Health in Emergencies and Disasters Quarterly
Volume:9 Issue: 3, Spring 2024

A hospital’s ability that is exposed to risk is important for maintaining its basic structure and functions by relying on increasing various capacities recovering from the effects of risks at the right time and reaching a higher level of readiness. Accordingly, the present study investigates the components of organizational resilience of hospitals during emergencies and disasters.

This comprehensive review was conducted in 2022. Data was collected by searching keywords in PubMed, Web of Science, Science Direct, Magiran, Irandoc, and SID databases from 2012 to 2022. The quality of the articles was evaluated using the strengthening of the reporting of observational studies in the epidemiology checklist by two researchers. The results of the studies were categorized in the form of dimensions and components.

A total of 20 studies with various methods were summarized after quality assessment. Subsequently, the identified components were categorized into 5 dimensions as follows: the vulnerability of the hospital (18 components), preparedness (31 components), management and support (33 components), responsiveness and adaptability (35 components), and recovery after crisis (8 components).

A review of the studies showed the importance of each component in the field of hospital organizational resilience. In this regard, policymakers at the decision-making level and managers at the executive level should pay attention to the components that affect the organizational resilience of the hospital regarding the structure, process, and expected consequences, and then make the necessary decisions regarding the implementation of policies and solutions.

Various studies indicate the risk of accidents and disaster rescuers suffering from burnout syndrome. Job burnout consists of three components, namely emotional exhaustion, depersonalization, and reduced personal accomplishment. Personality traits as crucial variables are involved in the occurrence of job burnout. No study was conducted in Iran on the relationship between job burnout and the personality traits of rescuers in accidents and disasters; therefore, this study investigates reducing burnout in rescuers by selecting them appropriately.

This was a cross-sectional correlational study conducted to investigate the relationship between burnout and the personality traits of rescuers. The studied population included all the rescuers of the 16 branches of the Red Crescent Society in Tehran Province, Iran, who worked in 19 rescue centers. The sample size was 414 men, of which, 254 people were randomly selected for this study. To evaluate the burnout of the participants in this study, the Maslach burnout inventory was used, and to measure the personality traits, the short form of the neuroticism, extraversion, openness, conscientiousness, and agreeableness questionnaire was employed. 

In this study, a positive significant relationship was observed between emotional exhaustion and depersonalization with neuroticism in rescuers, and a negative significant relationship was detected between emotional exhaustion and depersonalization with extroversion, agreeableness, and conscientiousness in rescuers. Additionally, a significant negative relationship was observed between personal accomplishment and neuroticism. Meanwhile, a significant positive relationship was observed between personal accomplishment with extroversion, agreeableness, and conscientiousness. No relationship was found between any of the three components of burnout and openness. This study showed that rescuers who score low in extroversion, agreeableness, and conscientiousness in their personality test and score high in neuroticism are more prone to burnout.

In addition to considering other necessary qualifications, rescuers should be selected based on low scores in neuroticism, and high scores in extroversion, agreeableness, and conscientiousness in personality tests. The result of such selection can be less burnout for rescuers along with providing better services to those injured in accidents and disasters.

The use of chemicals in academic laboratories is a major concern for the health and safety of individuals and the environment. Academic institutions are currently developing safe work procedures to ensure compliance with standard criteria and laboratory accreditation. However, it is unclear to what extent the activities of research laboratories are safe for the personnel and environment. Therefore, this research produces a chemical hazard assessment assembling data and knowledge on the health, safety, and environmental aspects of chemical applications in laboratories.

This cross-sectional study was conducted in 2021 in five research and teaching laboratories. The collecting data tool was a checklist, developed in 7 sections with 125 items and completed in all laboratories understudy. Then, the research team conducted a risk assessment for the 10 most widely used chemicals in the laboratories. In the end, the risk categorization was conducted based on the risk matrix of ISO 31000. 

Determining risk levels associated with using chemicals may provide a reasonable way to assess hazards and suggest controls for working in laboratories. Most non-compliance hazards were linked to inadequate waste disposal processes, the potential for poisoning and illness effects, and emergency actions. 

It is suggested to conduct knowledge, attitude, and practice studies of the students, staff, and faculties to provide appropriate level of training courses in the academic laboratories.

The concept of resilience has emerged in recent years in association with disaster risk reduction. In assessing adolescents’ resilience, it is important to consider resilience as a multi-factorial construct and context-based issue. Currently, there is a short resilience questionnaire to assess this construct among Iranian adolescents. Given the importance of using a short and valid questionnaire to assess resilience, this study investigates psychometric properties and the underlying structure of the Iranian translation of the child and youth resilience measure 12 (CYRM-12).

After obtaining permission, the CYRM-12 was translated into Persian and then back-translated based on the Wild (2005) process. The final version was distributed among 653 high school adolescents in the age range of 14 to 18 years. The reliability scale was evaluated by using the Cronbach α and test re-test reliability among 35 adolescents. Subsequently, the intra-class correlation coefficients were assessed. Confirmatory factor analysis was evaluated as the validity.

The Cronbach α coefficient for the CYRM-12 was 0.71 and the test re-test reliability was excellent (ICC=0.88, 95% confidence interval, 0.78–0.94). Confirmatory factor analysis showed that the root mean square error of approximation was significant (0.043) and all items were indicated with a high correlation with scales, including the comparative fit index (CFI), non-normed fit index (NNFI), normed fit index (NFI), incremental fit index (IFI), and relative fit index (RFI) that were more than 0.9 and only parsimony normed fixed index was 0.7 that would be acceptable as well. Moreover, the correlation between total anxiety and resilience is significant. This is the first study that used the Persian version of the CYRM-12 questionnaire in Iran. In disasters, time is important; therefore, this short version would be more appropriate to help measure children’s resilience more quickly. Moreover, the short version of the CYRM-12 questionnaire is suitable for measuring resilience.

