Background Recent studies have shown that reducing pre-hospital time could improve the outcomes of trauma victims. Due to the importance of pre-hospital time management, this study aims to determine the effects of the Pre-hospital Trauma Life Support (PHTLS) training program on the on-scene time interval reduction. Methods The PHTLS training program was implemented based on global standards for pre-hospital emergency technicians. The research tool was a questionnaire designed by the Ministry of Health and Medical Education in Iran. The mean on-scene time interval was calculated before, after and one month after the intervention in the control (n = 32) and experimental group (n = 32). The data were analyzed using SPSS. Results The mean on-scene time interval in the target group (one month after intervention) has been significantly lower than that of the control group. Moreover, the mean and standard deviation from the on-scene time interval in the target group has been reduced from 17.6 ± 5.5 (before intervention) to 12 ± 3.8 min (one month after intervention) which was statistically significant. Conclusion The implementation of the PHTLS training program can lead to the reduction of on-scene time interval. Therefore, considering the role of reducing on-scene time intervals on victims’ survival, the integration of the PHTLS training programs with pre-hospital emergency medical service systems seems inevitable.
The COVID-19 pandemic has had many effects on the process of receiving medical services in patients with chronic diseases such as cardiovascular diseases. The focus of all attention and the allocation of resources to control the epidemic has made it difficult for cardiovascular patients to access health services. This study aimed to identify the challenges of providing cardiovascular patients with health services during the COVID-19 pandemic in Iran. Methods: This applied study was performed via a qualitative descriptive method. Participants included 15 cardiologists, emergency medicine specialists, internal medicine specialists, and cardiac nurses. Collected through semi-structured interviews, the data were analyzed by qualitative content analysis using MAXQDA software. Results: In the present study, four categories and nine subcategories were extracted. The categories included lack of resources in the cardiovascular department [lack of physical space, allocation of resources to patients with COVID-19, limitations of equipment and facilities], weaknesses in providing efficient and effective education [fear of disease, lack of sufficient information], weaknesses in the hospital preparedness program [inadequate service delivery planning, inefficient resource management planning], poor quality and quantity of health care services [reduction in the amount of care provided, inadequate and untimely medical care. Conclusion: Providing cardiovascular patients with health services has been challenged due to the simultaneous response to the COVID-19 pandemic. Properly allocating resources, informing and educating the community and medical staff, and developing preparedness programs can help address these challenges and provide cardiovascular patients with optimal health services.
The article's abstract is not available.
Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.
Background: At the end of December 2019, a new infectious disease was reported in Wuhan, China. It was a new type of coronavirus named COVID-19. The spread of COVID-19 created an emergency in the global health system and the elderly was identified as a vulnerable group to the disease. Materials and Methods: This is a systematic review conducted to manage the vulnerability of the elderly during the COVID-19 pandemic. Accordingly, all articles published in this field from the beginning of March 2019 to the end of June 2021 have been extracted from the following databases: Web of Science, PubMed, Scopus, Cochrane Library, Google Scholar, Irandoc, Magiran, MedLib, and SID. Results: High incidences of COVID-19 are exacerbated in the elderly with cognitive disorders, immunodeficiency, malnutrition, use of various medicines and social problems, anxiety, distance from the family, lack of healthcare, history of falls, multi-drug use due to old age during the COVID-19 pandemic, in addition to the elderly with underlying diseases, such as kidney failure, diabetes, high blood pressure, arthritis, heart, and respiratory diseases. Conclusion: The prevalence of vulnerability in the elderly was high during the COVID-19 pandemic, which can be a significant risk factor for health. Suffering from several simultaneous diseases, the number of medicines used, the history of falls, underlying diseases, and living alone were some of the vital determinants of vulnerability and considering the adverse consequences of vulnerability, difficulty in designing and implementing appropriate interventions and self-care education for the elderly and their families to manage drug use, treating chronic diseases, and preventing falls, it seems necessary to observe health protocols and stay at home.
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