Emergency Healthcare Workers Research Articles

An overview of the poisonous plants of Lebanon and their effects.

Poisonous plants are naturally found in the environment and are easily reachable especially by children. These plants pose significant risks ranging from mild or asymptomatic to severe and even life-threatening. Data on poisonous plants of Lebanon is scarce and scattered; therefore, there remains a significant gap in the literature concerning poisonous plants in Lebanon. This study relied on a thorough review of existing literature on poisonous plants of Lebanon and their effects. Based on our experience in the field and on leveraging available data from the literature, a list of important potentially toxic plants in Lebanon was compiled. Toxic plants in Lebanon were categorized based on their chemical properties into groups such as alkaloids; glycosides; proteins, peptides, and lectins; phenols and phenylpropanoids; terpenes and resins; carboxylic acids; and other (uncategorized). The clinical effects of these plants were discussed in detail to provide an overview of the toxicity that they can cause. This study is part of our ongoing work on poisonous plants of Lebanon. It aims to fill a gap pertaining to poisonous plant; it will benefit healthcare workers and the public at the same time. Prompt recognition of plant exposure and their manifestations will allow for better clinical management especially among emergency healthcare workers and professionals. In addition, this review will increase awareness of Lebanese public about the poisonous plants of Lebanon with the ultimate aim to prevent these toxic occurrences from the beginning.

Readiness to manage Ebola Virus Disease among emergency healthcare workers in Uganda: a nationwide multicenter survey

BackgroundEmerging infectious diseases like the Ebola Virus Disease (EVD) pose significant global public health threats. Uganda has experienced multiple EVD outbreaks, the latest occurring in 2022. Frontline healthcare workers (HCWs) are at increased risk, yet there is insufficient evidence of existing knowledge of EVD of these HCWs. We aimed to assess the readiness of Uganda’s emergency HCWs to manage EVD and identify their training needs to inform targeted capacity-building interventions for future outbreaks.MethodsThis multicentre nationwide cross-sectional study was conducted from July to September 2023 among HCWs providing emergency care in 14 secondary and tertiary hospitals across Uganda. Participants were consecutively recruited using the probability-proportional-to-size sampling technique, and data was collected using a self-reported questionnaire. Factors associated with EVD knowledge were identified through a mixed-effect linear model.ResultsData from 691 eligible HCWs with a median age of 32 (IQR: 28–38) was analyzed (response rate: 92%). Only one-third (34.4%, n = 238) had received EVD training in the past year. The median EVD knowledge score was 77.4% (IQR: 71.2 − 83.4%). EVD knowledge was associated with longer professional experience in years (β: 0.21, 95% CI: 0.03 to 0.39, p = 0.024) and higher level of education: diploma (β: 3.37, 95% CI: 1.49 to 5.25, p < 0.001), undergraduate degree (β: 6.45, 95% CI: 4.11 to 8.79) and postgraduate degree (β: 7.13, 95% CI: 4.01 to 10.25, p < 0.001). Being a doctor (β: 2.55, 95% CI: 0.35 to 4.74, p = 0.023), providing care in the obstetrics/gynecology department (β: −1.90, 95% CI: −3.47 to − 0.32, p = 0.018), previous EVD training (β: 2.27, 95% CI: 0.96 to 3.59, p = 0.001) and accessing EVD information through social media (β: 2.52, 95% CI: 1.17 to 3.88, p < 0.001) were also significantly associated with EVD knowledge. HCWs were mostly interested in training on management (92.9%), infection prevention and control (87.1%), and clinical presentation (84.1%), and preferred physical (51.5%) and hybrid (38.2%) training modes.ConclusionOur study shows that the readiness of HCWs in Uganda to respond to EVD outbreaks varies by individual factors and information sources. We recommend targeted training and suggest future research on educational innovations and social media’s potential to fill knowledge gaps.

