The Accuracy of Diagnosis and Treatment Made by Pre-hospital Emergency Medical Technicians in Patients Admitted to Hospitals in Qazvin, Iran

authors:

avatar Peyman Namdar 1 , avatar Amir Mohammad Kazemifar 1 , avatar Mahsa Mohammadi 2 , *

Department of Surgery, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Student Research Committee, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Journal of Inflammatory Diseases: Vol.24, issue 6; 510-519
article type: issue_documents_importer

how to cite: Namdar P, Kazemifar A M, Mohammadi M. The Accuracy of Diagnosis and Treatment Made by Pre-hospital Emergency Medical Technicians in Patients Admitted to Hospitals in Qazvin, Iran. J Inflamm Dis. 2021;24(6):e156251. 

Abstract

Background: Correct diagnosis and appropriate treatment measures of pre-hospital Emergency Medical Technicians (EMTs) are very important in improving the quality of patient care and reducing mortality and costs.  Objective: This study aims to investigate the accuracy of diagnosis and treatment made by pre-hospital EMTs in patients admitted to hospitals in Qazvin, Iran. Methods: In this descriptive study conducted in 2018, the medical records of 600 patients who were transferred to Bu-Ali Sina and Velayat hospitals in Qazvin by ambulance during March-June 2018 were examined. Diagnosis and treatment measures were extracted from the emergency sheet. Education, work experience, and amount of in-service training of pre-hospital EMTs were also collected. Data were analyzed in SPSS V. 23 software using ANOVA, Chi-square test, and t-test. Findings: Out of 600 cases, 71.7% of the initial diagnoses made by EMTs were correct, 8.5% were incorrect, and 19.8% were without initial diagnosis. Regarding the treatment measures, 65.8% were correct and 3.5% were incorrect.  Conclusion: Prompt help and correct diagnostic and treatment measures of pre-hospital EMTs can significantly reduce mortality and potential injuries.

References

  • 1.

    Saberi Nia A, Nekouei Moghadam M, Mahmoudi Meymand F. Identify stressful factors causing dissatisfaction in pre-hospital emergency personnel in Kerman. Payavard Salamat. 2013; 6(6):489-97. [In Persian] http://payavard.tums.ac.ir/article-1-8-en.html.

  • 2.

    Abedi T. Vaezzade F, Baghbanian A, Bahreini F. Managing Hospital. First Edition. Rasht: Gap; 2003. http://opac.nlai.ir/opac-prod/bibliographic/677059.

  • 3.

    Hatami Sh, Tofighi Sh, Taheri A, Zarrin M, Nik Ravesh H. Presenting a model for improving Emergency Medical Services (EMS) based on cloud processing in the hospital. Hospital. 2014. [In Persian]https://jhosp.tums.ac.ir/article-1-5227-fa.html.

  • 4.

    Foo CPZ, Ahghari M, MacDonald RD. Use of geographic information systems to determine new helipad locations and improve timely response while mitigating risk of helicopter emergency medical services operations. Prehosp Emerg Care. 2010; 14(4):461 68. [DOI:10.3109/10903127.2010.493983] [PMID].

  • 5.

    Gomes E, Arajo R, Soares-Oliveir M, Pereira N. International EMS systems: Portugal. Resuscitation. 2004; 62(3):257-60. [DOI:10.1016/j.resuscitation.2004.04.013] [PMID].

  • 6.

    Elmqvist C, Fridlund B, Ekebergh M. More than medical treatment: The patients first encounter with prehospital emergency care. Int Emerg Nurs. 2008; 16(3):185-92. [DOI:10.1016/j. ienj.2008.04.003] [PMID].

  • 7.

    Boyle S. Emergency care. United Kingdom (England): Health system review. Health Syst Transit. 2011; 13(1):247-60. https://www.euro.who.int/__data/assets/pdf_file/0004/135148/e94836.pdf.

  • 8.

    Manitoba. Health and seniors care [Internet]. 2021 [Updated 2021]. Available from: https://www.gov.mb.ca/health/ems/index. html.

  • 9.

    National EMS Management Association (NEMSMA). Position Statement [Internet]. 2012 [Updated 2013 Apr 21]. Available from: https://www.nemsma.org/page/PositionPaper.

  • 10.

    Grogan S, Conner M, Norman P, Willits D, Porter I. Validation of a questionnaire measuring patient satisfaction with general practitioner services. Qual Health Care. 2000; 9(4):210-5. [DOI:10.1136/ qhc.9.4.210] [PMID] [PMCID].

  • 11.

    Ahmadi Amoli H, Tavakoli H, Khashayar P, Panahi F, Alavi Moghadam M, Ahmadi Amoli M. The efficacy of pre-hospital care in traumatic patients referred to emergency ward of Sina Hospital between September 2003 and September 2004. Pajoohandeh. 2008; 13(3):203-11. [In Persian] http://pajoohande.sbmu.ac.ir/article-1-635-en.html.

  • 12.

