مجید پورشیخیان

 Emergency Medical Services (EMS) personnel are often the first to provide healthcare services to the patient in different situations outside the hospital. Due to the sensitivity of this work, knowledge of ambulance equipment can affect the performance of Emergency Medical Services personnel. 
Objective This study aims to assess the knowledge of pre-hospital EMS personnel in Rasht, Iran about ambulance equipment.

 This cross-sectional analytical study was conducted on 84 EMS personnel who were selected from 17 medical centers in Rasht, Iran using a convenience sampling method. The data collection tool was a two-part questionnaire. The first part surveys demographic characteristics (age, gender, work experience, type of employment, education, field of study, history of retraining courses) and the second part assesses the knowledge of ambulance equipment according to the Pre-hospital Emergency Medicine/Equipment User Manual of Iranian Ministry of Health and Medical Education (fourth edition). The data were analyzed in SPSS v. 22 software and the significance level was set at 0.05. 

Most of participants had a bachelor’s degree, were under permanent employment, and had a degree in nursing and emergency medicine. Their mean work experience was 9.84±6.41 years, and most of them had a history of participating in retraining courses. Their knowledge of ambulance equipment was at a good level. Kruskal-Wallis test showed that their knowledge level had a significant relationship with their type of employment (P<0.001).

 It is necessary to increase the knowledge level of pre-hospital EMS personnel about ambulance equipment by holding short-term training courses and using simulation methods.

Spiritual intelligence leads to understanding between people, calmness, and management of changes. The spiritual intelligence of emergency personnel May affects the correct performance of emergency procedures. This type of intelligence exists in all people, but due to the challenging working conditions of medical staff in the emergency department and the need to do the best work at the best time, it Can be more important. The objective of this study was to evaluate the effect of spiritual intelligence on efficacy of health personnel in the emergency department.

This study was a descriptive cross-sectional study that was performed on 83 medical personnel working in the emergency department of Poursina educational, research and therapeutic center, in Rasht, Iran, in 2021. The sampling method was census. The data were collected using a tool that consisted of demographic characteristics and King's questionnaire. Data were analyzed using SPSS24 software and descriptive statistical methods (frequency, percentage, mean and standard deviation) and Kolmogorov-Smirnov, independent T-test, Pearson test and analysis of variance. The significance level was considered P <0.05.

The mean age of the research participants was 29.15±7.39 years and 47 (56.6%) of participants were female. The findings of the present study showed that people with higher spiritual intelligence had better occupational efficiency than others (P<0.001), but there was no statistically significant relationship between spiritual intelligence with age, sex, marital status, and education.

Medical personnel who had higher spiritual intelligence were more efficient than others. Apart from the effect of spiritual intelligence on reducing people's stress, improving the spiritual intelligence of personnel in critical departments such as emergency can increase their efficiency, especially in difficult situations that require management.

Hypotension is the most common serious complication during hemodialysis. The aim of this study was to evaluate the effect of cold dialysate on hemodynamic status of patients undergoing hemodialysis.

A before/after study using a quasi-experimental design was carried out in 99 patients undergoing hemodialysis attending Rasht Razi Hospital, 2019. All patients received hemodialysis using a dialysate at 37°C for three consecutive sessions and the next three sessions were performed using a cool temperature dialysate (35.5°C). Blood pressure and pulse rate were monitored in all sessions. Data were analyzed in SPSS V16 using independent t-test and paired t-test.

Systolic and diastolic blood pressure changes were significantly different between the two dialysate temperatures (P<0.001). At 35.5°C, the mean systolic/diastolic blood pressure changes were higher than at 37°C from pre-dialysis to post-dialysis. Also, pre-dialysis and post-dialysis pulse changes were significantly different between the two temperatures (P<0.001).

According to this study, cold dialysis solution can stabilize the hemodynamic status of patients during dialysis.

Airway management is a fundamental principle in treatment of emergency patients and reduction of mortality. The purpose of this study was to determine the performance of prehospital emergency medicine servises (EMS) in endotracheal intubation and its related factors in mannequin.

This cross-sectional analytic study was performed in 70 EMS  staff in Rasht, Iran 2019. The participants were selected through census sampling. Demographic and occupational characteristics questionnaire and a checklist for tracheal intubation performance were used. Data were analyzed in SPSS V21, using Mann-Whitney U Test, Kruskal–Wallis Test, and ordinal logistic regression.

The overall performance of EMS staff in placing endotracheal tube was moderate. There were significant correlations between endotracheal intubation and work experience (P=0.051), and experience and numbers of tracheal intubation in human (P=0.051, P=0.022, and P=0.021, respectively).