Investigation of The Factors Affecting the Vaccine Preferences of Pre-Hospital Emergency Healthcare Professionals

Objective: The aim of this study was to examine the factors affecting the vaccine preferences of prehospital emergency health workers and the status of vaccine opposition. Materials and Methods: This study was planned as a descriptive study to examine the factors affecting the vaccine preferences of prehospital emergency health care workers working in 112 emergency health services stations and command and control centers affiliated to the Ministry of Health in Aydın province between April 2022 and January 2023, their anti-vaccine status and their attitudes towards Covid-19 vaccine. The population of the study consisted of physicians, emergency medical technicians/technicians (ATT/Paramedics) and ambulance drivers (drivers) working in 112 emergency health services stations and command control centers affiliated to the Ministry of Health in Aydın province (N: 577). The sample selection method was not used and it was aimed to reach the whole population. Data were collected by sending online questionnaire forms to social media groups. The Case Report Form consisting of 12 (twelve) questions including socio-demographic characteristics such as age, gender, educational status, Attitudes Towards Covid-19 Vaccine Scale and Anti-Vaccine Scale were used. The data obtained in the study were analyzed using the SPSS for Windows 25.0 program. Findings: The population of the study was 577 people. 89.7% (n:427) people participated in our study. 51.5% (n:220) of the participants were female. 48.9% (n:209) were found to have Covid-19 infection. 95.8% (n:427) of the participants were vaccinated. Among the vaccinated participants, 70.4% (n:288) received Biontech, 70.4% (n:288) received Sinovac and 5.1% (n:21) received Turkovac vaccine types. When the scores of the attitudes towards Covid-19 vaccine scale and its dimensions were compared according to the descriptive characteristics of the participants, it was found that the positive attitude dimension scores of male participants (3.81) were higher than those of female participants (3.51). It was determined that the positive attitude dimension scores of the participants with chronic diseases and the participants who were vaccinated, and the positive attitude dimension scores of the participants whose vaccine type was Biontech, Sinovac and Turkovak were higher than those of the participants who were not vaccinated. It was determined that the positive attitude dimension and attitudes towards Covid-19 vaccine scale scores of the participants whose vaccine dose was three doses and more were higher than the participants whose vaccine dose was one dose and two doses, and the positive attitude dimension and attitudes towards Covid-19 vaccine scale scores of the participants who had a death due to Covid-19 infection in the family or close environment were higher than those of the participants who did not. According to the findings of our study, the view that there is no vaccine protection in those with chronic diseases has a higher score. Participants who did not have Covid-19 infection, who were not vaccinated, and who had no death loss in their close environment had higher scores on the anti-vaccination scale. Conclusion: In this study, which examined the hesitancy of prehospital emergency healthcare workers about Covid-19 vaccination, it was found that Covid-19 vaccines were administered at a very high rate. However, it was also found that 4.2% of the employees had high hesitation about vaccines and were not vaccinated. Pre-hospital emergency healthcare workers have an important role and responsibility in the acceptance of Covid-19 vaccine by the public and other healthcare professionals, as in other disaster situations. In a pandemic, vaccination of all members of the society is necessary for the control of the pandemic. For this reason, scientific studies should be conducted for emergency healthcare workers who are not vaccinated and who are hesitant about vaccines, including basic concerns about vaccines and examining potential side effects of vaccines. Training programs should be organized to ensure that healthcare workers are vaccinated with existing Covid-19 vaccines.

Knowledge and Confidence Level among Emergency Healthcare Workers in Airway Management and Resuscitation of Suspected Covid-19 Patients: A Cross-Sectional Study in Penang and Kelantan

