جستجوی مقالات مرتبط با کلیدواژه "paramedics" در نشریات گروه "پزشکی"

 Prehospital paramedics played a critical role in the COVID-19 pandemic crisis.

 This study aimed to evaluate paramedic performance and background factors in the outbreak of this emerging disease.

 This cross-sectional study recruited 335 paramedics selected from 49 emergency medical services stations in Urmia and Tabriz cities, Iran. Data was collected using a questionnaire to assess the demographics and performance of paramedics in caring for COVID-19 patients. The response rate for the questionnaires was 90%. Data were analyzed using descriptive statistics and regression analysis in SPSS version 21. The level of statistical significance was considered less than 0.05.

 The average age of the paramedics was 32.81 years (71.3% were 35 years old or younger). Results showed that assessing patients' vital signs, checking for COVID-19 symptoms/signs, administering oxygen and IV fluids, recommending home care, and transporting patients to the emergency department were the most common actions taken by paramedics. Invasive procedures performed by paramedics included cardiopulmonary resuscitation (60.9%), intubation (53.1%), and suctioning (38.8%). However, 15.5% of paramedics reported not performing physical exams on patients due to fear of COVID-19. A statistically significant correlation was observed between paramedics' performance and their education level, educational qualifications, and history of COVID-19 disease (p< 0.001).

 Study results provide insight into paramedic performance during the COVID-19 pandemic. During emerging disease outbreaks, further training and the provision of necessary personal protective equipment could help paramedics perform all tasks without undue concern for personal safety.

Workplace violence has always been a serious chal-lenge in health care systems. It reduces employees’ satisfaction and productivity, and increases the potential for adverse medical events. This study aimed to determine the prevalence and predictors of workplace violence among hospital clinical staff.

This cross-sectional study was conducted on 140 hospital care staff including nurses and paramedics in 2022. The standard questionnaire of WHO on workplace violence in health sector was used to collect data. To describe the quantitative variables, the mean and standard deviations were utilized, and for analyzing the data, multiple logistic regression model was used. The analysis was performed using SPSS 26. 

The results showed that 47.9% of the participants ex-perienced verbal violence at least once in the past year, and 19.3% experienced sexual violence. Regarding the perpetrators of violence, except for physical violence, colleagues accounted for the highest. Most physical violence cases against the clinical staff were perpetrated by one of the patient’s family members. Gender, marital status, and years of work experience were determined as predictors of workplace violence. Married male employees with limited work experience were disproportionately at risk of workplace violence.

Hospital clinical staff were exposed to all kinds of violence, especially verbal violence. Training personnel on the management of workplace violence and enhancing their communication skills and determining the scope, and predictors of workplace violence can help healthcare managers reduce the violence and its complications.

Patient handover in the emergency department (ED) is a 2-way communication process between the paramedics and in-hospital emergency personnel, which can result in miscommunication and delivery challenges. This study aimed to explore the lived experience of paramedics on patient handover to the ED.

Over a period of 5 months, an interpretative phenomenological analysis (IPA) was used to explore the lived experiences of 15 paramedics in Tabriz, Iran. Semi-structured interviews were conducted in the emergency medical stations using the Smith approach for data collection and analysis. The researcher used 4 criteria to ensure rigor, including credibility, dependability, confirmability, and transferability, according to Lincoln and Guba.

Three main themes emerged from the data analysis, including “the hole of hope,” “the boring issues,” and “paramedics are only a driver.” A further 11 sub-themes emerged under the main themes.

The highlighted issues that need to be considered during the process are the presence of staff in front of the ED's door to welcome the patient, removal of structural defects and defective hospital equipment, the presence of medical supplies in emergency triage to prevent the paramedics from stumbling, and listening to paramedics by physicians and nurses to obtain the patients’ history.

Interprofessional communication between nurses and paramedics is a crucial and challenging issue for safe and effective patient care, but it has not been addressed enough. The most important action for improving these communications is to identify their obstacles and challenges.

The aim of this study was to explain the obstacles to interprofessional communications between nurses and paramedics.

This study used the qualitative content analysis method. The participants of this research were 11 nurses and paramedics who were selected using purposeful sampling and took part in semi-structured in-depth interviews. The data were collected from May to September 2022. Data analysis was carried out by the conventional content analysis method proposed by Graneheim and Lundman. Guba and Lincoln’s criteria were used to assess the rigor and accuracy of the collected data.

The findings of this research disclosed 3 main themes; human resources challenges, lack of coordination between nursing and paramedics departments, and emergency situations.

The challenges of interprofessional communication between nurses and paramedics are influenced by different human and managerial factors, and identifying them is a significant step toward improving this communication. With regard to the findings of this study, managers and planners of healthcare centers can mitigate challenging factors and improve the communication between nurses and paramedical staff and, therefore, prepare the context for high-quality care of patients and boost the satisfaction of health professionals with their work conditions.

