Background: Incorrect and inadequate information is one of the most important obstacles in providing appropriate health care services to injured traffic accidents. The aim of this study was to measure the quality of patient information about the emergency medical services (EMS) 115 Report Form among traffic injured in Mashhad Social Welfare Hospitals. Materials and Methods: This descriptive cross-sectional study was comprised of Mashhad social welfare incident cases. The data collection tool was a checklist tailored to the data elements of the EMS 115 care report form. Data collection was carried out in two steps to verify the amount of information documentation and verify the accuracy of the information. To evaluate the findings, the score was less than 50%, 50-90%, and more than 90% was considered as weak, relatively favorable, and desirable, respectively. Data analysis was done using descriptive statistics. Results: The findings showed that the amount of information elements in the EMS 115 form was 83. 15%, and the accuracy of the completed information was 99. 27%. Conclusion: Although the degree of completion of the study was in a relatively favorable condition and the accuracy of information was in a favorable situation, but due to the importance of information in timely decision-making and the providing the appropriate treatment plan for patients, measures should be taken to optimize the information.

Context: emergency department is the first place in the hospital that patients refer to receive services, and patients often experience an emergency referral in their lives. emergency care and paraclinical services are provided to patients in this department. The current study aimed at evaluating the patients’ satisfaction with emergency department in Iran through a systematic review and meta-analysis.Evidence Acquisition: The databases including Web of Science (WOS), Embase, PubMed, Scopus, Ovid, as well as the Iranian databases such as IrandocandMagiran in the PersianandEnglish languages were searched from2000to 2017. TheSTROBE (strengthening the reporting of observational studies in epidemiology) checklist was used to assess the quality of the research methodologies.The random model was used to determine the mean value of satisfaction and the results were reported with the confidence interval (CI) of 95%. Also, sensitivity analysis, subgroup and meta-regression were conducted. The Egger test was used to investigate the publication bias in the studies.Results: Based on the random model, the mean of satisfaction with emergency services in Iran was 70.52% (95% CI: 63.81 - 77.23).The results of sensitivity analysis showed no change before and after the analysis of the results. Highest and lowest rates of patient satisfaction were reported in the Eastern (79.17%) and Northern regions (67.15%) of Iran, respectively.Conclusions: The current study findings showed that patients’ satisfaction with emergency services in Iran was high compared with the neighboring countries. Health policymakers should increase patients’ satisfaction through appropriate training, information, and increased human resources.

Introduction: Mapping of COVID-19 infection in the city can help us know more about how the disease is distributed and spread. This study was conducted to investigate the geographical distribution of probable COVID-19 patients who were transferred to destination hospitals by emergency medical services (EMS) in the first wave of the epidemic, in Tehran, Iran. Methods: This cross-sectional study was performed based on recorded missions during the first 3-month period of the pandemic in Tehran, Iran. All probable cases of COVID-19 who were transferred to the hospitals following contact with Tehran EMS during the study period were enrolled. Arc-GIS software was utilized to draw the distribution map of the contact places of the cases. Results: In this study, the data of 4018 patients were analyzed (60. 9% male). The mean age of the patients was 54. 1 ± 20. 7 years; and the mean age of the patients had increased with time during the studied 3 months (p = 0. 003). The average incidence rate of this disease in Tehran during the study period was 4. 6 per 10, 000 population. Generally, the lowest and highest raw frequencies of Tehran COVID-19 contamination were seen in municipal districts 21 and 4, respectively. The raw frequency of cases during the 3-month study period also showed that the highest number of cases in Tehran occurred in municipal districts 5 and 4, respectively. Conclusion: In the present study, using geographic information systems (GIS), geographical distribution map of COVID-19 in Tehran, Iran, during the first 3 months of the pandemic was drawn.

Over forty-three years have passed since the foundation of pre-hospital emergency care system in Iran. Considering the changes that have taken place in recent years in pre-hospital emergency and limited studies in this area, the present review aimed to describe the history, organizational structure, combination of workforce, dispatch system, medical direction and innovations in the pre-hospital system of Iran. The present paper also discusses the strengths and weaknesses of the current system.