INTRODUCTION: COVID-19 cases in Malaysia have followed a never-ending course of spike and fall since it was first detected. Though the prominent role of infection control standard precautions were strictly applied, cases among emergency healthcare workers (EHCW) contracting the disease continue to rise. Our study aims to evaluate the knowledge and confidence level and the factors that may influence the knowledge and confidence level among EHCW in airway management and resuscitation of suspected COVID-19 patients. MATERIALS AND METHODS: This was a cross-sectional study conducted in tertiary hospitals in Penang and Kelantan using a validated questionnaire. The territories evaluated include the possible method of transmission, proper steps during resuscitation, airway management and intubation, intensive care management, and etiquette of personal protective equipment. RESULTS: Out of 543 EHCW eligible for the study, only 300 participants responded to the questionnaire. Our study showed only 15.3% of respondents had good knowledge and 62.3% had high confidence in airway management and resuscitation of suspected COVID-19 patients. Significant associations were seen in knowledge and confidence level among respondents with previous experience attending continuing medical education (F=7.041, P=0.008 and F=19.398, P&lt;0.001 respectively). Significant associations were also demonstrated in confidence level among respondents with previous simulation training experience (F=13.905, P&lt;0.001). CONCLUSION: Our study revealed that most EHCW had poor knowledge and moderately adequate confidence in the airway management and resuscitation of suspected COVID-19 patients. A more comprehensive and strategized training program needs to be conducted to help in improvement of the knowledge and confidence level among EHCW.

Evaluating the impact of genomic epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) on hospital infection prevention and control decisions.

Genomic epidemiology enhances the ability to detect and refute methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in healthcare settings, but its routine introduction requires further evidence of benefits for patients and resource utilization. We performed a 12 month prospective study at Cambridge University Hospitals NHS Foundation Trust in the UK to capture its impact on hospital infection prevention and control (IPC) decisions. MRSA-positive samples were identified via the hospital microbiology laboratory between November 2018 and November 2019. We included samples from in-patients, clinic out-patients, people reviewed in the Emergency Department and healthcare workers screened by Occupational Health. We sequenced the first MRSA isolate from 823 consecutive individuals, defined their pairwise genetic relatedness, and sought epidemiological links in the hospital and community. Genomic analysis of 823 MRSA isolates identified 72 genetic clusters of two or more isolates containing 339/823 (41 %) of the cases. Epidemiological links were identified between two or more cases for 190 (23 %) individuals in 34/72 clusters. Weekly genomic epidemiology updates were shared with the IPC team, culminating in 49 face-to-face meetings and 21 written communications. Seventeen clusters were identified that were consistent with hospital MRSA transmission, discussion of which led to additional IPC actions in 14 of these. Two outbreaks were also identified where transmission had occurred in the community prior to hospital presentation; these were escalated to relevant IPC teams. We identified 38 instances where two or more in-patients shared a ward location on overlapping dates but carried unrelated MRSA isolates (pseudo-outbreaks); research data led to de-escalation of investigations in six of these. Our findings provide further support for the routine use of genomic epidemiology to enhance and target IPC resources.

Emotional burnout, job satisfaction, and intention to leave among pre-hospital emergency healthcare workers during the COVID-19 pandemic.

With the onset of the COVID-19 pandemic, pre-hospital emergency healthcare workers (PHEHW) assumed critical responsibilities in controlling and preventing the spread of the virus. This descriptive study aimed to explore the emotional burnout, job satisfaction, and intention to leave among PHEHW during the COVID-19 pandemic. The study was conducted with 401 emergency medical technicians and paramedics. The Sociodemographic Data Form, the Emotional Burnout Scale, the Job Satisfaction Scale, the Intention to Leave the Profession Scale were used to collect data. The findings were assessed with a significance level set at p < 0.05 and a 95% confidence interval. The participants demonstrated moderate scores in emotional burnout, job satisfaction, and intention to leave the profession. The analysis revealed a negative correlation, indicating that as emotional burnout increased, job satisfaction decreased, and the intention to leave the profession heightened. Notably, the participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, underwent COVID-19 testing, and experienced the loss of a healthcare worker due to COVID-19 exhibited higher levels of burnout. Furthermore, those who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and lost a healthcare worker due to COVID-19 reported lower levels of job satisfaction. Additionally, participants who had 6-9 years of service, lacked knowledge about COVID-19, had no COVID-19 training, and experienced the loss of a healthcare worker due to COVID-19 displayed a greater intention to leave the profession. It is important to implement improvement initiatives that will increase the motivation and job satisfaction of PHEHW. These include the regulation of working hours and shifts, augmenting staff numbers, enhancing working conditions, improving salaries, and implementing strategies aimed at fostering motivation and job satisfaction.