    Saeed Modaghegh MH, Sayyar Roudsari B, Sajadehchi A. Prehospital trauma care in Tehran: Potential areas for improvement. Prehosp Emerg Care. 2002; 6(2):218-23.[DOI:10.1080/10903120290938580] [PMID].

  • 13.

    Zargar M, Saeed Modaghegh MH, Rezaishiraz H. Urban injuries in Tehran: Demography of trauma patients and evaluation of trauma care. Injury. 2001; 32(8):613-7. [DOI:10.1016/S0020- 1383(01)00029-8].

  • 14.

    Perrott CA. Emergency medicine in South Africa. J Emerg Med. 2003; 25(3):325-8. [DOI:10.1016/S0736-4679(03)00215-4].

  • 15.

    Weninger P, Hertz H, Mauritz W. International EMS: Austria. Resuscitation. 2005; 65(3):249-54. [DOI:10.1016/j.resuscitation. 2005.03.006] [PMID].

  • 16.

    Pozner CN, Zane R, Nelson SJ, Levine M. International EMS systems: The United States: Past, present and future. Resuscitation.2004; 60(3):239-44. [DOI:10.1016/j.resuscitation.2003.11.004][PMID].

  • 17.

    Hunyadi-Anticevic S. EMS system in Croatia. Resuscitation. 2006; 68(2):185-91. [DOI:10.1016/j.resuscitation.2005.09.011 [PMID].

  • 18.

    Bayram JD. Emergency medicine in Lebanon: Overview and prospects. J Emerg Med. 2007; 32(2):217-22. [DOI:10.1016/j.jemermed. 2006.12.007] [PMID].

  • 19.

    Ebrahimian AA, Khalesi N, Mohamadi GR, Tordeh M, Naghipour M. Transportation management in pre-hospital emergency whit physiological early warning scores. J Health Adm. 2012; 15(49):7-13. [In Persian] http://jha.iums.ac.ir/article-1-1015-en.html.

  • 20.

    Schottke D. First responder: Your first response in emergency care [R. Shahrami, A. Shahrami, H. Shirzad, M. Naderifar, Persian trans.]. Tehran: Simin Dokht; 2004. http://opac.nlai.ir/opac-prod/search/briefListSearch.do?command=FULL_VIE W&id=754484&pageStatus=0&sortKeyValue1=sortkey_title&sortKeyValue2=sortkey_author.

  • 21.

    Peyravi MR, Ortenwal P, Djalali AR, Khorram-Manesh A. An overview of shiraz emergency medical services, dispatch to treatment. Iran Red Crescent Med J. 2013; 15(9):823-8. [DOI:10.5812/ircmj.10982] [PMID] [PMCID].

  • 22.

    Kamrani F, Ghaemipour F, Nikravan M, Alavi Majd H. Prevalence of miss triage and outcomes under triage of patients in emergency department. J Health Promot Manag. 2013; 2(3):17-23. [In Persian] http://jhpm.ir/article-1-117-en.html.

  • 23.

    Bullard MJ, Unger B, Spence J, Grafstein E, CTAS National Working Group. Revisions to the Canadian Emergency Department Triage and Acuity Scale (CTAS) adult guidelines. CJEM. 2008; 10(2):136- 51. [In English-French] [DOI:10.1017/S1481803500009854][PMID].

  • 24.

    Gransson KE, Ehrenberg A, Ehnfors M. Triage in emergency departments: National survey. J Clin Nurs. 2005; 14(9):1067-74.[DOI:10.1111/j.1365-2702.2005.01191.x] [PMID].

  • 25.

    Khorram-Manesh A, Lennquist Montn K, Hedelin A, Kihlgren M, rtenwall P. Prehospital triage, discrepancy in priority-setting between emergency medical dispatch centre and ambulance crews. Eur J Trauma Emerg Surg. 2011; 37(1):73-8.[DOI:10.1007/s00068-010-0022-0] [PMID].

  • 26.

    Wuerz RC, Milne LW, Eitel DR, Travers D, Gilboy N. Reliability and validity of a new five-level triage instrument. Acad Emerg Med. 2000; 7(3):236-42. [DOI:10.1111/j.1553-2712.2000.tb01066.x][PMID].

  • 27.

    Bahrampouri S, Khankeh HR, Dalvandi A. Assessment of stroke patients status and their transfer time by emergency medical services to Valiasr hospital in Arak city, Iran. Health Emerg Disasters Q. 2016; 1(3):163-73. [DOI:10.15412/J.HDQ.09010307].

  • 28.

    Shakeri Kh, Fallahi Khoshknab M, Khankeh HR, Hosseini MA, Hosseinzadeh S, Haghi Monie N. Evaluation of clinical skills of medical emergency personnel in Tehran Emergency Center confronting the trauma. J Health Promot Manag. 2012; 1(4):16-24. [In Persian] http://jhpm.ir/article-1-107-en.html.

  • 29.

    Haner A, rninge P, Khorram-Manesh A. The role of physician- staffed ambulances: The outcome of a pilot study. J Acute Dis. 2015; 4(1):63-7. [DOI:10.1016/S2221-6189(14)60086-X]##.