Effect of Professional Ethics Workshop on the Moral Intelligence of Prehospital Emergency Personnel in East Azerbaijan, Iran

Background: Moral intelligence is one of the several types of human intelligence. It is the ability to understand right from wrong and behave based on the value which is believed to be right. Objectives: This study was conducted to evaluate the effect of a professional ethics workshop on the moral intelligence of prehospital emergency technicians in East Azerbaijan Province, Iran, and consequently the improvement of their performance and increase in their work efficiency. Methods: In this before- and after-interventional study conducted in Tabriz University Prehospital Emergency Center, Iran, in 2020, a total of 234 participants were evaluated. The sample was collected using the Lennick and Kiel’s Moral Intelligence Questionnaire and full census method. Before the workshop, the questionnaire was completed by the participants. After the workshop, the same questionnaire was completed again. Results: The pretest and posttest scores for moral intelligence were 83.02 ± 7.33 and 83.49 ± 8.40, respectively, which showed a statistically significant difference (P < 0.05). In the three components of moral intelligence, namely consistent behaviors based on principles, values, and beliefs, persistence for the right, and responsibility for personal decisions, there were statistically significant differences (P < 0.05) before and after the workshop. Conclusions: According to the results, holding a professional ethics workshop was effective in increasing the overall level of moral intelligence, particularly in the three aforementioned components of moral intelligence. It is recommended to continue holding such workshops and improve the conditions and methods of training to increase their efficiency as much as possible.

Emergency Medical Services Challenges Regarding Resource Capacity and Competency during COVID-19 Pandemic

Objectives: This study aimed to investigate the availability of resources, personal protective equipment PPE) and beliefs amongst Emergency Medical Services (EMS) professionals in Makkah city. Also, we aimed to assess various aspects of how Emergency Medical Services are handling the COVID-19 pandemic via online self-administrated questionnaire. Methods: A cross-sectional analysis was conducted on a convenience sample of 276 EMS providers from the city of Makkah in Saudi Arabia during the period from July 2020 to June 2021. SPSS (version 21.0) was used for data entry and data analysis. We approximate a 95% confidence interval (±0.05). Results: Emergency Medical Technicians (EMTs) and paramedics are representing most of the participants, 44% and 43%, respectively. EMS doctor, EMS registered nurse and others represent the remaining 13%. When the participants assessed their level of satisfaction on how their institutions have handled the pandemic, 34% expressed that they were satisfied, 14% were very satisfied, while 21% and 13% expressed that they were dissatisfied and very dissatisfied. On the availability of resources, 42% had access to N95 masks whenever they needed access to them while 33% did not have access. Conclusion: As the study demonstrates a relationship between the capability of emergency medical services personnel to handle a pandemic like COVID-19 and institutional preparedness, there are still significant gaps in EMS personnel's PPE training. EMS agencies should be supported in their efforts to effectively prepare their workers while the pandemic continues in our communities. Therefore, institutions should adopt guidelines that stipulate care for patients with COVID-19, provide training to emergency personnel, and properly distribute resources and PPE.

Human Factors Research in Immersive Virtual Reality Firefighter Training: A Systematic Review

Immersive virtual reality (VR) shows a lot of potential for the training of professionals in the emergency response domain. Firefighters occupy a unique position among emergency personnel as the threats they encounter are mainly environmental. Immersive VR therefore represents a great opportunity to be utilized for firefighter training. This systematic review summarizes the existing literature of VR firefighting training that has a specific focus on human factors and learning outcomes, as opposed to literature that solely covers the system, or simulation, with little consideration given to its user. An extensive literature search followed by rigorous filtering of publications with narrowly defined criteria was performed to aggregate results from methodologically sound user studies. The included studies provide evidence that suggests the suitability of VR firefighter training, especially in search and rescue and commander training scenarios. Although the overall number of publications is small, the viability of VR as an ecologically valid analog to real-life training is promising. In the future, more work is needed to establish clear evidence and guidelines to optimize the effectiveness of VR training and to increase reliable data through appropriate research endeavors.

TeleSDC

Telemedicine promises to increase the quality of emergency treatments. Besides the transfer of speech and video data, medical device and patient data will add additional value to the tele-guided emergency personnel. In this paper, we develop a concept for transmitting device and patient data via the open communication standards SDC in a telemedical context, including data transmission over mobile radio networks while considering the limitations of public networks, and opening new usage scenarios for telemedicine.

Intraoperative Simulation: Team Training for Resuscitation While Using Intraoperative Computed Tomography: 2-Dimensional Operative Video

Spine surgeons increasingly use intraoperative computed tomography (iCT) to facilitate surgery. iCT has several advantages, including the ability to decrease radiation exposure, improve surgical accuracy, and decrease operative time.1-3 However, the large footprint of the equipment can impede fast patient access in the event of an emergency resuscitation. This challenge is compounded when the patient is prone with rigid head fixation. To achieve fast, high-quality resuscitation, a large team must overcome numerous challenges. Cohesive team functioning under these circumstances requires planning, practice, and refinement.4 As a result of our simulation sessions, we have made several changes to the setup of our iCT cases. The following equipment is now routinely used: extralong tubing between the anesthesia circuit and patient, portable vital monitor, additional intravenous access is obtained, and extension tubing is used with all lines. We have created educational diagrams to streamline 2 challenging processes: optimal bed placement (for supination) and removal of equipment from the operating room (OR) to accommodate an influx of emergency personnel and equipment. Since the implementation of this protocol, 1 prone posterior cervical patient had intraoperative cardiac arrest. The protocol was followed. Return of spontaneous circulation was achieved within 5 min. The patient was discharged from the hospital with no neurological sequelae. During debriefing, stakeholders uniformly credited the simulated practice with this positive outcome. Emergency planning is a multifaceted process that continually evolves. With a steady flux of personnel and equipment, ongoing practice is essential to ensure readiness. Here, we share the key elements of our twice-yearly simulation. This simulation was performed on a training mannequin. This study did not involve human subjects. Any depictions of care rendered to nonidentifiable patients were standard (nonexperimental).