The impact of workplace violence on the mental health of health care workers during the COVID-19 pandemic.

The COVID-19 pandemic introduced a new set ofwork-related stressors for health care workers. This study aimed to investigate the associations between exposure to violence and common mental disorders among health care workers in emergency care settings during COVID-19 in the city of São Paulo, Brazil. We randomly selected two emergency care units. The 12-item General Health Questionnaire was used to assess common mental disorders among emergency health care workers (n = 100). We examined the relationships between common mental disorders and COVID-19 pandemic-related variables, including availability of personal protective equipment, exposure to violence, discrimination, harassment, and confidence in the workplace to handle the pandemic. We used multivariate Poisson regression with robust variance to estimate prevalence ratios for common mental disorders. Overall, 50% (95%CI 39.8-60.1) of participants had a common mental disorder. In addition, 71% reported being victims of at least one type of violence during the COVID-19 pandemic. Higher risks ofcommon mental disorders were found among those who reported lacking personal protective equipment, being victims of discrimination, violence, or harassment, and reporting less confidence in the workplace to handle the pandemic. Participants exposed to two types of violence and three types of violence had higher prevalence ratios, with prevalence ratios of 2.28 (95%CI 1.23-4.21) and 3.14 (95%CI 1.62-6.08), respectively. Promoting access to personal protective equipment, addressing mistreatment of health workers as well as promoting their well-being at work, and building confidence in the workplace to deal with the pandemic are critical.

Assessment of Serum Vitamin D Levels and Evaluation of Knowledge, Attitude, and Practices of Vitamin D Deficiency among Emergency Health-care Workers at a Tertiary Care Center in North India: A Prospective Cross-sectional Study

Background: The importance of vitamin D in maintaining overall health cannot be overstated, as its deficiency is a significant contributor to mortality and morbidity. There is a paucity of literature on vitamin D deficiency among healthcare workers (HCWs) in India, especially those working in emergency settings and day-night shifts. Aims and Objectives: This prospective cross-sectional study aimed to assess the levels of vitamin D among emergency healthcare workers (HCWs) and evaluate their knowledge, attitudes, and practices (KAP) regarding vitamin D deficiency. The study sought to address the limited literature on vitamin D deficiency among HCWs in emergency settings in India. Materials and Methods: A total of 105 randomly selected healthy HCWs from the emergency department of a tertiary care hospital in north India participated in the study. A structured questionnaire was administered to collect demographic information and assess the participants' knowledge, attitudes, and practices related to vitamin D. Serum vitamin D levels were measured using a 2 ml venous blood sample. Results: The mean serum vitamin D level was 15.08 ± 8.52 ng/ml, indicating a high prevalence of vitamin D deficiency (94.3%) among the participants. While most participants were aware of the active form of vitamin D, its sources and critical functions, knowledge about non-skeletal manifestations and measurable forms of vitamin D deficiency was limited. A majority of the participants (85.3%) recognized the importance of vitamin D as a micronutrient, and 69.3% expressed the need for education on its role. However, only 48.5% emphasized regular vitamin D intake. Conclusion: This study highlights the high prevalence of vitamin D deficiency among HCWs in the emergency department and identifies knowledge gaps regarding its critical functions. There is a need for an effective system to identify and address vitamin D-related health issues among HCWs, which could potentially enhance their overall efficiency.

Severe acute respiratory syndrome coronavirus 2-reactive salivary antibody detection in South Carolina emergency healthcare workers, September 2019-March 2020.

