Purpose: Primary prevention has remained one of the most important ways to reduce the burden of injuries, but is increasingly recognized that many deaths and much long-term disability can also be prevented through strengthening trauma and emergency care. The purpose of this study was to survey of Iran Prehospital performance.Materials & Methods: In this cross- sectional descriptive study, we studied 15 experts of emergency medical and incident management. Data gathering done by using interview, especial form and survey of documents. Data analysis conducted by Spss and One Note.Results: Response time in whole of country, except to tehran city was 8 minute in urban and 14 minute in suburban, generic coverage 33%, number of ambulance numbers of ambulance are 3.19: 100000, dispatch coverage 80%, percent of early aids pervasives 58% and care model were mixed model.Conclusions: Iran Prehospital is tolerable but has distance from desirable and standard situation.

Background: Appropriate and timely response in urgent situations requires vast knowledge and physical and mental preparedness. Since emergency medical technicians are the first professional respondents in the health system, selecting the right people to study in this field is very important. Because there is no specific model in Iran to propose the indicators in the selection of applicants for this field, the present study was conducted to offer some indicators for the admission of Prehospital emergency medical students. Materials and Methods: This research was conducted using a mixed qualitative and quantitative approach in three steps: reviewing the relevant texts, meetings of scientific and operational experts, and determining the validity and reliability of the content. After finalizing, the areas and indicators of student selection were used in the interview process of candidates in 2020. SPSS v. 24 software was used for quantitative data analysis. Results: The selection tool for Prehospital emergency medical students included 4 areas (with 26 criteria): 1) general qualifications area with 8 criteria (documents concerning degree and identity, written GPA of diploma, entrance exam score, type of diploma, special abilities, working in relief organizations, gaining a scientific-sports position, and interviewing of faculty members); 2) physical health with 7 criteria (height, body mass index, visual health, hearing health, stuttering, organ dysfunction-physical disability, and chronic debilitating diseases); 3) psychological status with 5 criteria (orderliness, responsibility, quick and correct decision making, stress management, and belief in teamwork); and 4) physical fitness with 6 criteria (1600-m run, 45-m speed-run, 4×9 m run, sit-up, long jump, and Swedish swimming in 30 s). Conclusion: Given the vital importance of Prehospital emergency medical jobs as the front line of the health system response, selecting the right people will play a significant role in increasing the quality of services provided, increasing patient satisfaction, and ultimately improving health of the community.

Background and purpose: In urban health care system, pre-hospital emergency medical services are the first line to deal with critical patients. If a fast and accurate medical care is delivered, deaths and disabilities resulting from diseases reduce and trust of people to this system will increase. The purpose of this study was to determine the factors influencing the readiness of pre-hospital emergency care in Mazandaran province.Materials and methods: In this descriptive cross sectional study the population included 362 staff in pre-hospital emergency settings in Mazandaran province of whom 191 were selected by simple random sampling. Data was collected using a researcher-made questionnaire. Data was analyzed applying one sample t-test and Friedman’s test.Results: The most important effective factors on readiness of pre-hospital emergency care in Mazandaran province included human resources, equipment and logistics, training courses, information and communication technology, management and organization, and motivation. According to the staff in pre-hospital emergency care settings two factors including motivation (4.37 from 5) and human resources (2.26 from 5) had the most and least effects. Other effective factors included equipment and logistics (4.36), information and communication technology (3.30), training courses (3.19), and management and organization (3.15).|Conclusion: Motivation was found to be the most influencing factor affecting the readiness of pre-hospital emergency staff in Mazandaran province, therefore, policy-makers and managers should pay more attention to the incentives and all factors affecting the quality of services delivered.

Background: The patients' first encounter is usually with the Prehospital emergency. In order to meet the clients and beneficiaries' needs, it is necessary the Prehospital emergency nurses be a competent decision maker based on the patients' unstable conditions. This study aims to examine the factors influencing on the manner of Prehospital emergency nurses' decision making in emergencies and during the mission.Methods: In this qualitative study, 18 nurses of Prehospital emergency bases of Shahrekord University of medical sciences were studied. Data was collected by using semi-structured and in-depth interviews, and also it was used content analysis to analyze the qualitative data. The interviews were transcribed verbatim and analyzed concurrently with the data collection.Findings: By analyzing the data, five main themes were known as the influencing factors in Prehospital emergency nurses' decision making which are as follows: 1) patient-related factors; 2) nurse-related factors; 3) environmental factors; 4) colleagues related factors; 5) the factors related with the type of event and mission.Conclusions: The findings provide a deep understanding of the effective factors in Prehospital emergency nurses' decision making. Deep understanding of the manner of Prehospital emergency nurses' decision making can facilitate more effective decisions in emergencies, during the mission as well as its related factors and also influence on the output of nursing and medical cares.

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 electrocardiogram. 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.

Background: Because of the complexity, stressfulness, and the threatening nature of the working environment of Prehospital emergency Medical Technicians (EMTs), they encounter many ethical challenges during making decisions and providing quick and accurate care to patients. The present study aimed to investigate the ethical challenges among Prehospital EMTs. Materials and Methods: To review all published studies, we searched SID, Medlib, Iran Medex, Magiran, Web of Science, Medline, Google Scholar, CINAHL, PubMed, Ovid, and Scopus databases from 2000-18. The keywords were “ ethical challenges” , “ emergency medical technicians” , and “ Prehospital emergency” . Results: According to the evaluation of the studies, the ethical challenge regarding Prehospital emergencies included decision over dispatching an ambulance to the scene, cardiopulmonary resuscitation, triage in crisis and disaster, irrational interventions of the patient or patient’ s family, intervention in accordance with patient’ s informed consent, and safe driving. Conclusion: Considering the unique conditions of Prehospital caring, identifying, and discovering the ethical conflicts in this field of the health care system and providing the appropriate solution are very important.

Background and Objectives: Today, Prehospital care is an essential component of emergency patient treatment. The proper performance of different parts of this system leads to prevention of death and disability, so this study aimed to determine the performance of Prehospital emergency in Birjand.Materials and Methods: This descriptive study conducted in five Prehospital emergency stations of Birjand in 2015. Data on staffs and equipment of these emergency stations were examined using check-list and the mission reports in recorded information in the central database. The status of human resources and also their response time was compared with the Iranian Ministry of Health Standards; as well the equipment status is compared with Iranian Institute of Standards and Industrial Research.Results: The study showed that none of the stations had adequate human resources and no emergency ambulance had all the necessary equipment. The best situation was diagnostic equipment (94.17%) and the most shortage of equipment was related to personal protection (63.96%).Conclusion: The elimination of human resources shortages and the provision of ambulances to emergency equipment especially in terms diagnostic equipment seems to be necessary.

Prehospital emergencyMedical Care (EMC) is a critical service in disaster management. The aim of this study was to explore the challenges of Prehospital emergencyMedical Services (EMS) during disaster response in Iran. Methods: A qualitative study was conducted from April 2015 toMarch 2017. Data were collected through in-depth, semi-structured interviews with 23 experienced individuals in the field of disaster that were selected using purposeful sampling. Data were analyzed using content analysis approach. Results: Fifteen subthemes and the following six themes emerged in the analysis: challenges related to people, challenges related to infrastructure, challenges related to information management systems, challenges related to staff, challenges related to managerial issues and challenges related to medical care. Conclusion: Iran’ s Prehospital EMS has been chaotic in past disasters. Improvement of this process needs infrastructure reform, planning, staff training and public education.