Pre-hospital Emergency Personnel Research Articles

Exploring Burnout, Work Addiction, and Stress-Related Growth among Prehospital Emergency Personnel.

Burnout and stress-related issues are significant concerns among medical personnel involved in emergency situations due to the high demands of their work. A cross-sectional descriptive and comparative study was conducted on 266 prehospital emergency personnel across five Romanian counties, comprising 41 physicians, 74 nurses, and 151 paramedics. Data were collected through an online form, including demographic and professional characteristics, and five validated scales. This study revealed moderate (49.3%) to high (25.9%) burnout rates, with 35% showing signs of work addiction. Despite these challenges, the personnel demonstrated high levels of stress-related growth (61.2%), strong self-discipline (74.1%), and low to moderate responsive distress (100%). Physicians exhibited higher work addiction and job satisfaction, whereas paramedics faced higher burnout, self-discipline, and distress levels. Nurses showed lower burnout and self-discipline levels. These findings highlight the prevalence of burnout and work addiction among emergency medical personnel, while also underscoring the presence of protective factors like higher self-discipline, good level of stress-related growth, and low to moderate responsive distress. The distinct differences in experiences among physicians, nurses, and paramedics emphasize the need for tailored strategies to address these issues within each group.

The challenges of children's safety in pre-hospital emergencies: a qualitative study

Objective: Exploring the challenges experienced by the pre-hospital emergency personnel to prevent the secondary injuries and provide more effective services to children can be helpful. This study aims to explain the safety challenges of children in the pre-hospital emergencies. Method: This qualitative study, which was conducted with the content analysis approach, was a semi-structured, and in-depth data collection process with the field notes for pre-hospital emergency personnel in Dezful city in 2022. Sampling was done in a targeted and available manner. The sampling process continued until the data saturation was reached. The trustworthiness of data was improved by reviewing and revising the data, experience and expertise of the interviewer, review of research participants and researchers. The research data, including interview texts and field notes, were divided into the semantic units, and then summarized by compression, and then abstracted in the order of subclasses, main classes, and finally themes. Results: Qualitative data analysis of interviews and notes led to the extraction of eight themes, which expressed the nature of children's safety challenges in the pre-hospital emergency: the lack of pre-hospital equipment for children, physical and mental characteristics of children, the lack of safety of vehicles for children, the lack of clinical skills of personnel for children, anxiety and non-cooperation of parents, operational and legal problems, the lack of attention to professional responsibility and high work pressure in children's missions . Conclusion: This study’s results showed that identifying children's safety challenges for pre-hospital emergency personnel can help better understand the care needs of this age group and help managers plan in order to reduce children's safety challenges in the pre-hospital missions.

The effectiveness of non-attendance triage training based on the ESI-IV system on the knowledge and ability of pre-hospital emergency staff in the academic hospitals of Ahvaz Jundishapur university of medical sciences

Introduction: In recent decades, E-learning has gained widespread recognition globally as a vital application of information and communication technology. Objectives: The present study investigated the effectiveness of non-attendance triage training based on the ESI-IV system on the knowledge and ability of pre-hospital emergency staff. Patients and Methods: This study was a semi-experimental interventional study, and the study population consisted of the pre-hospital emergency staff of Ahvaz university of medical sciences academic hospitals in 2021. The study tool was a questionnaire on the awareness and performance of the triage system of hospital emergency (ESI). Initially, both questionnaires were completed, and submitted the triage training file to the intervention group. Two weeks after the first phase—completion of the questionnaire for the first time— and the study of the file by the subjects, the questionnaire was completed again by the intervention group, and the data of both groups were compared. Results: According to the results, the mean of awareness and decision-making in the control group before and after the intervention was (11.8, 10.85, and 13.82) and (7.51, 7.36, and 8.86) respectively. The results indicate that non-attendance triage training based on the ESI-IV system was effective in the knowledge and ability of the pre-hospital emergency personnel had a positive and significant impact, and remains at a good level. Conclusion: The present results of the research indicate that the use of non-attendance training as an effective method can improve interns’ knowledge and ability.