On 19 January 2020, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was identified in the United States, with the first cases in South Carolina confirmed on 06 March 2020. Due to initial limited testing capabilities and potential for asymptomatic transmission, it is possible that SARS-CoV-2 may have been present earlier than previously thought, while the immune status of at-risk populations was unknown. Saliva from 55 South Carolina emergency healthcare workers (EHCWs) was collected from September 2019 to March 2020, pre- and post-healthcare shifts, and stored frozen. To determine the presence of SARS-CoV-2-reactive antibodies, saliva-acquired post-shift was analysed by enzyme-linked immunosorbent assay (ELISA) with a repeat of positive or inconclusive results and follow-up testing of pre-shift samples. Two participants were positive for SARS-CoV-2 N/S1-reactive IgG, confirmed by follow-up testing, with S1 receptor binding domain (RBD)-specific IgG present in one individual. Positive samples were collected from medical students working in emergency medical services (EMSs) in October or November 2019. The presence of detectable anti-SARS-CoV-2 antibodies in 2019 suggests that immune responses to the virus existed in South Carolina, and the United States, in a small percentage of EHCWs prior to the earliest documented coronavirus disease 2019 (COVID-19) cases. These findings suggest the feasibility of saliva as a noninvasive tool for surveillance of emerging outbreaks, and EHCWs represent a high-risk population that should be the focus of infectious disease surveillance.

Psychological mediators between risk perception and psychological wellbeing in emergency healthcare workers.

Healthcare workers are subjected to numerous work-related stress factors, which have negative consequences on their physical and mental health, making them a vulnerable group. The recent pandemic caused by the new coronavirus created a high demand for attention from healthcare workers, which put their mental health at risk. This study aimed to test a mediation model in which resilience and the satisfaction of psychological needs play a mediating role in risk perception, the attitude toward the management carried out by the administration, emotional intelligence on psychological wellbeing, and depressive symptoms of frontline professionals. The sample consisted of 405 healthcare professionals aged between 22 and 65 years, belonging to critical care units in southern Spain. Linear correlation and mediation analyses were performed. The results showed that psychological wellbeing had positive correlations with resilience and negative correlations with the discrepancy in the satisfaction of psychological needs. Depressive symptoms had negative correlations with resilience and positive correlations with the satisfaction of psychological needs. To explore these results further, a mediation analysis was conducted, and a large set of significant indirect effects was found.

Evaluation of the Situations of Coping With Mental Trauma and Trauma in Emergency Service Personnel Who Medically Intervened to Earthquake Affected People in the 2020 Izmir Earthquake.

This study aimed to evaluate the mental trauma and coping status of emergency health care workers who responded to the earthquake affected people in the October 2020 Izmir earthquake. This was a descriptive and cross-sectional study. State-Trait Anxiety Inventory (STAI), Posttraumatic Cognition Inventory, Strategies for Coping with Earthquake Stress Scale (SCESS), and Post-earthquake Trauma Level Determination Scale (PETLDS) were used. Independent t-test, analysis of variance, Tukey's test, and Pearson's correlation analysis were used for statistical analysis. Statistical significance was accepted as P ≤ 0.05. A total of 113 health-care professionals participated in the study. There is a positive and high degree of correlation between the religious coping sub-dimension of the SCESS and the PETLDS (P < 0.001). There was a moderate positive correlation between the religious coping sub-dimension of the SCESS and the state anxiety (P < 0.001) and trait anxiety (P < 0.001) subscales of the STAI. In our study, mental trauma and post-traumatic coping levels of health-care workers who were exposed to earthquakes differed according to age, gender, and educational status. We found that post-earthquake trauma levels were directly related to state and trait anxiety levels and religious coping levels. We found that, after the earthquake, social support seeking behavior, state and trait anxiety levels increased; negative cognitions about self, negative cognitions about the world, and self-blame increased.Practice implications: This study draws attention to the evaluation of emergency health workers who work at the forefront of disasters in terms of subsyndromal post-traumatic stress disorder (PTSD). It is recommended to make plans for psychologically protective and preventive interventions for health-care workers especially after disasters.

Correlation of the COVID-19 Infection and Outcomes with Workload among Emergency Healthcare Workers in an Iranian Referral Hospital.