Background: To manage life-threatening conditions and reduce morbidity and mortality, pre-hospital’, s on-scene decision making is an influential factor. Since pre-hospital’, s decision making is a challenging process, it is necessary to be identified this process. This study was conducted to explore the model of Iranian emergency medical technicians’,decision making in emergency situations. Methods: This study was applied through grounded theory method using direct field observations and semi-structured interviews. Purposeful sampling with 26 participants including 17 emergency medical technicians including dispatchers, physicians of medical directions, managers and 1 representative for court affairs was performed. Interviews were lasted from October 2018 to July 2019. Corbin and Strauss approach, 2015 (open, axial and selective coding) were used to analyze data. Results: A paradigm model was developed to explain the relationships among the main categories. Decision making in the context of fear and concern was emerged as the core category. Unclear duties, insufficient authorities and competencies as well as lack of enough decision making’, s protocols and guidelines were categorized as casual conditions. Other important categories linked to the core category were interactions, feelings and “,customer focus approach”, . Action–, interaction strategies were taken by emergency medical technicians lead to some negative consequences that can threaten clinical outcome and patient safety. Conclusions: Based on the finding of this study, emergency medical technicians’,decision making in the context of fear and concern, as the core concept of this model, lead to decrease in quality of the pre-hospital services, stakeholders’,dissatisfaction, hospital emergency units’,overload, decrease in reputation of the emergency medical Technicians, threat to patient clinical outcome and patient safety. To prevent of these negative consequences, facilitation of the emergency medical Technicians’,on-scene decision making is recommended.

Background: Supraglottic airway management tools such as the laryngeal mask airway (LMA) have recently emerged as the first choice in pre-hospital and hospital airway management guidelines as well as an alternative strategy after endotracheal tube (ETT) placement failure. However, the pros and cons of the LMA compared to endotracheal intubation are still debated. Given that no study has been conducted to date on the skills of emergency medical technician (EMT) in airway management using LMA compared to endotracheal intubation, we decided to do a study in this regard. Methods: In this objective structured clinical examination (OSCE), EMTs who had a degree of associate or bachelor were participated. The examiner asked the examinees the required information and entered it in the pre-prepared checklists. The participants took part in a two-stage exam. In the first stage, the airway management of the simulated trauma patient was performed by endotracheal intubation, and in the second stage, the same scenario was performed with LMA. At each stage, the examiner evaluated the examinee's performance in 4 fields of Preparation, Preoxygenation, Position and Placement, and Post-intubation management using a standard checklist. In addition, the duration of the procedure from the beginning to the time of fixing the ETT or LMA was recorded and compared. Results: Totally, 105 EMTs participated in this study, of whom, 102 were male (97. 1%). The mean age of the subjects was 36. 4± 7. 3 years old. Of the total participants, 72 passed both practical exams successfully, and they generally insert the LMA faster; so that the duration of intubation and LMA insertion in 1. 4% and 30. 6% were <1 min, respectively (p< 0. 001). However, no significant difference was observed in terms of the mean time (p= 0. 427). Conclusion: In the present study, the skills of the technicians participating in the study in performing advanced airway procedures were moderate, and also, it was found that their skills in LMA insertion were less than endotracheal tube insertion.

Introduction: To save lives and reduce the disability and death of the patients, emergency medical technicians (EMTs) must make timely decisions in complex and, sometimes, life-threatening situations. Since the pre-hospital decision-making is a continuous and important process. Objective: The present study aims to identify the factors affecting EMTs’ on-scene decision-making in emergency situations. Methods: A qualitative approach using in-depth semi-structured interviews and field observations was employed to explore the factors influencing EMTs’ on-scene decision-making in emergency situations. Purposeful sampling was performed with 19 participants including 12 EMTs, 3 dispatchers, 3 medical directions physicians and one EMS manager as a policy maker. Interviews were conducted from October 2018 to March 2018 and the data were analyzed using Graneheim and Lundman’ s content analysis approach. Results: Eight categories and 18 sub-categories emerged to describe the factors effective in emergency medical technicians’ on-scene decision-making. they were cultural context (community’ s culture and organizational culture), interactions (malingering, threat and violence and considerations), competencies (acquisitive and intrinsic); personal feeling (positive feeling and negative feeling), authority (structural and in processing), education (public and professional), special conditions (patient’ s clinical situation, weather conditions, mission’ s time and mission’ s location), and organizational resource (facility and equipment, and human resources). Conclusions: To facilitate EMTs’ on-scene decision-making, it is recommended to clarify the EMTs’ responsibilities, promote the community’ s culture, modify people’ s expectations, police monitoring and control and value the star of logo on EMTs' uniform. The EMTs’ on-scene decision-making process should also be explored.