How prehospital emergency personnel manage ethical challenges: the importance of confidence, trust, and safety

BackgroundEthical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. Ethical challenges are associated with moral distress that can lead to burnout. Clinical ethics support has proven useful to address and manage such challenges. This paper explores how prehospital emergency personnel manage ethical challenges. The study is part of a larger action research project to develop and test an approach to clinical ethics support that is sensitive to the context of emergency medicine.MethodsWe explored ethical challenges and management strategies in three focus groups, with 15 participants in total, each attended by emergency medical technicians, paramedics, and prehospital anaesthesiologists. Focus groups were audio-recorded and transcribed verbatim. The approach to data analysis was systematic text condensation approach.ResultsWe stratified the management of ethical challenges into actions before, during, and after incidents. Before incidents, participants stressed the importance of mutual understandings, shared worldviews, and a supportive approach to managing emotions. During an incident, the participants employed moral perception, moral judgments, and moral actions. After an incident, the participants described sharing ethical challenges only to a limited extent as sharing was emotionally challenging, and not actively supported by workplace culture, or organisational procedures. The participants primarily managed ethical challenges informally, often using humour to cope.ConclusionOur analysis supports and clarifies that confidence, trust, and safety in relation to colleagues, management, and the wider organisation are essential for prehospital emergency personnel to share ethical challenges and preventing moral distress turning into burnout.

Investigation of the Relationship among Work Shift, Sleep Quality, and Work Ability Index in Pre-Hospital Emergency Personnel in Urmia City in 2023

Objectives: Nowadays, due to the increase in the volume of accidents, pre-hospital emergency personnel, as the frontline of treatment by providing relief and assistance to patients and victims of various incidents, have encountered various work-related challenges and problems, including cardiovascular diseases, digestive diseases, excessive fatigue, and reduced sleep quality. In this regard, the present research aimed to study the relationship among shift work, sleep quality, and work ability index in pre-hospital emergency personnel. Methods: This research was performed on 102 operational personnel of a pre-hospital emergency department in Urmia, Iran. After the collection of demographic information, the number of work shifts per week, the number of working hours per month, the quality of sleep, and the work ability of the personnel were measured by the Petersburg sleep quality questionnaire and work ability index questionnaire. The relationship between research variables was investigated using correlation coefficient, Fisher's exact test, and one-way analysis of variance tests. Results: Mean total sleep quality score of the personnel was 6.01 ± 2.38, which indicated poor and unfavorable sleep quality. Moreover, work ability index scores of 34.3%, 52%, and 13.7% of participants were at poor, moderate, good, and excellent levels, respectively. Regarding the comparison between the two variables of shift work and sleep quality, there was a significant difference, and a strong and significant relationship was observed between sleep quality and work ability index. Conclusion: Through the increase in the number of work shifts and working hours, the sleep quality of the personnel became unfavorable and weak which led to a decrease in the work ability index score and a reduction in the job performance of the personnel. Reduction of working hours, usage of young people with high work ability, management and control of the number of work shifts of the personnel by considering resting and closure time, consideration of morning-evening and night shifts in a balanced and equal manner, and prevention of people from working in monotonous shifts (activity only in the form of night work or only day work), and avoidance of working in consecutive work shifts without rest and vacation in order to improve the quality of sleep and work performance is recommended.

Care needs of adults with spinal trauma in the prehospital and hospital setting from the perspective of patient care team: A qualitative research.

Appropriate care of patients with definite spinal cord injury or at risk of it in the prehospital and hospital stages requires comprehensive planning in the health system. It is also the requirement of any successful program to explain the needs from the perspective of its stakeholders. Thus, this study aimed to discover the care needs of adults with spinal trauma in prehospital and hospital settings from the perspective of the patient care team. This qualitative study was conducted with the participation of urban and rural prehospital emergency personnel and emergency departments of educational and therapeutic hospitals affiliated to Isfahan, Tehran, Shiraz, Kermanshah, Ahvaz, and Yasuj Universities of Medical Sciences, through conducting 36 in-depth semi-structured interviews from September to December 2021. Using purposive sampling method, the participants were selected considering the maximum variation. The data saturation was reached after conducting interviews and group discussions with 36 subjects. Data were analyzed using conventional content analysis approach. Lundman and Graneheim approach were used for the study rigour. Data were simultaneously analyzed using MAXQDA software version 10. During the data analysis, two themes of prehospital care with two main categories (emergency care and management of secondary complications of spinal trauma) and hospital care with two main categories (emergency care and management of secondary complications of spinal trauma) emerged. Emergency care and management of secondary complications of spinal cord injury in the prehospital and hospital stages can affect treatment results, improve quality of life, and reduce mortality rate, secondary injuries, and healthcare costs. Thus, identification of the care needs of the adults with spinal trauma from the perspective of the patient care team can help the authorities to plan appropriate interventions.