The immediate spread of COVID-19 posed a great deal of strain on healthcare personnel, particularly emergency personnel. Considering the critical role of frontline health care personnel (HCPs) during the pandemic and the life-threatening effects of COVID-19 on them, the present study aimed to evaluate the hospital database among frontline emergency personnel, and to assess the factors affecting the health status of the emergency HCPs. In the current study, we collected data on coronavirus clinical features from 58 HCPs with confirmed COVID-19 who worked in the emergency ward of Baqiyatallah Hospital, Tehran, one of the most referral hospitals in Iran. We also assessed the factors affecting the health status of the emergency HCPs from February 2020 to November 2020. All of the 58 HCPs infected with COVID-19 were the personnel of the emergency ward with an age range of 20-59 years old. The median (interquartile range) of hospital length of stay (LOS) among all patients was 8 days. Length of stay is a critical factor in predicting hospital resource needs. Twelve (21.8%) patients had ground-glass opacity (GGO) alone, and 20 (35.7%) patients had patchy GGO. In our multivariable analysis, high levels of patient liver enzymes (P=0.04) and lymphopenia (P=0.01) were significantly associated with the LOS. In our study, there was an association between high levels of patient's ESR and CRP and longer LOS. We also found that age and gender had no effect on LOS. Nurses contributed to the highest number of COVID-19 infection. It was also found that HCPs who had more working shifts were more infected, and the intensive care unit of the emergency ward was the most infected area of the Emergency Room.

Palliative care needs and barriers in an urban Ugandan Emergency Department: A mixed-methods survey of emergency healthcare workers and patients

BackgroundPalliative Care offers patient-centered, symptom-focused relief for patients with incurable disease, and early integration of palliative care ensures quality of life and death while reducing medical impoverishment. The Emergency Department is an ideal yet understudied, under-utilized location to initiate palliative care. ObjectiveTo evaluate the palliative care needs of patients with incurable disease and perceived barriers amongst healthcare providers in the Emergency Department of Kiruddu National Referral Hospital, Kampala, Uganda. MethodsA mixed methods survey of Emergency Department healthcare workers and patients was conducted. A crosse sectional survey of ninety-nine patients was conducted using the integrated Palliative Care Outcome Scale (IPOS). Eleven interviews were conducted with healthcare workers at Kiruddu Hospital, identified by purposive sampling. Descriptive and inferential statistics were used to analyze quantitative data.. Grounded theory approach was used to construct the in depth interview questions, code and analyze qualitative results and collapse these results into final themes. ResultsThe most common diagnoses were HIV/HIV-TB (32 %), heart disease (18 %), and sickle cell disease (14 %). The prevalence of unmet palliative care needs was substantial: more that 70 % of patients reported untreated symptoms e.g., pain, fatigue, difficulty breathing. Seventy-seven percent of the population reported severe or overwhelming pain. The main barriers to provision of palliative care in the Emergency Department as identified by healthcare workers were: (1) lack of adequate training in palliative care; (2) Challenges due to patient volume and understaffing; (3) the misconception that palliative care is associated with pain management alone; (4) Financial constraints as the greatest challenge faced by patients with incurable disease. ConclusionsWe report a high prevalence of unmet palliative care needs among patients in this urban Ugandan Emergency Department, and important barriers reported by emergency healthcare providers. Identification of these barriers offers opportunities to overcome them including harnessing novel mHealth interventions such as clinical support apps or telehealth palliative care consultants. Integration of palliative care in this setting would improve the care of vulnerable patients, provide healthcare workers with an additional care modality while likely adding value to the health system.

Prevalence and Determinants of Workplace Violence Against Pediatric Emergency Healthcare Workers and Its Effect on Their Psychological Resilience.

The study aimed to determine the prevalence and risk factors of workplace violence (WPV) against pediatric emergency healthcare workers and evaluate the relationship between WPV and psychological resilience. This study is cross-sectional and correlational. According to the results, the prevalence of WPV was 69.8%, and its distribution was as follows: verbal abuse (56.9%), bullying/mobbing (37.6%), physical abuse (12.8%), and sexual abuse (2.2%). Being single/separated/divorced/widowed (odds ratio [OR]: 1.85, 95% confidence interval [CI]: 1.03-3.30), being a physician (OR: 4.74, 95% CI: 1.73-12.96), being a staff member (OR: 2.57, 95% CI: 1.10-5.99), routine direct physical contact with patients/clients (OR: 2.77, 95% CI: 1.40-5.48), and lack of encouragement to report WPV (OR: 3.76, 95% CI: 2.01-7.01) were independent predictors of WPV (P < .05), and WPV was found to be associated with low psychological resilience. Arrangements related to violence prevention, preparation, and intervention should be made and maintained in all pediatric emergency departments.