This study determined good fitness, reliability, and test re-test reliability of the Persian CYRM-12 for Iranian adolescents.

Vital signs and level of consciousness are one of the most important components of patient examination in traffic accidents. Vital signs show a suitable measure of the initial condition of the patient and also the effect of the interventions. In this study, to evaluate the effects of the type of helicopter emergency medical service (HEMS) or ground emergency medical service (GEMS) ambulance transport, the changes in initial vital signs and arriving at the hospital in traffic accident patients were compared.

The data collected in this retrospective analytical descriptive study as a census included the type of transfer, age, gender, distance from the scene to the hospital, duration of the mission, mechanism of injury, patient’s condition and vital signs, and level of consciousness. The propensity score matching was used to control confounding factors. The analysis of the outcomes of systolic blood pressure, heart rate, respiratory rate, and level of consciousness of patients when they arrived at the hospital was done with a generalized linear model. Before and after the matching of HEMS and GEMS patients, vital signs, level of consciousness, and other initial variables were compared with the t-test and the chi-square test.

Initial vital signs before matching showed that HEMS patients had lower systolic blood pressure and consciousness in addition to higher respiratory and heart rates (P<0.05). After matching, no significant difference was observed in primary vital signs (P<0.05). After interventions and transfer, no significant difference was observed in vital signs arriving at the hospital in HEMS and GEMS (P<0.05).

After matching, HEMS and GEMS patients did not have significant differences in the level of consciousness and initial vital signs when they arrived at the hospital. There should be more accuracy in the triage and selection of patients who need to be transported by HEMS.

Due to the nature of their work, prehospital personnel face various ethical challenges that can lead to moral distress. Compared to hospital nurses, the interaction of personnel in the pre-hospital environment is closer, and the ethical climate can affect the reaction of pre-hospital personnel in the face of moral challenges and distress. This study determines the relationship between moral distress and ethical climate among prehospital personnel.

This cross-sectional correlational study was conducted on 136 emergency medical services personnel selected via census sampling. To collect the data, two instruments were used, namely the revised moral distress and Victor and Cullen’s standard ethical climate. The data were analyzed using descriptive statistics and Pearson correlation in the SPSS software, version 23.

According to the results, the mean score of moral distress intensity (MDI) was high (3.65±1.14) and the mean score of moral distress frequency (MDF) was moderate (1.83±0.53) among emergency medical services personnel. The mean ethical climate was moderate (2.96±1.02). The study found a negative and significant relationship between ethical climate and MDI among emergency medical services staff (r=-0.34, P<0.05). However, there was no significant relationship between ethical climate and MDF (r=-0.11, P>0.05). This study also found a significant relationship between MDI and personal characteristics, such as age, work experience, and history of referral to the board of inquiry (P<0.05). Additionally, there was a significant relationship between MDF and work experience (P<0.05). However, no significant relationship was detected between demographic factors and ethical climate (P>0.05).

Considering the positive effect of the ethical climate on reducing emergency medical services providers’ moral distress, more attention is essential to the factors affecting moral distress.

Pre-hospital care is crucial in supervising and handling urgent patients and medical crises. Emergency medical centers’ swifter response and heightened precision lead to time efficiency and alleviate the burden on hospital capacities. This research pinpoints the influential factors contributing to the enhancement of pre-hospital emergency time indicators at Qazvin University of Medical Sciences.

In this research, a qualitative methodology using the content analysis technique was adopted to explore and derive influential elements to enhance time-based metrics. Information was gathered via semi-structured interviews, involving 10 individuals, including authorities, academic personnel, technicians, and specialized physicians stationed within educational and medical institutions’ emergency units. These participants were selected via purposeful sampling. Following the categorization and interconnection of these categories, a conceptual framework was formulated.

A total of 14 overarching aspects, encompassing staff readiness, skilled workforce, human resource administration, infrastructure and institutional amenities, communication and information technology oversight, intelligence, impactful environmental elements, patient-linked variables, proficient scene management elements, adherence to national protocols, contextual factors, inter-organizational harmony and collaboration, noteworthy attributes of the receiving treatment center, and feasibility of catering to the vulnerable populace resulted in the identification of a total of 41 influential constituents.

The research findings demonstrated that enhancements in base quantity, ambulance count, provisioning superior and top-tier equipment, augmenting staff numbers, designing enhanced training schemes for emergency medical services team members, and integrating contemporary technology and equipment could serve as viable resolutions for advancing time indicators.

Before the arrival of patients at medical facilities, emergency medical teams often encounter numerous challenges in dealing with mass casualties resulting from road traffic accidents. This study examines the challenges that pre-hospital emergency medical services face during mass casualty incidents caused by road traffic accidents. 

This study presents three road accidents that caused significant numbers of casualties in Golestan Province, Iran. The data for this report was gathered from various sources, including recorded images and videos, analysis of hospital records, and pre-hospital care reports. In addition, group discussions were held with emergency medical technicians who were present at the accident scene.

Providing relief aid in three sections, namely first responders, emergency call centers, and emergency medical technicians faces significant challenges. The challenges related to the management of mass casualties were mainly in terms of the inability to manage the accident scene by the first responders, management of calls and sharing information in the dispatch center, and medical measures required to be done at the incident scene.

To ensure a prompt and efficient response to mass casualty incidents, it is crucial to focus on managing the incident scene by the first responders, as well as optimizing the communication and information exchange during dispatches and field medical interventions. To enhance the quality of emergency medical services, it is vital to develop educational programs, communication strategies, and standardized policies that can be implemented across all mass casualty incidents.