According to this study, frequent in-service training courses are needed to improve the performance of EMS staff.

technology developed rapidly during the past decade and using these technologies increased in higher education more than before. Many studies in the field of electronic education has been done in recent years in Iran but e- learning assessment and its programs was neglected. This study was done with the aim of determining students’ views about using first principles of instruction in two electronic and traditional education methods.
This is a quasi- experimental study which was done in 2016. Statistical population was all nusrsing students at Shahid Beheshti nursing and midwifery school in Guilan University of Medical Sciences during their 3rd semester of bachelor degree which studying adult nursing in 2015- 2016. Among them 41 students were selected through censes Sampling method. “Teaching and learning quality” assessment tool was used For exploration of first principle of instruction(demonstration,application,duties,activation,unity). For comparison of first principles of instruction, paired T test and Wilcoxon test were used and data were anlayzed using SPSS.
Mean and standard deviation of The first principal of instruction in traditional education group was 3.70±0.24 and in electronic education group was 3.49±0.25 which was statistically ignificant difference based on paired T test analysis (p=0.001). Mean and standard deviation of The demonstration principal in electronic education group was 3.49±0.29 and in traditional education group was 3.69±0.40,The application principal in electronic education group was 3.31±0.52 and in traditional education group was 3.76±0.59, activation principal in electronic education group was 3.35±0.36 and in traditional education group was 3.70±0.34 which was statisticaly significant difference between 2 groups based on wilcoxon analysis (p it seems that traditional education method is superior to electronic education method in terms of first principles of instruction implementation.

The earthquakes have caused about 126,000 of deaths in the 20th century in Iran. Iran has long been known as one of the most seismically active areas of the world that there is the possibility of destructive earthquake in near future. Despite the importance of this issue, there has been no a comprehensive study to examine past earthquakes experiences.The use of past experiences in major incidents has a positive effect on the public awareness to respond disasters appropriately.This study aims to review lessons learned in health of the last 25 years of earthquakes in Iran. In this literature review, the information in the field of health searched and extracted from the related databases including Pub Med, Scopus, Google Scholar, Magiran and SID, conference papers, WHO reports and published papers in the last 25 years about earthquakes by keywords of Iran, earthquake and lesson learned. A total of 50 articles were reviewed; of these, 36 ones met the inclusion criteria. After studying the selected papers, the results were coded and presented in 10 groups thematically such as structural strengthening (4 articles), relief/ rescue/ housing (6 articles), response coordination (3 articles), efficient communication system (2 articles), sever physical damage (4 articles), preparation of healthcare unit (3 articles), vulnerable groups (4 articles), infectious diseases (3 articles), psychological support (2 articles), and socioeconomic changes (2 articles). The literature review of articles published in the last 25 years about major earthquakes in Iran showed that the evaluation results of the studies can be beneficial in order to prepare and deal more effectively with future earthquakes.

Hospitalization in intensive care units is regarded as a critical problem for patients and their family. The issue of visiting in these units is one of the most basic issues in promoting holistic care to patients. Although evidences show the benefits of visiting، it is forbidden in intensive care units of Iran. Visiting is always a challenging matter for nurses; consequently، they show different reaction to it. For changing the policy of visiting in intensive care units، it is important to pay attention to nurses’ beliefs. The aim of the present study was to investigate the nurses’ beliefs toward the open visiting in intensive care units.

This descriptive cross-sectional study was conducted on 127 nurses working in intensive care units of educational hospitals affiliated to Guilan University of Medical Sciences in Rasht in 2014. Data collection instrument form to access nurses’ socio-demographic information and BAVIQ questionnaire to assess nurses’ beliefs. Data collected was analyzed using SPSS ver. 21 by t test and binomial test and (P<0. 05) was considered as significant.

Results indicated that 80. 3 and 78. 7 percent of nurses have more negative beliefs to open visiting due to hampering adequate planning interfering with direct nursing care. But 59. 80 percent of nurses believe that open visiting policy decreases family’s anxiety (p<0. 05).

Most nurses believe that open visiting due to bad effects on patient and increasing their work load، is not useful and therefore insist on its prohibition.

