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Introduction: Emergency Medical Services (EMS) is one of the vital links in the care chain, and its services need to be improved. These services can be available through mobile-based automation system, in which low usability level of these systems lead to decrease the acceptance, satisfaction, and confidence of users especially the emergency care team. The purpose of this study was the usability evaluation of a national mobile- based automation system among the pre-hospital emergency care team. Material and Methods: This cross-sectional study was conducted on prehospital emergency care team members in Semnan and Shahroud Universities of Medical Sciences in 2022. The usability evaluation of the mobile- based EMS automation system was done using the Software Usability Measurement Inventory (SUMI) questionnaire. Multiple logistic regression models were used to analyze data. Results: One hundred eighty-eight EMS team members from the 31 EMS centers in Semnan province participated in present study. The mean total usability score was 61.93±15.37, the highest mean score was related to the efficiency feature (67.19±19.85) and the lowest mean score was related to the learnability feature (48.21±29.29). There was a reverse and significant relationship between being a manager and the agreement with the usability (p=0.04, OR= -3.383, CI 95%=0.389-29549). Conclusion: This study showed that although an automation system may be widely used in a country, its usability could be at a low level. In order to improve the different function of these systems, it is suggested to participate various clinical experts include prehospital emergency care team in all stages of designing and developing these systems. [ABSTRACT FROM AUTHOR]

Primary objective: The present prospective study was performed to investigate whether primary clinical findings and serum S100B concentrations at 3 and 6 hours post-trauma can contribute to the selection of patients for an initial computed tomography (CT) scanning. Research design and methods: S100B was measured in serum samples obtained at 3 and 6 hours after the injury. Adjusted odds ratios (OR) and 95% confidence interval (CI) associated with demographics and clinical predictors of positive CT scan were calculated. Sensitivity, specificity, negative and positive predictive values were also calculated for S100B levels. Main outcomes and results: It was found that the presence of loss of consciousness (OR = 2.3; 95% CI = 1.00–4.01;p= 0.008) and post-traumatic vomiting ≥ 2 episodes (OR = 1.8; 95% CI = 1.08–3.29;p= 0.019) are factors associated with positive CT scan. In this study the best cut-off point of 0.115 µg L–1for 3-hour S100B has sensitivity of 94.9% (95% CI = 86.8–98.3) with specificity of 35.4% (95% CI = 25.2–47.0) to predict intracranial injury on CT scanning. The corresponding results for 6-hour S100B > 0.210 µg L–1were 98.7% (95% CI = 92.1–99.9) for sensitivity and 39.2% (95% CI = 28.6–50.8) for specificity. Conclusions: Serum S100B measurement along with clinical evaluation of patients with mild traumatic brain injury has promising screening value to support selection of patients for CT scanning. [ABSTRACT FROM AUTHOR]