180 How prehospital emergency personnel experience and manage ethical challenges: results from a focus group study embedded in collaborative research to develop and implement clinical ethics support tailored to the organizational context of the emergency services

180 How prehospital emergency personnel experience and manage ethical challenges: results from a focus group study embedded in collaborative research to develop and implement clinical ethics support tailored to the organizational context of the emergency services

Investigation of the Effect of Virtual Stress Management Training on the General Health of Pre-hospital Emergency Personnel: A Semi-experimental Study during the COVID-19 Pandemic

Background and Objective: It is necessary to carry out urgent interventions to improve the general health of pre-hospital emergency personnel. The present study aimed to investigate the effect of virtual stress management training on the general health of pre-hospital emergency personnel. Materials and Methods: In this semi-experimental study conducted in 2022 in Jiroft City, Iran, 160 pre-hospital emergency personnel were randomly selected and divided into two intervention and control groups by simple random allocation (lottery). The educational content of stress management was held for eight sessions of 45 minutes (two sessions per week) for the intervention group virtually and online via the Adobe Connect application. The General Health Questionnaire (GHQ) was completed in two stages, before the intervention and one month after the completion of the intervention, in both groups. Using SPSS software (version 20), descriptive statistics (mean and standard deviation) and inferential statistics (ANCOVA) were used for data analysis. Results: The post-test results indicated a significant difference between the two groups in the overall score of general health (46.13±15.10 in the control group versus 34.50±12.63 in the intervention group). Moreover, after the intervention, the overall score of general health and its subscales decreased significantly only in the intervention group (P<0.001). Conclusion: The implementation of the stress management virtual training program helps to improve the general health of pre-hospital emergency personnel. Therefore, it is recommended to be used as an effective method for empowering human resources.

The Relationship Between Organizational Justice and Job Burnout in Pre-hospital Emergency Nurses

Background: Personnel working in emergency departments are exposed to a lot of burnout due to their nature and occupational factors; therefore, it is very important to pay attention to the factors that cause and aggravate burnout. In the meantime, the existence of organizational justice is an important principle in employee efficiency that can also affect the quality of employee services. Therefore, this study was conducted to investigate the relationship between organizational justice and burnout in emergency department personnel of Tabriz hospitals in 2019. Materials and Methods: The present study is a descriptive cross-sectional correlational study that was performed on 140 pre-hospital emergency personnel in Tabriz, Iran in 2021. The sampling method was census. Data were collected using a three-part questionnaire including participants’ personal demographic information form, Niehoff and Moorman organizational justice questionnaire, and Maslach burnout inventory (MBI). For data analysis, SPSS software, version 22 was used through descriptive statistics and analytical statistics. The significance level was considered at 0.05. Results: The results showed that the level of organizational justice and job burnout of participants was in the moderate range. Also, the results of the correlation statistical test showed that there was a significant reverse relationship between organizational justice and job burnout of pre-hospital emergency personnel (P<0.05). Conclusion: The findings of this study showed that organizational justice is not very desirable from the perspective of pre-hospital emergency personnel and their sense of burnout can be largely related to this situation. Therefore, based on the findings of the present study, it is suggested that managers and officials of pre-hospital medical centers and emergencies by adopting new administrative policies and creating a favorable organizational climate based on human dignity can take positive steps to improve organizational justice and reduce job burnout.

