Health in Emergencies and Disasters Quarterly
Volume:6 Issue: 4, Summer 2021

Violence is increasing in societies and workplaces around the world. This study aimed to review the literature on violence against paramedics in the prehospital setting and estimate the related exposure rates and types.

The study was conducted based on the guidelines of systematic reviews and meta-analyses. The literature on the prevalence of workplace violence against paramedics published from January 1990 to September 2019 was searched in PubMed, Web of Science, Scopus, ProQuest, and Embase databases. The prevalence of violence was measured by using the random-effects model in Stata software. Sub-group analysis and meta-regression models were applied to explain the sources of heterogeneities.

The prevalence of overall violence, physical violence, verbal violence, and sexual harassment among study subjects were calculated to be 0.66 (95% CI CI: 0.20-1.11), 0.25 (CI: 0.16- 0.34), 0.58 (CI: 0.29-0.86) and 0.16 (CI: 0.09-0.22), respectively. There was no significant difference between male and female paramedics in terms of violence types. However, the prevalence of sexual harassment among women was higher than men (24% vs. 6%). The highest rate of physical violence and sexual harassment belonged to Europe and North America, while they had the lowest verbal violence. Asia and Australia had the lowest rate of physical violence and sexual harassment. 

Prehospital emergency service providers face a higher risk of potential exposure to violence in health care settings. This issue necessitates the special attention of prehospital care administrators to reduce the risk and related consequences of workplace violence by taking effective measures.

The ability to respond to any emergency before happening is a potential issue that manifests as operational readiness. This study aimed to evaluate the preparedness of prehospital emergency services of Mazandaran University of Medical Sciences in response to the epidemic of COVID-19.

This cross-sectional study was performed in April 2020 using a translated standard checklist of the Pan American World Health Organization (PAHO). The list consists of four components of call management (6 items), first responders (operational codes with 3 items), medical transportation (including primary and interhospital with 16 items), and emergency medical services administration (including medical guidelines, human resources, and education with 11 items).

There were 168 operational logistics facilities and 555 personnel to cover organizational missions. Except for two items that scored half a point, the rest of the measures received total points (35 out of a maximum of 36 points with 97% of the total points). According to the complete scores, operational readiness was at a good level.

The preparedness of the Center for Disaster Management and Medical Emergencies at Mazandaran University of Medical Sciences in the face of the COVID-19 epidemic has been at a good level. However, because of the continuation of the epidemic, strengthening the supply chain and empowering personnel are essential to sustainable readiness.

Prehospital emergency department provides land, air, boat, and rail ambulance care. This study aimed to compare the situation of air and ground emergency casualties in road traffic accidents transferred to Shahid Beheshti Medical Center in Qom City, Iran, 2015-2018.

The present study is a retrospective descriptive-analytical study. All road traffic accident victims transferred to Shahid Beheshti Medical Center in Qom by prehospital emergency land or air staff from 2015 to 2018 at 6 to 20 o’clock were included in this study (census method). The exclusion criteria included burns, death, transmission during cardiopulmonary resuscitation or by urban ambulances, and information deficiencies. We used a researcher-made checklist to examine victims’ age, sex, type of transmission, type of accident, type of trauma, distance, initial vital signs, time intervals, and day of the accident. SPSS software version 16 was used to analyze the data. Data were compared in two groups with the t test and the Chi-square test.

A total of 2057 casualties were included in the study: 566 casualties were transferred by air emergency and 1491 by ground emergency. The mean age of air emergency casualties was significantly lower than the ground emergency (P=0.008). Trauma to the neck, chest, abdomen and lower back was significantly higher in air emergency casualties, but hand and foot trauma were more common in ground emergency casualties. Most air missions took place on holidays or weekends, while most ground missions were done during weekdays (P<0.001). The mean distance of the air emergency missions was more than Beheshti Medical Center (P<0.001). Compared with ground emergency casualties, air emergency casualties had average systolic blood pressure, lower level of consciousness, and higher heart rate and respiration (P<0.001). The mean duration of transfer from the accident scene to the medical center in the air emergency was significantly shorter (P<0.001).

Air emergency casualties were usually accompanied by more critical vital signs and severe injuries to the neck, chest, abdomen, and back. This study can provide clinical triage criteria that focus on key environmental factors and reduced transport time. Further studies are needed to investigate the consequences of traffic accident casualties at the medical center to determine which subgroups will benefit most from using air emergency.

This study aims to design a multi-objective model for locating emergency relief bases with maximum coverage and minimum costs. As a result, this model is expected to reduce mortality by increasing the efficiency of relief services.

Based on the ambulance distribution in the east of Tehran City, Iran, and the statistical information on demand (at least 30 samples for data normalization) in the last six months of 2018, we introduced and implemented a definitive mathematical model. We also evaluated the model with GAMS software. Using previous studies and interviews, we identified key and practical indicators of site locations. These indicators are being easy to access, locating in high-demand areas, such as an urban area, and not being too close to another relief base. These factors were then prioritized using the hierarchical method, and the output indicates the high weight of the factor of “being in a place with high demand”. The objective functions are to maximize coverage, minimize costs, and provide equity in relief time. To deal with the uncertainty of the parameters, we used the robust optimization approach. To initially select potential proposed sites to establish the database, we used Geographic Information System (GIS). To test the above mathematical model in the real world, we conducted a case study in East Tehran.

Based on the designed model, the initial points proposed by GIS were identified. Finally, it was found that the number of stations in East Tehran must increase from 27 to 34 bases.

By implementing this model, the emergency medical service can provide the highest level of coverage. Also, the maximum relief time at stations will be reduced to 8 minutes.

This study aimed to model the relationship between occupational accidents, work-family conflict, and quality of work-life in emergency room nurses.

This correlational research uses path analysis. The study population consisted of all nurses working in the emergency rooms of hospitals in Tehran City, Iran, in 2020. Of them, 200 samples were selected by the available sampling method. To obtain the data, we used the occupational accidents questionnaire, the quality of work-life questionnaire, and the work-family conflict scale. SPSS v. 24 and Amos v. 24 software were used for data analysis.

The analysis of the findings showed that occupational accidents and work-family conflict have a negative and direct effect on the quality of work-life (P<0.01). Occupational accidents also have a positive and direct effect on work-family conflict (P<0.01). On the other hand, the mediating role of work-family conflict between occupational accidents and quality of work-life was confirmed (P<0.01).

The relationship model of occupational accidents with quality of work-life mediated by work-family conflict has a good fit, and there is a relationship between family, job, and environmental stressors with the quality of work-life.

There has been a significant increase in the number of train crashes worldwide, mainly due to the extension of the rail network and the use of the most sophisticated and cutting-edge technology.

The Tehran-Zahedan train had 260 passengers on board and left for Tehran City at 14:50 local time on Wednesday, September 25, 2019. The accident happened at 16:20 local time at 100 km distance from Zahedan City.

Five train cars derailed 2 km from Shorou Station, where four people died, and 157 were injured. According to the investigations, the accident occurred due to the unscrewing of some bolts and spring washers. There were 170-180 screws and spring washers removed along 50-60 m, which resulted in the creation of a dangerous point and derailment of the train. This study examined the challenges, strengths, and learned lessons of the incident.

Concerning standard and vast rail networks in Iran and the latest train crashes that mainly occurred just outside the cities, accessibility to the accident scene should be considered one of the most important physical vulnerability indexes. As a result, accessibility to special firefighting and rail rescue train car at some stations in crowded routes effectively decreases the consequences of such accidents.