficient documentation is required in this field and studying triage is necessary. The purpose of this study was drawing a scheme of the studies carried out regarding triage in emergency departments during 2013 and 2014. For this purpose, articles published in this field were searched in Pubmed internet gateway using triage, fast track, hospitals, health care, emergency, medical services and emergency service as keywords. Based on this search strategy, 119 articles were found and classified into 7 triage- related fields. Finally, distribution of the articles regarding place, subject, type and methodology of the study was evaluated using descriptive analysis.

Overcrowding in the emergency department is a major obstacle in receiving care. The present study was done with the aim of evaluating the relationship of nursing care and documentation qualities with overcrowding in emergency department.
The present cross-sectional study was carried out in Alzahra Hospital, Isfahan, Iran in 2012. Data were gathered by a trained observer throughout working hours of the hospital using a standard checklist extracted from nursing textbooks. Overcrowded shifts were separated from other shifts by considering the number of patients admitted, and results were compared between the 2 situations using statistical analyses.
170 patient files were evaluated regarding the quality of nursing and its documentation. According to the statistical analyses, documenting the nursing care given decreased at overcrowded times (p = 0.028), however the quality of care given did not vary (p = 0.36).
The results of this study showed that despite the decline in quality of nursing care documentation following overcrowding in emergency department, rate and quality of care were not affected by overcrowding.

One way of evaluating medical services is through assessment of patient satisfaction. Patient satisfaction is a concept that has become so important in medical care nowadays and is even more important in pre-hospital emergency. Therefore, the present study was carried out aiming to evaluate patient satisfaction from pre-hospital emergency services in cities under supervision of Arak University of Medical Sciences.
In this cross-sectional study to evaluate patient satisfaction, a valid and reliable questionnaire of satisfaction scale from pre-hospital emergency care was used. The questionnaire consisted of 33 questions, 9 of which evaluated demographic data and the rest assessed satisfaction in various fields including condition of the ambulance, behavior, expertise and performance of the technicians, efficiency of care, and one question regarding the overall satisfaction with pre-hospital emergency care. Finally, gathered data were analyzed using SPSS and descriptive statistics and proper tests.
During the study period, 12564 missions were accomplished. The highest frequency belonged to Arak city (65%) and lowest frequency belonged to Ashtian city (9%). 366 patients participated in this study, most of which were male (59%) and had an education level less than high school diploma. In addition, most (52%) had no history of hospitalization and the number of those who were married was higher than singles (71%). The overall satisfaction score correlated with sex (p = ), marital status (p = ), education level (p = ), place of living (p = ), and history of using emergency services. Based on the results, women, those who were married, less educated people and those who had used emergency services before had reported a higher satisfaction rate. Mean satisfaction score from emergency service of Arak University of Medical Sciences was 0.7 ± 14.5 regarding condition of the ambulance, 83.7 ± 15.5 for technician behavior, 83.4 ± 15 for their expertise, 82.7 ± 14 for performance of the technicians, 89.7 ± 4 for efficiency of care, and the overall satisfaction score was 82.5 ± 14. The overall satisfaction score in cities under supervision of Arak University of Medical Sciences varied significantly (p The results of the present study showed that patient satisfaction rate from pre-hospital emergency service, was desirable. This rate was higher in women, married people, less educated people, trauma patients and in city bases compared to others. The highest satisfaction rate belonged to the professional performance and the lowest belonged to efficiency of technicians.

Iran is among the 10 disaster prone countries and based on the report of world disaster relief organization, Iran holds the first rank in mortality following earthquake. Fars province (south Iran) is one of the most earthquake prone areas in Iran. Therefore, the present study was done aiming to investigate the preparedness of Fars province households against earthquake.
In this cross-sectional study, the study sample consisted of all the families living in earthquake prone areas of Fars province selected by systematic random sampling. To gather data, a questionnaire, approved by Red Crescent research center of Shiraz was used, which consisted of demographic data preparedness status, knowledge and vulnerability of the families to earthquake. Trained interviewers visited households, and filled the questionnaire by interviewing the family caretaker. Data were analyzed using SPSS version 16.
500 families were included in this study. Mean age of the family caretakers was 47.5 ± 13.06 years (95% male). 38% of the families had necessary packages for emergencies. Mean score for preparedness, knowledge, and vulnerability of families to earthquake were 13.4 ± 3.27, 5.03 ± 1.37, and 27.61 ± 6.43, respectively. There was a significant correlation between the caretaker’s education level and taking part in training sessions (p Results of the present study showed that most of the families lacked preparedness and sufficient knowledge to face earthquakes and were vulnerable to dangers of earthquake. Therefore, providing accurate information for people, as well as increasing their knowledge in facing dangers of earthquake and decreasing its resulting damages seems necessary. In addition, holding maneuvers can be very effective in increasing preparedness.

Since pre-hospital care is the first line of trauma care, its right and accurate implementation can reduce problems such as long-term disabilities and mortality due to trauma. Therefore, the present study aimed to evaluate knowledge and clinical competence of bachelor of medical emergencies students in facing trauma.
The present study is a cross-sectional one. All the students of medical emergencies in Alborz University of Medical Sciences were included using convenience sampling. To gather data a demographic questionnaire, “clinical competence checklist” including 9 skills, and an oral test were used. Face and content validity, and reliability of the tool were evaluated and approved by 10 experts. In addition, reliability coefficient was calculated to be 0.82 for all the skills. Data gathering was done by taking oral and OSCE tests and observation of skill performance and filling the checklists. Data analysis was done using SPSS version 20 and using univariate t-test and Pearson’s correlation coefficient.
The findings of the study showed that 6.5% of the students had poor knowledge, 82.6% had fair, and 10.9% had good knowledge regarding trauma. In addition, 89.1% of the studied student had good clinical competences, and 10.9% had fair competence regarding trauma. In comparing the competence with an ideal state, there was a significant gap in all sub scales. There was a significant correlation between clinical competence level and work experience (p The results of this study showed that most bachelor of medical emergencies students in Alborz University of Medical Sciences had acceptable knowledge and competence regarding taking care of trauma patients in a pre-hospital setting. However, considering the significant gap between the acquired points and ideal state, continuous training in this regard seems necessary.

Today’s world is ever-changing and adapting to changes is essential for survival. Health technology and performing procedures to make an evolution has been considered in Imam Hossein Hospital since a long time ago and numerous measures have been taken in this regard. Implementing change in health care, equips experts and managers to better prepare themselves for the future. Therefore, the present study was done to provide a thorough report on carrying out health technology and performing procedures to make an evolution in Imam Hossein Hospital, a major hospital in Tehran, Iran.