Save-Life Helpline System

In the current context, road accidents have become a major loss to society, with ordinary people being left with little help during an emergency. The SAVE-LIFE Helpline is a comprehensive record of various human contributions. This contribution is very important for people who need help, especially for people who cannot afford to pay their bills. The project is intended to help these cases through donors, where the donor can donate money through the web project directly to people in need. Provides communication between provider and client. The donor can donate to the emergency personnel or to the SAVE-LIFE Helpline, which keeps track of those who need help.

COVID-19 Preventive Behaviors in Pre-hospital Emergency Personnel: Application of Protection Motivation Theory

Background: Pre-hospital emergency personnel plays a critical role in providing communities with essential medical care during the corona pandemic. Emergency medical services (EMS) are at the forefront of the health care system, and they are the first treatment group associated with COVID-19 patients to transfer suspected and known COVID-19 patients to medical centers. This study aims to investigate the factors affecting COVID-19 preventive behaviors in pre-hospital emergency personnel in Fars province, Iran based on protection motivation theory.Methods: This cross-sectional, web-based survey was conducted on 650 pre-hospital emergency personnel in Fars province in 2020. Data were collected by a questionnaire consisting of demographic information, protection motivation theory, and COVID-19 preventive behaviors.Results: 650 employees of Fars pre-hospital emergency and emergency bases participated in the study. The average age of participants in the study 45.14±10.37 years. There was a positive and significant correlation between preventive behaviors and constructs of the PMT model, including perceived susceptibility, severity, response efficacy, self-efficacy, response cost, and protection motivation. The response cost and protection motivation (behavioral intention) had the lowest and highest percentage of the mean from the maximum obtainable score among structures of the model, respectively. Perceived vulnerability, perceived severity, self-efficacy, and protection motivation (behavioral intention) are the strongest predictor of behavior. The variables predicted 61.3% of the variance of coronavirus preventive behaviors.Conclusion: The results of this study confirm the role of protection motivation theory in adopting preventive behavior of pre-hospital emergency personnel, it is suggested that interventional training be held with this theory, and facilitating protective behaviors as a principle in education should be considered.

Quality of life assessment in pre-hospital and hospital emergency healthcare workers: A pilot study

Introduction Quality of life (QoL) is an important index of general and mental health. Several studies have demonstrated healthcare staff can provide higher quality services to patients when they have a better QoL. Working in emergency care services has a heavy workload therefore poor QoL can lead to poor quality of service to patients. We aimed to assess the QoL in pre-hospital and hospital emergency healthcare workers in Isfahan province in Iran via the WHOQOL-BREF (World Health Organization Quality of Life) questionnaire. Methods A total of 891 pre-hospital and hospital emergency personnel were selected via the census method. The WHOQOL-BREF questionnaire was filled out by the participants over a period of 1 year. Results A total of 891 subjects participated. About 33.7% of the participants were pre-hospital emergency staff, 59.1% emergency department nurses, 5.3% emergency department physicians, and 1.6% emergency medicine specialists. Approximately 412 participants (48.8%) were women and 469 (53.2%) were men (mean age 37.72 ± 11.02 years). QoL in pre-hospital and hospital emergency personnel had the highest mean score in the general health domain (61.43 ± 21.38) and the lowest mean score in the environmental health domain (48.54 ± 17.62). Social relationships with a mean score of 53.30 ± 23.56 were not significantly different to the average (p>0.05). Workplace and work experience had a significant effect on all domains of QoL. Conclusion Pre-hospital and hospital emergency personnel in Isfahan province had an optimal QoL, except in environmental health. Therefore, to increase the QoL in this area the periodical evaluation of environmental health is recommended. Appropriate training to create workplace adjustment and work experience can also improve QoL.

An emergency response model for evaluating the formation and dispersion of plumes originating from major fires (BUOYANT v4.20)

A mathematical model called BUOYANT has previously been developed for the evaluation of the dispersion of positively buoyant plumes originating from major warehouse fires. The model addresses the variations of the cross-plume integrated properties of a rising plume in a vertically varying atmosphere and the atmospheric dispersion after the plume rise regime. We have described in this article an extension of the BUOYANT model to include a detailed treatment of the early evolution of the fire plumes, before the plume rise and atmospheric dispersion regimes. The model input and output consist of selected characteristics of forest or pool fires, and the properties of a source term for the plume rise module, respectively. The main model structure of this source term model is based on the differential equations for low-momentum releases of buoyant material, which govern the evolution of the plume radius, velocity and density differences. The model is also partially based on various experimental results on fire plumes. We have evaluated the refined BUOYANT model by comparing the model predictions against the experimental field-scale data of the Prescribed Fire Combustion and Atmospheric Dynamics Research Experiment, RxCADRE. The predicted concentrations of CO2 agreed fairly well with the aircraft measurements conducted in the RxCADRE campaign. We have also compiled an operational version of the model. The operational model can be used for emergency contingency planning and for the training of emergency personnel, in case of major forest and pool fires.