An In-Depth Mixed-Method Study on Stress Exposure and Coping Strategies in Civilian and Military Prehospital Emergency Personnel from a Systemic Perspective

Introduction:Although prehospital emergency care in a civilian versus military context may differ in terms of working conditions and injuries, in both contexts the exposure to stressful and extreme events are present. Besides the continuous reports of post-traumatic stress symptoms, an alarming increase of burnout and suicide in (emergency) physicians is recognized as well. However, most of the research on this topic is either retrospective or peri-recovery, which might have an impact on the availability of information with regard to causes and underlying processes. Hence, in the current study, we conducted an in-depth study of well-functioning emergency caretakers, studying their profile while including their perspective on both their professional and personal context and the interconnectedness with their operational performance.Method:We used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information. We interviewed well-functioning and operating prehospital emergency professionals, recruited in three different settings, i.e., a military hospital, a military Special Operations Surgical Team, and a civilian hospital in the capital city.Results:The quantitative part showed a preference for task-oriented coping. However, the interviews broadened this result, showing how the personnel are continuously seeking to find a balance between emotional connection and disconnection. Several risk-factors for mental injury were detected and the support and recognition from both the personal and professional environment showed to be crucial in finding a balance between job passion and the sacrifice of one's personal life.Conclusion:The interviews showed that a variety of interrelated underlying professional and personal factors are related with how emergency personnel perceive and cope with stress events. A systemic approach to prevent mental health problems is highly recommended.

EVALUATION OF PRACTICES OF HEALTH CARE PERSONNEL IN THE EXPANDED PROGRAM ON IMMUNIZATION IN SA’ADAH, YEMEN, IN MAINTAINING VACCINE EFFICACY

Background and aim: The effectiveness of any vaccine depends on maintaining it at recommended temperatures from manufacture to administration. Health workers in any health facility play an important and vital role in maintaining the cold chain and vaccine efficiency. Therefore, the aim of conducting this research was to evaluate the practice of health workers working in the Expanded Program on Immunization in Sa’adah, Yemen in the correct procedures to maintain the effectiveness of the vaccine and recording data. Method: This study was conducted on 60 health facility (H.F) in 11 districts in Sa’adah Governorate, Yemen during the period from 1 June to 30 July 2019. The focus was on the checklist used to assess the general practices of healthcare personnel participating in the immunization program. The location of the refrigerator, the arrangement of the vaccines, the presence of a thermometer, the handling of the syringes, the cleaning of the injection area, the direction of the pentavalent and measles vaccination needle, and the method of storing the vaccines during the sessions were evaluated. Data were entered and cleaned using Microsoft Excel 2019 and exported to SPSS version 26. Results: The findings show that, the ages of participants ranged from 23-55 years with Mean±SD (34.17±7.310) and 38 (63.3) were male. From a total of health facilities, 43 (91.5) had a good site of refrigerators, 45 (95.7) had a good distance from the wall, and 42 (89.4) had thermometers. There is no significant correlation between the socio-demographics of HCPs and score practice, the total practice scores for HCPs were (21.7%, and 78.3%) for right practice and right but not complete practice, respectively. Conclusion: Only a small percentage of healthcare providers have corrected practice, while a large number have shown correct but not perfect practice. Hence, regular supportive supervision, ongoing technical support, and on-the-job training are highly recommended to improve the healthcare provider's practice with regard to immunization. Peer Review History: Received: 2 January 2023; Revised: 11 February; Accepted: 6 March 2023, Available online: 15 March 2023 Academic Editor: Dr. Ali Abdullah Al-yahawi, Al-Razi university, Department of Pharmacy, Yemen, alyahawipharm@yahoo.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, shmahe@yemen.net.ye Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Dr. Amany Mohamed Alboghdadly, Princess Nourah bint abdulrahman university, Riyadh, amalbgadley@pnu.edu.sa Similar Articles: UTILIZATION OF HEALTH MANAGEMENT INFORMATION SYSTEM AND ASSOCIATED FACTORS IN HEALTH INSTITUTIONS OF KEMBATA TEMBARO ZONE, SOUTHERN ETHIOPIA INVESTIGATING THE OBSTACLES OF IMPLEMENTING HEALTH INFORMATION SYSTEMS FROM VIEWPOINT OF PERSONNEL OF MEHRIZ HEALTHCARE SYSTEM IN 2017 DETERMINING THE IMPACT RATE OF TRIAGE TRAINING ON AWARENESS AND SKILL LEVEL OF PRE-HOSPITAL EMERGENCY PERSONNEL OF FASA CITY

Potrebna lična zaštitna oprema za pružaoce prehospitalne zdravstvene zaštite u pandemiji kovida 19 - sistematski pregled

