Purpose Resilience can be of assistance to paramedics in order to maintain their own mental balance in stressful work environments. Since it is not well defined which personality traits are correlated with resilience in these personnel, the purpose of this paper is to explain the relationship between personality traits and levels of resilience. Design/methodology/approach This cross-sectional study was conducted on paramedics in Eastern Iran through field research. The study participants were selected by convenience sampling method. The data collection instruments included NEO-Five Factor Inventory-Short Form and Connor-Davidson Resilience Scale. The data obtained were also analyzed using descriptive and inferential statistics (correlation and regression analysis) through the SPSS 16.0 software. Findings A total of 252 paramedics with a mean age of 28.9±5.1 years participated in this study. The personality traits of neuroticism (r=−0.24), openness to experience (r=−0.22), and agreeableness (r=−0.18) were significantly correlated with resilience. In contrast, extraversion (r=0.26) and conscientiousness (r=0.32) were in a significant relationship with resilience. In this respect, the given personality traits could account for 31.5 percent of changes in resilience. Research limitations/implications It was concluded that the paramedics with lower scores of neuroticism had higher levels of resilience and they could similarly show better compliance with their work conditions in stressful situations and consequently maintain their mental health. Practical implications It is recommended to conduct psychological examinations of personality traits in recruitment and selection stages of medical emergency personnel and to implement psychological interventions for those medical emergency staff with the personality trait of neuroticism. Social implications Resilient paramedics may also perceive less stress and it may be negatively associated with burnout. Originality/value The study examined the relationship between personality traits and resiliency in order to clarifying recruitment criteria in emergency medical services.

CPSS is more efficient for use by telephone triage nurses in identifying stroke. The use of CPSS assists nurses by reducing the triage error and supports the evidence-based care. It needs to be developed to cover signs and symptoms of posterior-circulation stroke patients.

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AimsThis study aims to determine the effect of teaching Orem's self‐care model on nursing students’ clinical performance and patient satisfaction.DesignThe study was a quasi‐experimental, non‐randomized, two‐group design with posttest.MethodsIn this quasi‐experimental study, 66 nursing students were selected via convenience sampling method. The intervention group was trained based on Orem's self‐care model and the control group based on the routine nursing process method. Both groups cared patients for a week. Students’ performance was evaluated during the clinical course by performance observation checklist and patient satisfaction was assessed at the end of clinical course using patient satisfaction form. Data were analysed in SPSS software using chi‐squared, Fisher Exact test, Mann–Whitney, t test and two‐way ANOVA.ResultsClinical performance evaluation mean score in the intervention group was significantly higher than that of the control group. However, patient satisfaction scores in both the control group and intervention group did not show statistically significant differences. Orem's self‐care model showed a 23% improvement in students’ performance. It is recommended to use Orem's self‐care model for undergraduate courses, especially in clinical training.

Introduction: Diabetes mellitus is a risk factor for cardiovascular disease. Some recent studies have shown an association between diabetes and out-of-hospital cardiac arrest incidence and survival. We aimed to investigate whether there is an association between the presence of diabetes mellitus and survival after cardiopulmonary resuscitation (CPR) in patients with an in-hospital cardiac arrest. Methods: A cross-sectional study was conducted during the period of January to February 2014, among 80 cases of cardiopulmonary arrest in patients at Qaem hospital of Mashhad, Iran. A code 99 was announced after a cardiac arrest was identified, and CPR was performed by the cardiac arrest team. Twenty four hour survival was compared in diabetic and non-diabetic patients who had a return to spontaneous circulation after CPR. We used SPSS statistics for Windows version 16 for data analysis. Results: The return to spontaneous circulation in the diabetic group was not significantly lower than for the non-diabetic group (42.9% versus 61.0% [P = 0.15]). However, the 24-hour survival in the diabetic group was significantly lower than for the non-diabetic group (19.0% versus 44.1% [P = 0.04]). Conclusion: The presence of diabetes mellitus is associated with a significantly lower rate of survival after CPR.

Objectives: Sudden cardiac arrest is a major cause of death in the adult population of developed countries, with only 10%-15% of cardiopulmonary resuscitations (CPRs) being successful. We aimed to compare the effects of interposed abdominal compression CPR (IAC-CPR) with standard CPR (STD-CPR) methods on end-tidal CO 2 (ETCO 2 ) and the return of spontaneous circulation (ROSC) following cardiac arrest in a hospital setting.Methods: After cardiac arrest was confirmed in a patient at Mashhad Ghaem Hospital, 80 cases were randomly assigned to one of the two methods of resuscitation, either IAC-CPR or STD-CPR, respectively. The inclusion criteria for the study were nontraumatic cardiac arrest, in patients between the age of 18 and 85 years, and the presence of endotracheal tube. Exclusion criteria were abdominal surgery in the past 2 weeks, active gastrointestinal bleeding, pulmonary embolism, and suspected pregnancy.Results: There was a significant difference between the two groups in ETCO 2 (p < 0.003), but there was no significant difference as far as the ROSC (p > 0.50). Conclusion:The increase in the ETCO 2 during IAC-CPR is an indicator of the increase in cardiac output following the use of this method of CPR.ACADEMIC EMERGENCY MEDICINE 2016;23:448-454

Introduction It is unclear whether the Emergency Severity Index (ESI) can identify high-risk patients with Chronic Obstructive Pulmonary Disease (COPD). This study aims to compare the mistriage rates of the ESI plus the Peak Expiratory Flowmeter (PEF) approach and ESI approach among dyspneic patients with COPD. Methods This study was a randomized clinical trial conducted between July and October 2018. We randomly assigned COPD patients with dyspnea to the ESI + PEF or ESI groups. Triage levels, disposition rates, number of resources used, and time to first physician contact were compared in patients admitted to the Intensive Care Unit (ICU), the Pulmonary Care Unit (PU), or discharged from the ED. Reliability of the ESI was evaluated by using the interobserver agreement (Kappa). Results Seventy COPD patients were equally assigned to the ESI + PEF and ESI groups. The under-triage rates were 11.42% and 0%, the over-triage rates were 31.42% and 2.85% in the ESI and ESI + PEF groups, respectively. The triage levels of the patients admitted to the ICU (2 vs. 3), the PU (2 vs. 4), or discharged from the ED (3 vs. 2) were significantly different between the ESI + PEF and ESI groups. Conclusions Addition of PEF to the ESI provides a more accurate method for triaging COPD patients compared to ESI alone. We recommend using PEF for the triage of COPD patients in the ED.