Exploring coping strategies of emergency medical technicians against COVID-19 stress: a qualitative study.

Introduction: The COVID-19 pandemic has been shown to cause enormous psychological burden among health care workers, including first responders. However, the psychological well-being of first responders, essential in the fight against COVID-19 pandemic, has often been ignored. This qualitative study aimed to explore the coping strategies used by EMTs to manage stress during the pandemic. Methods: The research was designed as a qualitative study, utilizing a thematic analysis framework. Semi-structured interviews were conducted with 15 EMTs from a single geographic area between September 2022 and December 2022. The data were analyzed using Braun and Clarke analytic techniques, and this study used Lincoln and Guba's to assess the reliability of the data. Results: Four main coping strategies emerged from the data: seeking social support, practicing self-care, utilizing coping mechanisms, and finding meaning and purpose in work. EMTs sought support from both professional and personal sources, engaged in physical and emotional self-care, used humor and distraction as coping mechanisms, and found meaning and purpose in helping others and growing as professionals. Conclusion: Based on the extracted results from the study on EMTs in Iran, it can be concluded that the importance of social support cannot be overstated, as it serves as a crucial buffer against the negative effects of stress and trauma. The findings suggest that addressing the social and emotional needs of EMTs is important for promoting their mental health and well-being during the pandemic.

Nurses' perception of emergency department overcrowding: A qualitative study.

INTRODUCTION: One of the most important wards of the hospital is the emergency department (ED). Due to the increasing number of referrals, overcrowding has become a significant problem. It means an increase in patients' referrals and swarms at the ED, limiting their medical staff access. This study investigates the nurses' experiences and perceptions about the reasons for ED overcrowding. MATERIALS AND METHODS: Twelve emergency nurses were purposefully selected to take part in this study. Data collection was through face-to-face semi-structured interviews until data saturation was finalized. Data analysis was conducted using Graneheim and Lundman's conventional content analysis. RESULTS: Nurses' experiences with the reasons for ED overcrowding came into two main categories. The first was "increased referral to the emergency department," which had three subcategories: "increased referral due to health system reform plan," "increased referral due to corona pandemic," and "improper triage." The second was "increased patients' length of stay at the ED" with seven subcategories including "shortage of bed," "shortage of nursing staff," "lack of physical space," "turtle para-clinic," "on-call specialists' delay," "timely medical record documentation requirements," and "delaying in patients' transfer from the ED to the ward." CONCLUSION: The results showed ED overcrowding is inevitable. Intentional or unintentional changes in the health system, such as implementing the health system reform plan or the corona pandemic, can also increase overcrowding. Findings showed ED overcrowding increased referrals and patients' length of stay. This study suggests the health system authorities pay more attention to this phenomenon and look for solutions.

Workplace interpersonal conflict in prehospital emergency: Concept analysis.

BACKGROUND: In the turbulent and stressful work environment of prehospital emergencies, the conflict among emergency medical technicians (EMT) and other health-care providers is inevitable. This study aims to examine the concept of workplace interpersonal conflict (WIC) in prehospital emergencies. MATERIALS AND METHODS: The eight-step Walker and Avant's concept analysis approach was adopted to define the concept. Iranmedex, SID, Magiran, ISC, PubMed, Scopus, Embase, and Web of Science searched with keywords such as WIC and hospital emergencies. After an extensive review of online national and international databases, one dictionary, nine books, and 25 articles in English and Persian were retrieved for the purposes of the study. RESULTS: The antecedents, attributes, and consequences of the concept identified. EMT must learn how to eliminate their destructive effects while enhancing constructive effects. CONCLUSION: Conflict is an inevitable part of life, and EMT must learn how to reduce their destructive effects while increasing constructive results.

Emergency Medical Technicians' Experiences of the Challenges of Prehospital Care Delivery During the COVID-19 Pandemic: A Qualitative Study.

Background: Exploring emergency medical technicians' (EMTs) experiences of COVID-19 epidemic, help to identify the challenges they face in their daily work and develop strategies that address these challenges. This study aimed to explore EMTs' experiences of the challenges of prehospital care delivery during the COVID-19 pandemic. Methods: This qualitative study was conducted in March-July 2020 using conventional content analysis approach. Fifteen EMTs were purposively selected from the Emergency Medical Services (EMS) Center in Qom, Iran. For data collection, semi-structured interviews were conducted until data saturation was reached. Results: EMTs' experiences of the challenges of prehospital care delivery during the COVID-19 pandemic were classified into three main categories including "restless society", "difficult care delivery conditions", and "unprepared organization". The emergent subcategories were "need for information", "limited perception of the COVID-19 risk", "obsessive use of disinfectants", "fear over the transmission of COVID-19 to self and others", "burnout due to heavy workload", "altered communication with hospital staff", "ethical conflicts", "lack of a definite treatment plan", "lack of protective equipment", "staff shortage due to the affliction of EMTs by COVID-19", and "inadequate support by authorities". Conclusion: During COVID-19 pandemics, EMTs face many challenges including emotional and occupational stress, social strains, risk of affliction by infections, heavy workload, and ethical conflicts and hence, experience difficulties in quality care delivery. Developing appropriate strategies, guidelines, and policies are needed to effectively manage these challenges and improve the quality of prehospital care delivery in COVID-19 epidemic.

Evaluation of Bacterial Contamination on Prehospital Ambulances Before and After Disinfection.

BACKGROUND: The contamination of the environment, ambulance equipment, and staff hands consequently are major factors which create nosocomial infections in emergency patients. The contamination of equipment and devices plays an important role in nosocomial infections. OBJECTIVES: The aim of this study was to determine the effectiveness of a disinfectant on the rate of microbial contamination of ambulances in Qom Emergency Medical Services (EMS), Qom, Iran. METHODS: This is a quasi-experimental study with a before-after design in order to determine microbial contaminations at the rear and front cabin of ambulances, as well as medical equipment being utilized in Qom EMS. Saya sept-HP-2% solution was used for disinfection. Bacteriological standard methods were used to identify the contaminations. RESULTS: The contamination rates before and after use of disinfection solution were 52% and eight percent, respectively. Coagulase-negative staphylococci were the most commonly isolated bacterial agent from the equipment (53%). In all equipment, the contamination level has shown a significant reduction after applying disinfectant. CONCLUSIONS: In spite of the fact that the rate of infection from ambulance equipment is high, the results showed that the use of the suitable disinfectant had an effective role in the reduction of bacteria. FarhadlooR, Goodarzi FarJ, AzadehMR, ShamsS, Parvaresh-MasoudM. Evaluation of bacterial contamination on prehospital ambulances before and after disinfection. Prehosp Disaster Med. 2018;33(6):602-606.

Bus Crashes in Iran.

Parvaresh-Masoud M , Asayesh H . Bus crashes in Iran. Prehosp Disaster Med. 2018;33(2):227-227.