Aims. Coronavirus Disease 2019 (COVID-19) is a highly contagious disease, and a variety of personal protective equipment (PPE) has been recommended as preventive measures for prehospital emergency personnel, which has led to considerable challenges and a great confusion for the personnel. This review aims to identify different types of PPE required in the care of COVID-19 patients in prehospital emergency system. Material and methods. This study was carried out by searching through databases including: Pubmed, Proqust, Google Scholar, and Cinahl. All articles that recommended different types of PPE against COVID-19 and infectious diseases for prehospital emergency personnel were collected in a table. Results. After carrying out the initial search in the databases, 1,009 studies were obtained and then 16 articles were selected. The findings seem to suggest using equipment including: gloves, face shields (shield/goggles), protective clothes (medical jumpsuit/scrubs), surgical masks, N-95 masks, powered air purifying respirators (PAPR), hair covers, shoe covers and washing up the hands by the emergency medical service (EMS) personnel. Discussion. The scrutiny of the relevant studies showed that each of them advised the EMS personnel to use a number of PPE. The present study highlighted the fact that there are other components of the PPE which can be useful to them. Conclusion. This study identified the most appropriate PPE needed for prehospital emergency personnel against COVID-19, and it is believed that planning for adequate access to this equipment and training on how to use them can significantly help to reduce the infection among the personnel.

Self-reported Emergency Skills Competence among Pre-hospital Emergency Personnel in a Rural Area of Indonesia

Background: Pre-hospital emergency medical services (EMS) personnel are responsible for providing intervention outside of the hospital setting. Consequently, the pre-hospital emergency personnel demand high capability of the personnel to perform emergency aid at the scene and during transport to the hospital. Objective: The purpose of this study is to explore emergency skills competence among pre-hospital emergency personnel in the area on the north coast of Java. Method: This study used the Essential Knowledge and Skills Questionnaire (EKSQ) as the instrument. There was 42 pre-hospital emergency personnel participated in this study. Results: This study revealed that most pre-hospital emergency personnel are nurses (93%). Most respondents reported not having sufficient competency in resuscitation (2,78 of 5 points) and giving medication (2,81 of 5 points). Age and experience were significantly correlated with pre-hospital emergency personnel's competence. Conclusion: This study concluded that there was a lack of competence in resuscitation. Hence, continuous professional-development courses are necessary to maintain pre-hospital emergency personnel's professional proficiency.

Investigating the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic

BackgroundPre-hospital emergency staffs as the frontline forces fighting against COVID -19 have been affected by this pandemic. Today, the occupational and mental health of these individuals is particularly important to the health care system. Death anxiety is one of the inevitable things in this job, and not paying attention to it can cause unwanted effects such as changing the level of job satisfaction of the personnel. The purpose of this study was to determine the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic.MethodsThis cross-sectional descriptive study was conducted among pre-hospital emergency staffs in Qazvin Province, Iran in 2021–2022. Among the bases chosen by the census method, 198 samples were included in the study by the available method. Data collection tools included the Demographic Checklist, Templer's Death Anxiety scale, and the Minnesota Job Satisfaction Questionnaire. The data were analyzed with descriptive and inferential statistics and SPSS 20 software.ResultsThe mean age of the samples was (33.14 ± 6.77). 167 persons were male and the others were female. The average job satisfaction and death anxiety of the personnel were 55.07 ± 11.50 and 8.18 ± 1.96, respectively. Pearson's correlation coefficient between the two variables was r = -0.126 And a null correlation coefficient hypothesis has been confirmed with p-value = 0.077.ConclusionsThe results showed a high level of death anxiety and average job satisfaction. Although these two variables do not have a significant relationship with each other, considering that they do not have the appropriate level, it needs more investigation and consideration.

Prevalence investigation and Comparison of Anxiety of Pre-Hospital Emergency and Hospital Emergency Personnel in Birjand in Covid-19 Epidemic

