emergency medical technician

Poor sleep quality influences daily functioning, making sleep quality an important clinical construct. Indeed, inadequate sleep quality can serve as a significant symptom of various medical and sleep disorders. Poor sleep can impair academic and social performance as it reduces students' concentration in the classroom. This study aimed to investigate the quality of sleep and its correlation with background variables among emergency and allied medicine students studying at Gilan University of Medical Sciences.

In this descriptive cross-sectional study, a total of 555 male and female students from Gilan University of Medical Sciences were selected via a multistage random sampling method in 2021. The data was collected using a demographics form and the Pittsburgh Sleep Quality Index. Data were analyzed with SPSS version 16 using descriptive (prevalence, mean, standard deviation) and inferential (Chi-square test, Fisher's exact test) statistical tests. The significance level was set at P <0.05.

The research results indicated that the majority of participants fell within the 21-year-old age group (30.45%) and identified as female (59.65%). In terms of marital status, 57.7% of the students were married. Half of the students experienced poor sleep quality. The mean score for sleep duration was reported to be higher than the scores for other subscales. Students' sleep efficiency was similarly low. In this regard, the Friedman test results revealed significant differences between the scores of the sleep quality subscales (P=0.001).

The study's results indicated that the sleep quality of emergency and allied medical students at Gilan University of Medical Sciences was below average. Additionally, the students reported a higher mean score in the sleep latency subscale than in other subscales. In order to enhance the students' sleep quality and address sleep latency issues, it is recommended to implement planning along with nursing interventions. Effective measures can be taken to improve the sleep quality of this group of students by providing suitable educational and welfare conditions.

Standard precautions are a basic strategy to prevent occupational exposure in prehospital emergency staff. The Health Belief Model (HBM)‑based education can be used to promote and educate health behavior. The aim of this study was to investigate the effect of the HBM‑based education on infection control standard precautions in prehospital emergency technicians.

This clinical trial study was conducted on 84 prehospital emergency staff of Hamadan who were randomly assigned to two groups: Experimental (n: 42) and control (n: 42) using a cluster method. The data were collected by a researcher‑developed questionnaire. Before education, the questionnaires were completed by both groups, and then three educational sessions were held for the experimental group within one month. Two months after the intervention, the two groups completed the questionnaire and the data were analyzed by SPSS 21 software.

Before education, there was no significant difference in the mean scores on HBM constructs and performance between the two groups (p > 0.05). The results of the Analysis of Covariance (ANCOVA) after educational intervention showed there was a significant difference in the mean scores of all constructs and performance between the two groups (p < 0.05).

HBM‑based educational intervention could affect the scores of the model’s constructs and improve the use of standard precautions in emergency medical technicians. In‑service training is recommended to be developed for the staff based on HBM.

To avoid making decisions based on the unproven opinions of emergency medical technicians (EMTs), many emergency medical service (EMS) systems rely on emergency medical protocols. As protocol‑based on‑scene decision‑making is influenced by many challenges, identifying these challenges can result in providing appropriate conditions for EMTs’ decision‑making. Therefore, this study aimed to identify the barriers and requirements in the off‑line emergency medical protocols implementation m in the prehospital emergency medical system.

To conduct this study, qualitative content analysis using 10 field observations, 22 interviews, and 2 rounds of focus group discussions was applied. The duration of interviews lasted from October 2019 to January 2020. The Graneheim and Lundman approach was used to analyze the data.

Seven categories (15 subcategories) including education and awareness (professional training and education and community‑based education); attitudes (professional attitude and community attitude); interactions and coordination (interpersonal interactions, organizational interferences, and community’s interactions); rules and instructions (instructions and supportive rules); control system (monitoring and evaluation and motivational system); accessibility (recourses and communication); and organization (structure and process) were obtained as the obstacles and challenges in the offline emergency medical protocol implementation in the prehospital system.

There are many challenges in implementing offline emergency medical protocols in the prehospital emergency system. To achieve the effectiveness and efficiency of offline prehospital emergency protocols, it is necessary to facilitate these challenges and improve the EMTs’ knowledge, attitude, and performance through cooperative and skill‑based education. The findings of this study can be useful for EMS systems from national to local levels.

To assess the possible factors associated with increasing risk of COVID-19 among EMTs.

This study was a case-control study conducted in Tehran, Iran. Case group was consisted of confirmed COVID-19 EMTs based on the results of reverse transcriptase polymerase chain reaction and/or lung computed tomography scan. Healthy EMTs were randomly selected as control group. Patients were asked to fill out a checklist including demographic data, data related to the work situation (such as number of missions and type of mask and cloth) and PPE precautions.

Sixty-eight patients and 148 healthy persons took part in this study as case and control group, respectively. Having two EMTs involved directly in taking care of patients (p <0.001) and working with a confirmed case teammate (p <0.001), considering the precautions such as seal check after wearing the mask (p=0.015), covering the hair with a medical hat (p <0.001), not using personal items despite protective clothing (p <0.001), and avoiding contact with the outer surface of clothing while removing (p <0.001) had significant difference in two groups.

We found that the type and method of use of PPE were correlated with the increasing risk of COVID-19 in EMTs. Also, we found that when two EMTs were involved directly in taking care of the patients, and those who worked with a confirmed case teammate, more frequently affected.

To save lives and reduce the disability and death of the patients, emergency medical technicians (EMTs) must make timely decisions in complex and, sometimes, life-threatening situations. Since the pre-hospital decision-making is a continuous and important process. 

The present study aims to identify the factors affecting EMTs’ on-scene decision-making in emergency situations. 

A qualitative approach using in-depth semi-structured interviews and field observations was employed to explore the factors influencing EMTs’ on-scene decision-making in emergency situations. Purposeful sampling was performed with 19 participants including 12 EMTs, 3 dispatchers, 3 medical directions physicians and one EMS manager as a policy maker. Interviews were conducted from October 2018 to March 2018 and the data were analyzed using Graneheim and Lundman’s content analysis approach. 

Eight categories and 18 sub-categories emerged to describe the factors effective in emergency medical technicians’ on-scene decision-making. they  were cultural context (community’s culture and organizational culture), interactions (malingering, threat and violence and considerations), competencies (acquisitive and intrinsic); personal feeling (positive feeling and negative feeling), authority (structural and in processing),  education (public and professional), special conditions (patient’s clinical situation, weather conditions, mission’s time and mission’s location), and organizational resource (facility and equipment, and human resources). 

To facilitate EMTs’ on-scene decision-making, it is recommended to clarify the EMTs’ responsibilities, promote the community’s culture, modify people’s expectations, police monitoring and control and value the star of logo on EMTs' uniform. The EMTs’ on-scene decision-making process should also be explored.