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Background: Emergency Medical Technician (EMT) can play a vital role in decreasing morbidity and mortality. Due to the increasing development of electronic systems, their use can be effective in improving the quality of services and reducing costs. This study aimed to assess the satisfaction of EMTs with electronic forms. Materials and Methods: This cross-sectional analytical study was conducted on 99 EMTs in Rasht City, Iran. Data was collected via a questionnaire, including demographic characteristics (age, sex, work experience, type of employment, level of education, field of study, and retraining course) and 17 questions about the satisfaction of personnel in using electronic forms. The validity and reliability of the questionnaire were assessed by 7 emergency medicine specialists via a pilot study. The questionnaire had a Likert scale to respond with Cronbach's alpha of 0.83. Data were analyzed using SPSS software v. 22. Results: The Mean±SD age of participants was 36.08±0.73 years. Most of them had a bachelor's degree (71.7%), contractual employment (40.4%), and Bachelor of Science (BSc) in nursing (46.5%) or emergency technician (42.4%). Their average work experience was 10.45±0.69 years. The level of satisfaction of most EMTs (65.7%) in using the electronic form was moderate, which statistically had a significant relationship with their employment status (P<05). Conclusion: According to the average satisfaction of EMTs in using electronic forms, it is necessary to increase the level of use and satisfaction of electronic forms by holding appropriate retraining programs on how to use and benefits of electronic forms. [ABSTRACT FROM AUTHOR]

Background Emergency Medical Services (EMS) personnel are often the first to provide healthcare services to the patient in different situations outside the hospital. Due to the sensitivity of this work, knowledge of ambulance equipment can affect the performance of Emergency Medical Services personnel. Objective This study aims to assess the knowledge of pre-hospital EMS personnel in Rasht, Iran about ambulance equipment. Methods This cross-sectional analytical study was conducted on 84 EMS personnel who were selected from 17 medical centers in Rasht, Iran using a convenience sampling method. The data collection tool was a two-part questionnaire. The first part surveys demographic characteristics (age, gender, work experience, type of employment, education, field of study, history of retraining courses) and the second part assesses the knowledge of ambulance equipment according to the Pre-hospital Emergency Medicine/Equipment User Manual of Iranian Ministry of Health and Medical Education (fourth edition). The data were analyzed in SPSS v. 22 software and the significance level was set at 0.05. Results Most of participants had a bachelor's degree, were under permanent employment, and had a degree in nursing and emergency medicine. Their mean work experience was 9.84±6.41 years, and most of them had a history of participating in retraining courses. Their knowledge of ambulance equipment was at a good level. Kruskal-Wallis test showed that their knowledge level had a significant relationship with their type of employment (P<0.001). Conclusion It is necessary to increase the knowledge level of pre-hospital EMS personnel about ambulance equipment by holding short-term training courses and using simulation methods. [ABSTRACT FROM AUTHOR]

Background and Objectives: Traumatic injuries have become a health problem worldwide, especially in low- to middle-income countries. Therefore, this study was conducted to identify predicting factors of death in adult severe multiple trauma patients. Methods: This retrospective cross-sectional study was performed on 1397 adult multiple trauma patients referred to the emergency department (ED) of Poursina Hospital between June 2019 and August 2021. The demographic characteristics, on admission clinical parameters, laboratory tests, the need for packed red blood cell transfusion, and the need for endotracheal intubation were recorded. The revised trauma score (RTS) was calculated according to the physiological variables collected on admission to ED. The primary outcome was 1-day mortality after admission. Results: The mean age of subjects was 37.12 ± 13.61 (18--60) years, and 1250 (89.5%) subjects were male. The 1-day mortality was 339 patients (24.3%). Initial RTS score and the mean Glasgow coma scale (GCS) scores were significantly higher in the survived group than in the nonsurvived group (6.6 ± 1.2 vs. 4.9 ± 1.0, 10.2 ± 3.7 vs. 4.9 ± 2.4, P < 0.001). The multivariate analysis resulted in low GCS (odds ratio [OR] = 1.527, 95%CI 1.434-1625, P < 0.001), low O2 saturation (OR = 1.023, 95%CI 1.003-1.043, P = 0.022), and need for intubation in the ED (OR = 0.696, 95%CI 0.488-0.993, P = 0.046) as predictors of 1-day mortality. The area under the curves receiver operating characteristics of RTS and GCS scores to predict mortality were 0.853 (95% CI: 0.831-0.874) and 0.866 (95% CI: 0.846-0.887), respectively. Conclusion: Multiple factors associated with 1-day mortality were reduced GCS score, decreased oxygen saturation, and need for intubation in the ED. The RTS and GCS scores are good predictors of mortality survival in multiple trauma patients. [ABSTRACT FROM AUTHOR]

Background: Seizure and electrocardiographic (ECG) abnormalities are of the most common complications of tramadol toxicity., Objective: This study aimed to show the prevalence and predictive value of various factors for ECG findings in patients with tramadol-induced seizures., Method: In a descriptive cross-sectional study, 146 patients with tramadol-induced seizures referred to Poursina Hospital, Guilan, Iran, between June and November 2018 were enrolled. The clinical manifestations, such as blood pressure, respiratory rate, and pulse rate (PR), and ECG parameters, including PR interval, QRS duration, R wave in aVR lead, and corrected QT interval, were assessed. Appropriate statistical tests were used to analyze the data., Results: We showed that tramadol dose was significantly higher in patients with abnormal ECG findings compared with those with normal ECG pattern both upon admission (p = 0.001) and after 6 hours of admission (p = 0.001). The results found the predictive value of tramadol dose for abnormal ECG patterns upon admission (odds ratio (OR) 1.014, 95 percent CI 1.008 to 1.020) and 6 hours later (OR 1.008, 95 percent CI 1.003 to 1.013) in these patients. In addition, it was revealed that PR was a strong predictor of abnormal ECG findings in patients with tramadol-induced seizures upon admission (OR 1.085, 95 percent CI 1.038 to 1.134). Nevertheless, age only predicted abnormal findings 6 hours later (OR 1.104, 95 percent CI 1.019 to 1.195)., Conclusion: Tramadol dose, age, PR, and seizures frequency could be used as indicators of abnormal ECG findings in patients with tramadol-induced seizures., Key Points: The results of our study showed a high prevalence of sinus tachycardia, terminal S and R waves in aVR lead terminal S wave, and the combination of these abnormalities in this subset of patients.