Introduction: Coronavirus is a large family of viruses that may cause respiratory infections. Recently, a new coronavirus epidemic (COVID-19) has caused great anxiety worldwide. Given that pre-hospital and hospital emergency staffs are the first group of frontliners to be exposed to and fight COVID-19 infection, this study aimed to investigate the anxiety of pre-hospital and hospital emergency staff in Birjand during the COVID-19 pandemic.
 Materials and Methods: In this descriptive cross-sectional study, 270 pre-hospital and hospital emergency personnel were included in the census method in 2021. Data collection tools included a demographics form and the Coronavirus Anxiety Scale (CDAS). Data analysis was performed in SPSS software version 21 using descriptive and inferential statistical tests.
 Results: The mean score of psychological symptoms of pre-hospital emergency personnel (20.65%) was higher than hospital emergency personnel (17.78%). Also, the mean score of physical symptoms of pre-hospital emergency personnel (16.09%) was greater than that of hospital emergency personnel (17.73). There was a significant difference between pre-hospital and hospital emergency personnel regarding the mean anxiety score (P <0.001).
 Conclusion: Considering these results and the associated morbidity rate in healthcare providers caused by their presence in the first line of treatment against the COVID-19 infection, health policymakers are suggested to take the necessary steps to reduce the anxiety of the medical staff.

Ethical challenges experienced by prehospital emergency personnel: a practice-based model of analysis

BackgroundEthical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. In prehospital emergency medicine, decision-making commonly takes place in everyday life, under time pressure, with limited information about a patient and with few possibilities of consultation with colleagues. This paper explores the ethical challenges experienced by prehospital emergency personnel.MethodsThe study was grounded in the tradition of action research related to interventions in health care. Ethical challenges were explored in three focus groups, each attended by emergency medical technicians, paramedics, and prehospital anaesthesiologists. The participants, 15 in total, were recruited through an internal information network of the emergency services. Focus groups were audio-recorded and transcribed verbatim.ResultsThe participants described ethical challenges arising when clinical guidelines, legal requirements, and clinicians’ professional and personal value systems conflicted and complicated decision-making processes. The challenges centred around treatment at the end of life, intoxicated and non-compliant patients, children as patients—and their guardians, and the collaboration with relatives in various capacities. Other challenges concerned guarding the safety of oneself, colleagues and bystanders, prioritising scarce resources, and staying loyal to colleagues with different value systems. Finally, challenges arose when summoned to situations where other professionals had failed to make a decision or take action when attending to patients whose legitimate needs were not met by the appropriate medical or social services, and when working alongside representatives of authorities with different roles, responsibilities and tasks.ConclusionFrom the perspective of the prehospital emergency personnel, ethical challenges arise in three interrelated contexts: when caring for patients, in the prehospital emergency unit, and during external collaboration. Value conflicts may be identified within these contexts as well as across them. A proposed model of analysis integrating the above contexts can assist in shedding light on ethical challenges and value conflicts in other health care settings. The model emphasises that ethical challenges are experienced from a particular professional perspective, in the context of the task at hand, and in a particular, the organisational setting that includes work schedules, medical guidelines, legal requirements, as well as professional and personal value systems.

Effect of Wearing N95 Mask on the Quality of Chest Compressions in Prehospital Emergency Personnel: A Cross-over Study

Objective To evaluate the effect of wearing an N95 mask on the quality of chest compression and fatigue of prehospital emergency personnel during cardiopulmonary resuscitation (CPR). Methods Twenty-four eligible participants were recruited. Participants' age, sex, height, and weight were recorded. After completing the CPR training and examination, participants were tested twice, wearing surgical mask or an N95 mask, while performing chest compressions for 2 minutes. The quality of chest compression (including compression frequency, depth, rebound, and position) was recorded by the simulator. Borg fatigue scores and physiological parameters (including heart rate, mean arterial pressure, pulse oxygen saturation, and respiratory rate) were recorded before and after chest compressions. Results Compared to wearing surgical masks, participants wearing N95 masks had significantly lower quality of chest compression, including compression frequency (98.3 ± 4.9 bpm vs 104.0 ± 6.0 bpm, P < 0.001), depth (47.1 ± 4.5 mm vs 50.5 ± 5.4 mm, P < 0.001), and rebound (90.2 ± 2.7% vs 94.3 ± 2.1%, P < 0.001). The compression position was not affected. The period data showed that the difference in compression quality started after 1 minute of compressions. Participants wearing N95 masks had higher Borg fatigue scores [6.1(2) vs 5.1(2), P < 0.001], heart rates (121.2 ± 5.7 bpm vs 109.9 ± 6.0 bpm, P < 0.001), mean arterial pressures (106.3 ± 8.0 mmHg vs 99.0 ± 8.5 mmHg, P = 0.012), and respiratory rates (29.5 ± 2.7 bpm vs 24.7 ± 2.5 bpm, P < 0.001). Conclusion This study showed that the use of an N95 mask by prehospital emergency personnel during the performance of chest compressions resulted in a reduction of compression quality and increased clinician fatigue. There is a need for CPR training for medical personnel wearing personal protective equipment.

