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Volume 3, Issue 3 (2022)                   J Clinic Care Skill 2022, 3(3): 97-104 | Back to browse issues page
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Sadat S, Khodayarian M, Vafaeenasab M. Factors Affecting the Skill and Efficiency of Emergency Medical Service Staff in Mass Casualty Road Traffic Incidents: A Qualitative Study. J Clinic Care Skill 2022; 3 (3) :97-104
URL: http://jccs.yums.ac.ir/article-1-143-en.html
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1- Department of Nursing, School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
2- “Social Determinants of Health Research Center” and “Department of Health Education and Promotion, School of Public Health”, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Yazd Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, lran , rzvafaee@yahoo.com
* Corresponding Author Address: Yazd Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Shahid Paknejad Boulevard, Yazd, lran. Postal Code: 8916978477
Abstract   (2121 Views)
Aims: Identifying the knowledge and skills of emergency medical technicians in mass casualty incidents can minimize the risks associated with the response. This study was conducted with the aim of investigating the factors affecting the skill and efficiency of emergency medical service staff in mass casualty road traffic incidents.
Participants & Methods: The present research was conducted with a semi-structured qualitative method on 31 officials and personnel of pre-hospital emergency, Red Crescent and police forces who were selected by purposive sampling method from June 2018 to September 2019. Data were analyzed by conventional content analysis method
Findings: Effective factors on skill and efficiency were identified in the two main categories of professional performance (with 2 subcategories of triage requirements and challenges and functional deficiencies) and employee competence (with 4 subcategories of necessity for psychological recovery, professional competence improvement, technician skill improvement, and commitment and professional ethics).
Conclusion: Inability in triage, functional deficiencies and lack of knowledge and skills related to trauma at the scene of the accident, cause disruption in the professional performance of emergency medical service staff. Unpredictable conditions put additional stress on relief workers on the scene. Improving knowledge and skills, psychological recovery, compliance with moral values, and efforts to improve professional qualifications will improve competence and increase skills and efficiency at work. By training people in first aid, people-oriented management and using people's participation, people can be involved and their potential can be used to provide relief services.
 
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References
1. Ardalan A, Khankeh H, Mehrabi Tavana A, Nejati A, Masoumi G. Textbook of health in emergencies and disasters. 1st Edition. Tehran: Mehr-e Ravash; 2016. [Persian]
2. Alazmy W, Samarkandi O, Williams B. The history of emergency medical services response to mass casualty incidents in disasters, Saudi Arabia. J Emerg Medi Trauma Acute Care. 2020;2020(1):1-10. [DOI:10.5339/jemtac.2020.3]
3. Hylander J, Saveman B-I, Björnstig U, Gyllencreutz L, Westman A. Time-efficiency factors in road tunnel rescue as perceived by Swedish operative personnel-an
4. interview study. Int J Emerg Serv. 202;11(2):312-24.
5. World Health Organization. Global status report on road safety 2018 [Internet]. Geneva, World Health Organization; 2018 [Cited 2020 Feb 28]. Available from: https://www.who.int/publications/i/item/9789241565684.