Prehospital emergency is an important part of the health care system. The prerequisite for providing appropriate services in this sector is existence of the necessary equipment, particularly equipped ambulances that plays an important role in saving the patients’ life who need emergency measures. Given the high incidence of traffic accidents and other emergencies, this study was concluded to investigate current status of medical equipment of prehospital EMS ambulances in Rasht and compare with Iranian standards. In this descriptive-analytical and functional study, 13 active ambulances of emergency medical services were studied in Rasht in 2013. Data were collected and studied due to the checklist of standard medical examination card of ambulances type B MOH (Ministry of Health) and the checklist of 4374 of relief vehicles and equipment of Iranian National Standards Organization. Researchers completed the checklists with reference to emergency medical centers in Rasht and observation of medical equipment and ambulances. Data were analyzed by using descriptive and inferential statistics appropriate. Overall, average medical equipment of EMS ambulances in Rasht was 66.5% and 64.8% respectively that had a significant difference with standards (p<0.05) according to standards of MOH & Iran Standard National organization. In addition, the average equipment regarding both standards was as follows: In the medical and diagnosis groups:80% and 82.4%; equipment of respiration/ventilation: 97%; injection/drugs: 73% and 58.4%; equipment of treatment-critical management: 65.3% and 55.7%; nursing care/ bandage 58.3% and 53.8% that have significant differences with Iran defined standards in all cases (p<0.05). According to the results and both standards, about 84% of ambulances had all equipment related to the airway/ventilation management. According to the results, the best condition of medical equipment of EMS ambulances was related to equipment of airway/ventilation management. There was a significant deficiency in other equipment groups. The deficiencies of medical equipment of ambulances will reduce the efficiency of all the pre-hospital emergency medical services; therefore, it seems essential to reduce deficiencies and to achieve the national standards.

Learning and academic achievement are the most important subjects in educational psychology influenced by some individual and situational factors. Because of lack of studied research, there is not accurate statistic about nursing students’ motivation and its relation with academic achievement. Thus, we aimed to determine the relationship between nursing students’ motivation and academic achievement in Guilan University of medical sciences. This correlational study was conducted on 243 nursing students. Using Academic motivateion and work environment scales, data was collected and analyzed by SPSS. Out of 243 subjects, with the mean age of 21, 126 (51.9%) were female and 117 (48.1%) were male. student’s motivation level and their grad point average (GPA) was good. There was significant positive correlation between GPA and identified motivation (p=0.03), and introjected motivation (p= 0.00). While between GPA and demotivation, the correlation was significantly negative. Extrinsic and intrinsic motivation was not correlated significantly with GPA. According to the study, motivation level of nursing students is high. Internal motivation is not correlated with academic achievement, but identified and introjected motivations that are in lover level in proportion to internal motivation are highly correlated. Thus, the lecturers may need to consider more attempts regarding to identifying the impressive factors affected on motivation and academic achievement, and improving intrinsic motivation.

Pressure ulcer is a painful، disabling process which has side effects such as decreased quality of life and increased treatment cost in treatment process. Therefore it is important to assess at risk patients using a reliable objective criteria in order to take preventive measures. The purpose of this study was to determine the predictive value of Braden scale in occurrence of pressure ulcer among hospitalized patients in educational and therapeutic centers of Rasht city، Iran. This is a cross-sectional descriptive analytic study. Samples were chosen by consecutive method consisted of 350 hospitalized patients in orthopedic، ICUs، neuromedical wards in educational-therapeutic centers of Rasht city in 2011. The data collection tool was consisted of Braden scale. Data was analyzed using T test، Chi square، Fisher test and logistic regression. From 350 patients studied، 221 were male and 129 were female. The mean age was 49. 77±20. 54. Incidence of pressure ulcer in this study was 22. 6%. The most pressure ulcer cases were identified in ICUs patients. In logistic regression model، the chance of pressure ulcer formation in Braden scale in «limited sense of understanding” versus» lack of sense disorder«was significant [OR=3. 59، (CI: 1. 57-8. 20)]. The probability of pressure ulcer formation in completely motionless sub group versus lack of limitation in motility was significant [OR= 19. 97، (CI: 1. 81-219. 81)]. The probability of formation of pressure ulcer in problem sub group in friction versus lack of problem in friction was significant with [OR=6. 51، (CI: 1. 12-37. 87)]. The findings of study showed that Braden''s instrument is proper and standard measurement in determining at risk patients for pressure ulcer. The use of this instrument for evaluating patients and attending effective factors of pressure ulcer development before hospitalization can identify patients at risk and decrease the incidence of pressure ulcer.

Aim. The purpose of this paper is to describe different types of primary triage methods that are common and applicable in disaster scene in order to familiarize medical team personnel with these methods.Background. Disaster occurrence is rising all over the world. Primary assessment, treatment and transfer of victims to the medical centers which are away from the disaster scene is important considerations for first responder teams in response phase of disaster management cycle. In this regard, triage is an efficient tool for mass casualty management for which different strategies have been recommended in various countries.Method. In this review, published articles from 1995 to August 2013 were searched in Ovid, Science Direct, Google Scholar and PubMed data bases by using the keywords Triage, On-scene and Disaster.Findings. Based on search strategy, 50 English articles were found. Finally, 6 commonly adults triage methods and 2 pediatric triage methods were chosen to be described in this paper.Conclusion. Regarding the sudden nature of disaster and creating chaos following them, it is necessary for medical team members to apply the appropriate tools for managing mass casualties in attention to limited resources and the large number of victims. In order to perform proper triage method and reduce the amount of error in this procedure, it is necessary to educate correct practices of applicable triage methods to medical team members, Red Crescent workers and volunteers.