Post-traumatic Stress Disorder and Its Associated Risk Factors Among Emergency Healthcare Workers: A Saudi Cross-Sectional Analytical Study.

Post-traumatic stress disorder (PTSD) is a psychiatric disease characterized by exposure to threatened death or serious injury and directly experiencing or witnessing the event. Many healthcare professionals have had PTSD, but emergency physicians may be particularly susceptible. To our knowledge, no study has been performed in Saudi Arabia to identify the prevalence and associated risk factors of PTSD among emergency staff. This study aims to determine the prevalence and risk factors of post-traumatic stress disorder (PTSD) among emergency healthcare workers (HCWs) in Saudi Arabia. A cross-sectional analytical study will be conducted in emergency departments around Saudi Arabia in all regions. The study population will include healthcare workers in emergency departments who work and presently live in Saudi Arabia. The survey was divided into two sections. The first section focuses on the emergency personnel's demographic data; the second concentrates on screening for post-traumatic stress disorder using the PTSD checklist for DSM-5 (PCL-5). Our population included 519 emergency healthcare staff, including males (51.4%) and females (48.6%). Most emergency HCWs worked in the Ministry of Health Hospitals (58%). The highest diagnosed psychological disorders among emergency staff were anxiety (19.3%) and mood disorders (10.2%). The prevalence of PTSD among emergency workers in Saudi Arabia was 14.1%. The prevalence of PTSD was significantly higher among emergency HCWs who had chronic diseases, emergency workers with anxiety or mood disorders, emergency staff who were using psychiatric medication (p<0.001), and those with psychotic disorders (p=0.002). The prevalence of PTSD among emergency healthcare workers in Saudi Arabia is estimated to be 14.1%, and pre-existing mental illnesses are associated with a higher risk of PTSD.

Utilization of Wellness Practices For Burnout and Stress During COVID-19 Among an Interdisciplinary Cohort of Emergency Healthcare Workers

Utilization of Wellness Practices For Burnout and Stress During COVID-19 Among an Interdisciplinary Cohort of Emergency Healthcare Workers

Coping and Quality of Life Differences between Emergency and Rehabilitation Healthcare Workers.

Audit and Feedback (A&F) is a systematic process involving the collection of data, which are subsequently compared with the established reference standards and then subsequently disseminated to healthcare providers through feedback meetings. This allows continuous improvement to be ensured in the quality of care processes. Often, the parameters taken into account concern only the patient and the treatment processes, neglecting other variables. Quality of life in the workplace and coping skills are determining variables for the clinical performance of all healthcare professionals. For this reason, in this study, these variables were investigated and differences were highlighted in two different role categories and context: cardiovascular emergency and neurological rehabilitation. A psychological screening was carried out by sending the computerized Coping Orientation to Problems Experienced-Nuova Versione Italiana (COPE-NVI) and Professional Quality of Life Scale-5 (ProQoL) questionnaires to all healthcare workers involved. Ninety-five healthcare providers (mean ± SD age: 47 ± 10.4 years; 37.9% male) answered the questionnaire and were assigned into two groups (G1 and G2) based on the ward in which they worked. These were further divided into two subgroups (R1 and R2) based on their role. The obtained results show that avoidance strategies are used more by health professionals working in rehabilitation (G2) wards than in intensive-care units (G1). Moreover, in G1 nurses, physical therapists and speech therapists (R2) obtained higher scores in terms of turning to religion (TR) and compassion satisfaction (CS), while physicians and psychologists (R1) obtained higher scores on the burnout scale (BO). The TR score for R2 was found to be higher, even in G2. The response trend of the two groups in the different departments was analyzed and commented on.

