A qualitative study about experiences and emotions of emergency medical technicians and out-of-hospital emergency nurses after performing cardiopulmonary resuscitation resulting in death

Abstract Background: Study about cardiopulmonary resuscitation in pre-hospital setting in Iran is limited. In present study we explored the challenges of the organizational structure and the human resources in pre-hospital emergency medical systems for cardiopulmonary resuscitation.Methods: This qualitative study was conducted using the content analysis approach. Data were collected through semi-structured interviews in 2020 until saturation was achieved. Sixteen people with the work experience at geographical bases were selected purposefully. Data were analyzed based on the Graneheim and Lundman’s approach. The main questions in this part included: What has been your experience with cardiopulmonary resuscitation? What were the challenges you experienced in cardiopulmonary resuscitation? Please explain more about the challenges of organizational structure and human resources?Results: By analyzing the data, the information was placed in two main categories 1) “the challenges of human resources” includes four sub categories (lack of experience and skills, intrapersonal challenges, non-targeted performance, and weakness in education as the existing challenges) and 2) “the challenges of organizational structure” includes three sub categories (improper structure and access, lack of organizational support, and shortages of the facilities and the equipment as the existing challenges).Conclusions: Results revealed that pre-hospital emergency medical systems personnel face various problems, challenges and limitations in cardiopulmonary resuscitation. Therefore, the ability of these personnel to manage these challenges should be increased through the opportunity to acquire clinical knowledge and skills in order to improve patient-centered services.

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Challenges of Organisational Structure and Human Resources in Pre Hospital Emergency Medical Systems for Cardiopulmonary Resuscitation: A Qualitative Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/50586.15498 ◽

2021 ◽

Author(s):

Nahid Dehghan Nayeri ◽

Hassan Nouri Sari ◽

Fatemeh Bahram Neghad ◽

Fatemeh Hajibabaee ◽

Mojtaba Senmar

Keyword(s):

Qualitative Study ◽

Cardiopulmonary Resuscitation ◽

Human Resources ◽

Work Experience ◽

Hospital Setting ◽

Organisational Structure ◽

Medical Systems ◽

Hospital Emergency ◽

Emergency Medical ◽

Emergency Medical Systems

Introduction: Studies about Cardiopulmonary Resuscitation (CPR) in pre hospital setting in Iran is limited. Despite the importance of this issue, numerous challenges in this area are left unattended. Aim: To explore the challenges of the organisational structure and the human resources in pre hospital Emergency Medical Systems (EMSs) for CPR. Materials and Methods: This qualitative study was conducted using content analysis approach. Data was collected through semi-structured interviews in 2020, until saturation was achieved. The participants were 16 Iranian emergency medical staff who were selected through a purposive sampling method. Data were analysed based on the Graneheim UH and Lundman B approach. Results: Thirteen participants were males and the rest were females. The mean age of the participants was 33.06±7.85 years and their mean work experience was 10.62±6.63 years. By analysing the data, the information was placed in two main categories- “the challenges of human resources” which includes four sub categories (lack of experience and skills, intrapersonal challenges, non targeted performance and weakness in education as the existing challenges), and “the challenges of organisational structure” which includes three sub categories (improper structure and access, lack of organisational support and shortages of the facilities and the equipment as the existing challenges). Conclusion: Results from the present study revealed that pre hospital EMSs staff had to face various problems, challenges and limitations in CPR. Therefore, the ability of these staff to manage these challenges should be increased through the opportunity to acquire clinical knowledge and skills in order to improve patient-centered services.

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Barriers and facilitators to cardiopulmonary resuscitation within pre-hospital emergency medical services: a qualitative study

BMC Emergency Medicine ◽

10.1186/s12873-021-00514-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nahid Dehghan-Nayeri ◽

Hassan Nouri-Sari ◽

Fatemeh Bahramnezhad ◽

Fatemeh Hajibabaee ◽

Mojtaba Senmar

Keyword(s):

Qualitative Study ◽

Cardiopulmonary Resuscitation ◽

Emergency Medical Services ◽

Human Resource ◽

Organizational Factors ◽

Medical Services ◽

Hospital Emergency ◽

Human Resource Policy ◽

Emergency Medical ◽

Resource Policy

Abstract Background Out-of-hospital cardiopulmonary arrest is a common and fatal problem. Rescuing patients with this problem by pre-hospital emergency medical services is associated with various barriers and facilitators. Identifying these barriers as well as the facilitators in a qualitative and an information-rich way will help to improve the quality of performing the maneuver and to increase the patients’ survival. Therefore, the current study was qualitatively conducted with the aim of identifying the factors affecting the cardiopulmonary resuscitation within the pre-hospital emergency medical services. Methods This qualitative study was conducted using a content analysis approach in Iran in 2021. The participants were 16 Iranian emergency medical technicians who were selected through a purposive sampling method. For data collection, in-depth and semi-structured interviews were conducted. For data analysis, the Elo and Kyngäs method was applied. Results The mean participants’ age was 33.06 ± 7.85 years, and their mean work experience was 10.62 ± 6.63 years. The collected information was categorized into one main category called “complex context of the cardiopulmonary resuscitation” and 5 general categories with 17 subcategories. These categories and subcategories include patient condition (patient’s underlying diseases, age, high weight, number of children, and place of living), dominant atmosphere in companions at home (companions’ feeling of agitation, companions doing harm, and companions helping), policy (educational policy, human resource policy, up-to-date equipment and technology, and do-not-resuscitate policy), performance of the out-of-organizational system (disorganization in the patient handover process, and cooperation of the support organizations), and conditions related to the treatment team (conscience, cultural dominance, and shift burden). Conclusions The results showed that the conditions related to the patient and his/her companions, as well as the organizational factors such as the policies and the out-of-organizational factors act as the barriers and the facilitators to the cardiopulmonary resuscitation within pre-hospital emergency medical services. Therefore, the barriers can be modified and the facilitators can be enhanced by taking various measures such as educating, human resource policy-making, upgrading the equipment, and considering appropriate management policies.