The experience of pre-hospital emergency personnel in breaking death news: a phenomenological study

BackgroundToday, breaking the death of patients to their families has become one of the challenges for medical staff. Considering the lack of study in the pre-hospital emergency, the present study aimed to explore the experience of pre-hospital emergency personnel regarding the breaking death news to families.MethodIn this qualitative study with a descriptive phenomenological method, data were collected by purposeful sampling method through in-depth interviews with thirteen pre-hospital emergency personnel in Kermanshah and Kurdistan provinces. After recording and writing the interviews, the data were managed by MAQUDA-10 software and analyzed using the Collaizi approach.ResultsOf 13 participants, five from Kermanshah, eight from Kurdistan, and 12 (92%) were married. The mean age and work experience were 34.38 and 10.38 years, respectively. Five main extracted themes were 1) perceived stress, 2) challenge factors of breaking death news, 3) unnecessary actions, 4) death breaking precautions, and 5) BDN requirements. They were covered fifteen sub-themes.ConclusionIn this study, emergency medical employees were always faced with stress and challenges to announce the patient's death to families, including the stress of violence against employees. Hereof, personnel had to take unnecessary care actions such as slow resuscitation to transfer the patient to the hospital.

Exploring the Challenges of Prehospital Emergency Personnel in COVID-19 Pandemic: A qualitative study

Objectives: To explore the challenges and experiences of Prehospital Emergency Personnel in the context of the COVID-19 pandemic in Iran. Design: Qualitative study Setting: Prehospital Emergency Medical Services (EMS), Iran. Participants: 15 Prehospital Emergency personnel were invited to participate. Semi-structured in-depth interviews were conducted between Januarys to March 2021. Results: Themes relating to challenges of Prehospital Emergency Personnel in COVID – 19 were: Lack of preparedness of EMS for the pandemic, shortage of Personal Protective Equipment (PPE), psychological distress and negative emotions, shortage of staff and challenges associated with delivering care for patients using PPE. Conclusions: The current study found that Health Care Workers (HCWs) in the prehospital emergency field had multiple challenges in caring for their patients during COVID-19. Therefore, they are vulnerable in this situation. These challenges must be addressed in order to protect them in pandemics.

Comparative study of virtual and face-to-face training methods on the quality of healthcare services provided by Kermanshah pre-hospital emergency staff (EMS): randomized educational Intervention trial

BackgroundEmergency medical centers are globally one of the most important pillars of pre-hospital care. The most important purpose of this system is to provide satisfactory services in the shortest possible time and in accordance with the modern scientific standards of the world. The present study aimed to compare the effect of virtual and face-to-face training methods on the quality of service provided by Kermanshah pre-hospital emergency personnel, Iran.MethodsThis was a randomized educational intervention trial performed among the staff of Kermanshah Emergency Medical Center. Individuals were randomly divided into two training groups of virtual and face-to-face. Participants in the face-to-face group received slides, lectures, and practical work with moulage for 6 h a day. Subjects were taught the four skills of intubation, laryngeal mask airway (LMA), cardiopulmonary resuscitation (CPR) and attenuated electrical device (AED). Participants in the virtual group received the same content in the form of a training video on CD with a full explanation of the project's objectives. Pre- and post-test scores of participants were compared within and between the groups by Stata 14.0 software.ResultsEighty-seven individuals were participated in the study, 43 of whom were assigned to the face-to-face training group and 44 to the virtual training group. There was no significant difference between the two groups in terms of work experience and educational level (P > 0.05). Post-training scores in both groups were significantly higher than pre-training in the four skills (P ≤ 0.005). After adjusting for educational level and work experience, however, the quality of CPR, intubation, and AED was higher in the face-to-face training group than in the virtual group. However, the increase in the mean score of LMA in the virtual training was not significantly different than that of the face-to-face training group.ConclusionThe results of our study showed the same efficacy of both face-to-face and virtual methods in improving the performance of personnel in tracheal intubation, LMA, CPR and AED shock skills. E-learning methods can be used as a complement to face-to-face methods in education.