General anesthesia and surgery cause several physiological disorders in different organs of the respective patients that may appear as several complications during recovery, which need to be identified and evaluated. Survey of the incidence of such complications at Post Anesthesia Care Unit (PACU) 1 and some of the effective risk factors in Rasht Razi Hospital. In this cross-sectional and descriptive study, 155 patients 10-75 years old, in ASA 1 and 2 classes were selected in the hospital. Cases included those who underwent general anesthesia with the same techniques for elective urology surgery and transferred to PACU, in 2010. Questionnaires consisted of two parts, part one included basic information and part two included: respiratory, cardiovascular, neural and digestive complications. Collected data were analyzed using chi-square, paired tests by SPSS 16 and P≤0/05 was considered significant. Findings indicated that the incidence of considerable changes (increase or decrease) in BP, PR and respiration were 42%, 36% and 49%, hypoxemia(SaO2< 90%) 8/4%, pain 76%, shivering 22%, postoperative restlessness 26%, and nausea and vomiting 12% cases, as observed. We found a significant correlation between age and the incidence of considerable changes of PR and postoperative shivering and also between sex and the incidence of pain, shivering, postoperative restlessness and delay in recovery. In addition, the data showed a significant relationship between duration of surgery and shivering, postoperative pain severity and delay in recovery. The relatively high incidence of complications in recovery indicates the importance of employing skilled personnel and also using enough monitoring equipment at PACU in order to decrease mortality and morbidity of the patients and also save on hospital charges.

High incidence of postoperative shivering leads to complications such as increased oxygen consumption, intracranial & intraocular pressure and pain. Some drugs including pethedine, dexamethasone and doxapram are used for prevention of shivering. The aim of this study is to compare the effect of dexamethasone and doxapram in prevention of post-anesthetic shivering. This study is a double blind clinical trial including 90 patients in ASA 1 and 2 classes. The patients were under general anesthesia for elective abdominal and chest surgery with same the anesthesia techniques. Samples were randomly divided into three groups (two drug received groups and one control group). First group received dexamethasone 0.1 mg/kg, the second group doxapram 0.75 mg/kg and the control group 3 ml of distilled water as injection. The visible shivering observed after each treatment. Collected data were analyzed using Chi-square, Fisher exact and ANOVA tests By SPSS 16 and p ≤ 0.05 was considered significant. Our results showed a significant difference between shivering in drug received and control groups. Shivering was significantly decreased in drug received groups (p = 0.05) but there was no significant difference between them. This study showed that both drugs of dexamethasone and doxapram are effective in prevention of post-anesthetic shivering and can be substituted with pethedine. In addition to antishivering effect, doxapram has a respiratory stimulant effect that is, that is clinically important in postoperative stage.

Myocardial infarction (MI) is one of the most common causes for hospitalization. That accounts for proximately 30% the mortality and about one half of cases occur during the early hours following the onset of symptoms just before the transfer of patient to the hospital. Thus, delay in treatment has on important effect on developing the myocardial damage and the prognosis of the patients. In this study, interval between the onset of acute chest pain and the transfer to an cardiac center was studied. This study is a descriptive, a kind of new data, carried out on 100 inpatients, the age range was 56 years old (66% were male and 34% were female), with acute heart attack in Rasht Dr. Heshmat hospital by using a sampling during period from June to December in 2005. The onset of acute chest pain and acceptance in cardiac center divided in three periods: 1- Onset of acute pain to help call. 2- From help call to transfer time to an initial treatment center. 3- Transfer time from the initial treatment center to the heart center. Intensity pain was studied by using from visual accordance scale (V.A.S) and range 0-10. The data were collected by using from questionnaire and then were analyzed. Results showed that the total length of time between the onset of chest pain and hospitalization was 230 minutes. From the onset of pain to the help call lasted 91 minutes. Transfer time to an initial treatment center (or heart center) was 55 minutes and the transfer to the heart center was 84 minutes. There was significant relation between female (P=0.05) & low intensity pain with the delay timed. The greatest delay was in the help call following the onset of chest pain. Therefore, increasing patient’s knowledge for better understanding of symptoms in the onset of MI can reduce the delay time, side effects and mortality, especially in females for faster help call in the event of any type of chest pain