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Experiences of pre-hospital emergency medical personnel in ethical decision-making: a qualitative study

BMC Medical Ethics ◽

10.1186/s12910-018-0334-x ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Mohammad Torabi ◽

Fariba Borhani ◽

Abbas Abbaszadeh ◽

Foroozan Atashzadeh-Shoorideh

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Ethical Decision ◽

Ethical Decision Making ◽

Medical Personnel ◽

Hospital Emergency ◽

Emergency Medical ◽

Emergency Medical Personnel

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Is Rescuer Cardiopulmonary Resuscitation Jeopardised by Previous Fatiguing Exercise?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186668 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6668

Author(s):

J. Arturo Abraldes ◽

Ricardo J. Fernandes ◽

Núria Rodríguez ◽

Ana Sousa

Keyword(s):

Cardiopulmonary Resuscitation ◽

Emergency Medical Technicians ◽

Survival Outcomes ◽

Compression Rate ◽

Strong Impact ◽

Gas Analyzer ◽

Video Cameras ◽

Physiological Variables ◽

Emergency Medical ◽

Fatiguing Exercise

Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuer’s fatigue can compromise CPR delivery. We investigated the effect of a 100-m maximal run on CPR and physiological variables in 14 emergency medical technicians (age 29.2 ± 5.8 years, height 171.2 ± 1.1 cm and weight 73.4 ± 13.1 kg). Using an adult manikin and a compression-ventilation ratio of 30:2, participants performed 4-min CPR after 4-min baseline conditions (CPR) and 4-min CPR after a 100-m maximal run carrying emergency material (CPR-run). Physiological variables were continuously measured during baseline and CPR conditions using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and analyzed using two HD video cameras (Sony, HDR PJ30VE, Japan). Higher VO2 (14.4 ± 2.1 and 22.0 ± 2.5 mL·kg−1·min−1) and heart rate (123 ± 17 and 148 ± 17 bpm) were found for CPR-run. However, the compression rate was also higher during the CPR-run (373 ± 51 vs. 340 ± 49) and between every three complete cycles (81 ± 9 vs. 74 ± 14, 99 ± 14 vs. 90 ± 10, 99 ± 10 vs. 90 ± 10, and, 101 ± 15 vs. 94 ± 11, for cycle 3, 6, 9 and 12, respectively). Fatigue induced by the 100-m maximal run had a strong impact on physiological variables, but a mild impact on CPR emergency medical technicians’ performance.

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Spatial Analysis of Pre-Hospital Emergency Bases in Disasters in Tehran Province, Iran

Journal of Rescue and Relief ◽

10.32592/jorar.2021.13.1.7 ◽

2021 ◽

pp. 61-76

Keyword(s):

Emergency Medical Technicians ◽

Rational Maps ◽

Medical Sciences ◽

Hospital Emergency ◽

Descriptive Research ◽

Emergency Medical ◽

Pilot Work ◽

Tehran Province ◽

Human Burden

INTRODUCTION: Tehran is always exposed to various dangers due to its high population density. A geographic information system (GIS) can be very useful for reducing the financial and human burden caused by accidents, disasters, and diseases. METHODS: This field study was performed using a practical and descriptive research method. The pre-hospital emergency bases in the east of Tehran province and all the emergency bases covered by Shahid Beheshti University of Medical Sciences in disasters were evaluated as a case study. The population of these cities amounted to 1,149,485 people and included cities in the east of Tehran province, Iran, including Damavand, Firoozkooh, Pakdasht, Pishva, Qarchak, and Varamin. FINDINGS: Rational maps were created and analyzed in the areas where emergency bases were located using ArcGIS software, as well as analysis of regions, distances, point density, and a combination of these factors. Regarding the standards and indicators, it was determined that the Disaster and Emergency Medical Management Center needs to have130 emergency medical technicians, 23 ambulances, and one ambulance bus to equip the exiting emergency bases according to the standard pre-hospital regulations. Other requirements in this regard include the replacement of worn-out ambulances with new ones, construction of two emergency bases in Qarchak, Tehran, Iran, and three emergency bases in Pakdasht, Tehran, Iran, as well as the transfer of bases in the proximity of faults and flood-prone areas to safe places. CONCLUSION: Based on the obtained results, a comprehensive pre-hospital database was designed for the use of managers and officials in the occurrence of accidents, which might be used as a pilot work that can be expanded to other areas of Tehran, Iran, and other provinces in managing disasters and accidents.

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