6. Mehmood A, Rowther AA, Kobusingye O, Hyder AA. Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach. Int J Emerg Med. 2018;11(1):53. [DOI:10.1186/s12245-018-0207-6] [PMID] [PMCID]
7. Chou C-C, Chiang W-C, Chen AY. Emergency medical response in mass casualty incidents considering the traffic congestions in proximity on-site and hospital delays. Transport Res Part E Logist Transport Rev. 2022;158:102591. [DOI:10.1016/j.tre.2021.102591]
8. Henry JA, Reingold AL. Prehospital trauma systems reduce mortality in developing countries: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2012;73(1):261-8. [DOI:10.1097/TA.0b013e31824bde1e] [PMID]
9. Dadashzadeh A, Dehghannejhad J, Shams Vahdati S, Soheili A, Sadeghi Bazarghani H. The nature of prehospital medical interventions delivered to traumatic patients in Tabriz. Nurs Midwifery J. 2017;15(3):159-67. [Persian]
10. Hagiwara MA, Nilsson L, Strömsöe A, Axelsson C, Kängström A, Herlitz J. Patient safety and patient assessment in pre-hospital care: a study protocol. Scand J Trauma Resusc Emerg Med. 2016;24(1):14. [DOI:10.1186/s13049-016-0206-7] [PMID] [PMCID]
11. Ebadi A, Froutan R. Positive coping: a unique characteristic to pre-hospital emergency personnel. Electronic Physician. 2017;9(1):3575-83. [DOI:10.19082/3575] [PMID] [PMCID]
12. Khorasani-Zavareh D, Mohammadi R, Bohm K. Factors influencing pre-hospital care time intervals in Iran: a qualitative study. J Inj Violence Res. 2018;10(2):83-90. [DOI:10.5249/jivr.v10i2.953]
13. Goniewicz K, Goniewicz M. Disaster preparedness and professional competence among healthcare providers: Pilot study results. Sustainability. 2020;12(12):4931. [DOI:10.3390/su12124931]
14. Aliakbari F, Aein F, Bahrami M. Assessment competencies among emergency nurses for responding in disaster situation with Objective Structured Clinical Examination. J Health Promot Manag. 2014;3(3):47-57. [Persian]
15. Raeisi AR, Mohajervatan A, Mehraein Nazdik Z. Mass casualty response to mine explosion: a case report in Iran. Health Emerge Disast Q. 2019;4(3):173-8. [DOI:10.32598/hdq.4.3.173]
16. Bøtker MT, Bakke SA, Christensen EF. A systematic review of controlled studies: do physicians increase survival with prehospital treatment? Scand J Trauma Resusc Emerg Med. 2009;17(1):12. [DOI:10.1186/1757-7241-17-12] [PMID] [PMCID]
17. Hyde P, Mackenzie R, Ng G, Reid C, Pearson G. Availability and utilisation of physician-based pre-hospital critical care support to the NHS ambulance service in England, Wales and Northern Ireland. Emerg Med J. 2012;29(3):177-81. [DOI:10.1136/emj.2010.106963] [PMID] [PMCID]
18. Abbasi E, Nosrati A, Nabipour I, Emami SR. Assessment of the level of knowledge of Physicians in Bushehr Province about preparedness and response for nuclear emergency. Iran South Med J. 2005;7(2):183-9. [Persian]
19. Shakeri K, Fallahi Khoshknab M, Khankeh H, Hosseini MA, Hoseinzadeh S, Haghi Monie N. Evaluation of clinical skills of medical emergency personnel in Tehran emergency center confronting the trauma. J Health Promot Manag. 2012;1(4):16-24. [Persian]
20. Heidari T, Zainat Motlagh S, Afrasiabifar A, Hosseini N, Fooladi M. Facilitators and inhibitors of self-care behaviors among the Iranian patients with type 2 diabetes: A qualitative research. J Clin Care Skills. 2021;2(4):187-94. [DOI:10.52547/jccs.2.4.187]
21. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: A focus on trustworthiness. SAGE open. 2014;4(1):1-10. [DOI:10.1177/2158244014522633]
22. World Health Organization. Hospital safety index: Guide for evaluators. 2nd Edition. Washington D.C.: WHO, PAHO; 2019.
23. Burns N, Grove SK. Understanding nursing research-eBook: Building an evidence-based practice. 5th Edition. Maryland Heights, Missouri: Elsevier Health Sciences; 2010.
24. Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative. 4th Edition. Lippincott Williams & Wilkins; 2011.