The Middle East Respiratory Syndrome coronavirus (MERS-Co V) was known as a human pathogen associated with respiratory symptoms. This study aimed to investigate attitudes, knowledge, and practice about MERS-CoV in paramedics. In this quasi-experimental study, 82 paramedics in Iran in April 2019 were selected in a stratified cluster sampling. Paramedics worked in Health Centers in Iran. We performed educational intervention in this study. A four-point Likert scale researcher-made questionnaire containing demographic (9 questions) and MERS-CoV (33 questions) items was administered to collect the data. The collected data were analyzed by SPSS 18 software. Out of 82 paramedics, who completed questionnaires, 42.7% (35 people) were male, 56.1% (46 people) had a diploma degree, and 19.5% (16 people) had less than 1 year of work experience. about the participants reported 2 laboratoryconfirmed infections at Kerman State. In addition, 67.1% (32 people) passed a course to become familiar with disease. Theparamedics’ mean age was 37.52±8.88. The knowledge mean score of paramedics was 12.82 (SD=10.04). The highly significant source of data collection in paramedics was the attendance in a course to become familiar with disease (43.9%, 36). The mean score of the practice of paramedics was 13.98 (SD=10.00). The most significant concern in neglecting travel to polluted areas in paramedics was public health defects (39%, 32). There was a significant relationship (P<0.05, t=9.06) between knowledge score and variables: gender (P=0.001), education level (P=0.001), and years in service (P=0.039). The paramedic had concerns and tend to increase the knowledge regarding prevention. The awareness of the transmission of diseases was the most important factor for modifying practice and preventing diseases. Health decisionmakers recognized preventive actions to hinder the transmission of this fatal virus.

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.

Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE).

In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests.

Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma.

Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.

Cardiovascular emergencies have a high prevalence and are important among other pre-hospital emergencies. In such emergency situations, making decisions to provide the best care and transport to the hospital are brought with many challenges. The current study reports paramedics’ on-scene decision-making challenges in relation to a patient with the acute coronary syndrome. The case was an old woman who complained of sudden dizziness and weakness. The patient’s vital signs included a blood pressure of 100/70 mm Hg, heart rate of 58 beats per minute, respiratory rate of 17 breaths per minute, O2 sat of 96% and blood sugar of 145 mg/dL. The past medical history of the patient indicated that she had no previous disease or use of medications. In the hospital emergency unit, electrocardiography was recorded and ST-segment elevation myocardial infarction was observed. Paramedics face many challenges in on-scene decision making, which affect the time, process, and consequences of their decisions. In low and middle-income countries, due to resource limitations, all ambulances are not equipped with diagnostic equipment including portable sonograph and electrocardiograms. In such contexts, decision-making protocols need to be designed and used at the emergency scenes to guide the paramedic and ensure their optimal performance.

Blood transfusion service is an important part of our healthcare system whose aim is to provide safe, effective blood components for the patient’s requirement. The laboratory technicians and nurses working in the blood bank form the core for the effective functioning of blood bank. The study was to analyze the knowledge, attitude, and practice of nurses and paramedics such as laboratory technicians working in blood banks and whether intervention of a training program had any benefit to the participants.

This study was conducted in our department which is a regional training center approved by the National AIDS Control Organization for training medical officers, laboratory technicians, and staff nurses working in blood banks. There were a total number of 48 government run hospital blood banks who participated in the study and we conducted six training programs for 43 nurses and 64 laboratory technicians working in blood banks from the southern states of Tamil Nadu and Pondicherry in India. The training program was for 5 days for technicians and 3 days for nurses with theory sessions followed by hands on practical classes regarding the daily activities in blood bank. They were given a pre‑evaluation questionnaire to test their knowledge, attitude, and practice followed by a post evaluation questionnaire after conducting the training program.

The mean percentage score in the pre evaluation test before the training program for nurses and technicians was 47% and 53% while after the training program; the mean percentage was 66.8% and 77% which was statistically significant in both the groups. The correct blood bank practices followed by nurses and laboratory technicians overall were 67% and 75%, respectively. The technicians and nurses scored poorly in blood bank practices related to hemovigilance.

Regular and standardized training can lead to improvements in the knowledge, skills, and practice of nurses and paramedics who provide blood transfusion services. The constraints faced by the nurses and paramedical personnel needs to be addressed for the overall betterment of blood transfusion services.

The increase in the knowledge subsequently contributed to a better practice in the technicians. The concept of haemovigilance and error reporting has to be stressed on the nurses and paramedics to improve their good practices.

The use of Magnetic Resonance Imaging (MRI) systems is on the rise and the number of installed systems is constantly increasing all over the world. This raises the possibility for emergency personnel to get in contact with these systems. However, the clothing and working material of paramedics and firefighters is not designed for the use on magnets. More research is needed to gain a deeper understanding of the risks for emergency personnel, working on MRI systems. Therefore, this study examined the effects of magnetic force on selected working materials and clothes of firefighters and paramedics.
This study was conducted as a field study, utilising a 1.5 tesla MRI system. Selected items were examined on their behavior in the magnetic field and the following parameters were measured: (i) the force of attraction and (ii) the distance to the magnet when a force of attraction is recognisable. Manual force meter and a wooden distance meter were used to measure the parameters.
Findings: The highest force of attraction can be researched in helmets (30 newton), boots (90 newton) and gloves (17 newton). The measured force is high enough to pull these items into the magnet. Jackets and pants did not receive a high force of attraction. Working material can be influenced by eddy currents, according to the composition. The movement of the item can then be restricted.
Considering the results of this study, most of the clothing and working materials can be considered as MRI safe. However, the force of attraction of boots and helmets might be high enough to cause serious distraction for emergency personnel. There might be a high risk for emergency personnel to forget small items in their pockets which subsequently can act as dangerous projectiles. Additional tests might display the need for an independent MRI system. There is a high risk to damage the system (e.g. to break the cover by attracted objects) and hospitals might not be willing to take the risk in the future.