Explaining the challenges of pre-hospital emergency healthcare workers in providing care at the scene

Background and Purpose: Pre-hospital emergency healthcare workers face various problems because of the complexities of providing care during emergencies. These challenges can affect their successful performance in achieving their professional goals. To identify these challenges, the present study was conducted to explain the challenges of pre-hospital emergency workers in providing care at the scene. Materials and Methods: The present qualitative study was conducted at Shahrekord University of Medical Sciences in 2022 using the contractual content analysis method. Twenty pre-hospital emergency workers were selected purposefully, and data were collected using individual in-depth semistructured interviews and analyzed using Granheim and Lundman’s approach. Results: The findings include three categories (systemic obstacles, society’s cultural ignorance, and religious obstacles) and seven subcategories (manpower-related obstacles, inappropriate and insufficient equipment, lack of attention and support, inconsistency between organizations, disruptive measures of care, wrong attitude and wrong belief, and gender-related barriers) of obstacles that cause emergency healthcare workers to face challenges in providing care at the scene. Conclusion: The factors that need consideration in strengthening pre-hospital emergency healthcare include improving the training process of students, planning for in-service training of employees, increasing their motivation levels, noticing their psychological issues, developing inter-organizational protocols and policies, and educating, training, and employing women in pre-hospital emergency care.

The New Stealth Drug on the Street: A Narrative Review of Xylazine as a Street Drug.

Xylazine is an alpha-adrenergic receptor agonist approved for use only in animals with a prescription from a veterinarian. It is a powerful sedative that is slowly infiltrating the recreational street drug scene and is often used by polysubstance abusers. Known as "tranq," it can be fatal, and xylazine-induced toxicity cannot be reversed with naloxone or nalmefene. Due to its vasoconstrictive effects, chronic use of xylazine is associated with necrotic skin lesions and general deterioration of health. Since xylazine is not approved for human use and is not scheduled as a controlled substance, there are no human studies to provide evidence of drug-drug interactions, lethal doses, or reversal protocols. Xylazine is available online without a prescription. Street drug users may take xylazine knowingly or unknowingly, as it is often combined with other illicit substances such as fentanyl. There are no rapid tests for xylazine, although there are specialty tests that can be ordered. Xylazine represents a major threat to street drug users and another challenge to emergency healthcare workers, first responders, and others who care for those who have taken this "new" street drug.

Emergency Health Care Workers’ Preparedness for Disaster Management: An Integrative Review

Introduction:Around two billion people globally were affected by natural disasters between 2008 and 2018. Countries are required to effectively prepare their healthcare workers for disaster response. A greater level of preparedness is associated with a more effective response to disasters. The World Health Organization requires countries and governments to have disaster plans and emergency health workers ready and prepared at all times. This integrative review aims to understand emergency healthcare workers’ perceived preparedness for disaster management.Method:An integrative literature review using the PRISMA checklist guidelines was conducted to explore physicians, nurses, emergency medical services, and allied medical professionals’ preparedness for disasters. Literature was searched from 2005, published in the English language and from MEDLINE (PubMed), Google Scholar, EMBASE, PsycINFO, SCOPUS, ProQuest and CINAHL databases. Reviews, case reports, clinical audits, editorials and short communications were excluded. Studies were critically appraised using the Mixed Methods Appraisal Tool.Results:The initial search yielded 9,589 articles. Twenty-seven articles were included following the application of the eligibility criteria. Included studies were geographically diverse including North America, the Middle East, and the Asia Pacific. Most studies (n=24) assessed the knowledge of healthcare workers in general disasters. Studies using the Disaster Preparedness Evaluation Tool reported moderate disaster preparedness and knowledge, while studies using other instruments largely reported inadequate disaster preparedness and knowledge. Regional variations were recorded, with high-income countries’ reporting a higher perceived preparedness for disasters than low-income countries.Conclusion:The majority of emergency healthcare workers appear to have inadequate disaster preparedness. Previous disaster experience and training improved disaster preparedness. Future research should focus on interventions to improve emergency healthcare workers' preparedness for disasters.