25. Keykaleh MS, Sohrabizadeh S. The Emergency Medical System (EMS) response to Iraqi pilgrims' bus crash in Iran: a case report. BMC Emerg Med. 2019;19(1):38. [DOI:10.1186/s12873-019-0253-2] [PMID] [PMCID]
26. Cha M-I, Kim GW, Kim CH, Choa M, Choi DH, Kim I, et al. A study on the disaster medical response during the Mauna Ocean Resort Gymnasium collapse. Clin Exp Emerg Med. 2016;3(3):165-74. [DOI:10.15441/ceem.15.106] [PMID] [PMCID]
27. Raeisi AR, Mohajervatan A, Mehraein Nazdik Z. Mass casualty response to mine explosion: a case report in Iran. Health in Emergencies and Disasters. 2019;4(3):173-8. [DOI:10.32598/hdq.4.3.173]
28. Lee HY, Lee JI, Kim OH, Lee KH, Kim HT, Youk H. Assessment of the disaster medical response system through an investigation of a 43-vehicle mass collision on Jung-ang expressway. Accid Anal Prev. 2019;123:60-8. [DOI:10.1016/j.aap.2018.11.004] [PMID]
29. Parsa Yekta Z, Ahmadi F, Tabari R. Factors defined by nurses as influential upon the development of clinical competence. J Guilan Univ Med Sci. 2005;14(54):9-23. [Persian]
30. Wehbi NK, Wani R, Yang Y, Wilson F, Medcalf S, Monaghan B, et al. A needs assessment for simulation-based training of emergency medical providers in Nebraska, USA. Adv Simul. 2018;3(1):22. [DOI:10.1186/s41077-018-0081-6] [PMID] [PMCID]
31. Donnelly EA, Bennett M. Development of a critical incident stress inventory for the emergency medical services. Traumatol Int J. 2014;20(1):1-8. [DOI:10.1177/1534765613496646]
32. Mahony K. Restructuring and the production of occupational stressors in a corporatised ambulance service. Health Sociol Rev. 2005;14(1):84-96. [DOI:10.5172/hesr.14.1.84]
33. Said MN, Sukonthasarn A, Wangsrikhun S, Chanpransit C. Assessing and exploring the competency of prehospital emergency medical service personnel in Klang Valley, Malaysia: A mixed method approach. Int Med J Malaysia. 2014;13(2):7-19. [DOI:10.31436/imjm.v13i2.472]
34. Kumar S, Agarwal AK, Kumar A, Agrawal G, Chaudhary S, Dwivedi V. A study of knowledge, attitude and practice of hospital consultants, resident doctors and private practitioners with regard to pre-hospital and emergency care in Lucknow. Indian J Surg. 2008;70(1):14-8. [DOI:10.1007/s12262-008-0003-2] [PMID] [PMCID]
35. Studnek JR, Fernandez AR, Shimberg B, Garifo M, Correll M. The association between Emergency Medical Services field performance assessed by high‐fidelity simulation and the cognitive knowledge of practicing paramedics. Acad Emerg Med. 2011;18(11):1177-85. [DOI:10.1111/j.1553-2712.2011.01208.x] [PMID]
36. Lammers RL, Byrwa MJ, Fales WD, Hale RA. Simulation-based assessment of paramedic pediatric resuscitation skills. Prehosp Emerg Care. 2009;13(3):345-56. [DOI:10.1080/10903120802706161] [PMID]
37. Tavares W, Bowles R, Donelon B. Informing a Canadian paramedic profile: framing concepts, roles and crosscutting themes. BMC health Serv Res. 2016;16(1):477. [DOI:10.1186/s12913-016-1739-1] [PMID] [PMCID]
38. Ford R, Webb H, Allen-Craig S, Goodwin V, D'Antonio J, Lofts C. A simulated wilderness exercise: the development of relational competence in paramedic students. Int J Paramed Pract. 2015;5(11):14-21. [DOI:10.12968/ippr.2015.5.1.14]
39. Kilner T. Desirable attributes of the ambulance technician, paramedic, and clinical supervisor: findings from a Delphi study. Emerg Med J. 2004;21(3):374-8. [DOI:10.1136/emj.2003.008243] [PMID] [PMCID]