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Prehospital Emergency Medical Services Challenges in Disaster; a Qualitative Study

Mohamad Sorani, Sogand Tourani, Hamid Reza Khankeh, Sirous Panahi
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Abstract

Introduction: Prehospital Emergency Medical Care (EMC) is a critical service in disaster management. The aim of this study was to explore the challenges of prehospital Emergency Medical Services (EMS) during disaster response in Iran.

Methods: A qualitative study was conducted from April 2015 to March 2017. Data were collected through in-depth, semi-structured interviews with 23 experienced individuals in the field of disaster that were selected using purposeful sampling. Data were analyzed using content analysis approach.

Results: Fifteen sub-themes and the following six themes emerged in the analysis: challenges related to people, challenges related to infrastructure, challenges related to information management systems, challenges related to staff, challenges related to managerial issues and challenges related to medical care.

Conclusions: Iran’s prehospital EMS has been chaotic in past disasters. Improvement of this process needs infrastructure reform, planning, staff training and public education. 


Keywords

Disaster planning; emergency medical services; qualitative research; earthquakes

References

Centre for research in the epidemiology of disasters. The human cost of natural disasters 2015: A global perspective. Website. Http://emdat.Be/human_cost_natdis. Published 26 june 2015, accessed 6 may, 2018.

van den Berg B, Grievink L, Gutschmidt K, Lang T, Palmer S, Ruijten M, et al. The public health dimension of disasters--health outcome assessment of disasters. Prehosp Disaster Med. 2008;23(4):s55-9.

Djalali A, Hosseinijenab V, Hasani A, Shirmardi K, Castren M, Ohlen G, et al. A fundamental, national, medical disaster management plan: An education-based model. Prehosp Disaster Med. 2009;24(6):565-9.

Djalali A, Khankeh H, Öhlén G, Castrén M, Kurland L. Facilitators and obstacles in pre-hospital medical response to earthquakes: A qualitative study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2011;19(1):30.

McKay MP. Commentary: Emergency medical services: Just the beginning of an effective system. Ann Emerg Med. 2008;52(4):454-6.

MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354(4):366-78.

Hardy S, Fattah S, Wisborg T, Raatiniemi L, Staff T, Rehn M. Systematic reporting to improve the emergency medical response to major incidents: A pilot study. BMC Emerg Med. 2018;18(1):4.

Ardagh MW, Richardson SK, Robinson V, Than M, Gee P, Henderson S, et al. The initial health-system response to the earthquake in christchurch, new zealand, in february, 2011. Lancet. 2012;379(9831):2109-15.

Biddinger PD, Baggish A, Harrington L, d'Hemecourt P, Hooley J, Jones J, et al. Be prepared--the boston marathon and mass-casualty events. N Engl J Med. 2013;368(21):1958-60.

Berggren RE, Curiel TJ. After the storm — health care infrastructure in post-katrina new orleans. New England Journal of Medicine. 2006;354(15):1549-52.

A global report: Reducing disaster risk a challenge for development. United nations development programme. Website. Http://www.Undp.Org/cpr/disred/documents/publications/rdr/english/rdr_english.Pdf. Published 26 june, 2004, accessed april 6, 2017. .

Ardalan A, Rajaei MH, Masoumi G, Azin A, Zonoobi V, Sarvar M, et al. 2012-2025 roadmap of i.R.Iran's disaster health management. PLoS Curr. 2012;4:e4f93005fbcb34.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.

Strauss a, corbin jm. Basics of qualitative research: Grounded theory procedures and techniques. 4 ed. Los angeles: Sage publications; 2015. P. 270.

. Polit DF, Beck CT. Nursing research principles & methods. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. P. 340.

Kirk MA, Deaton ML. Bringing order out of chaos: Effective strategies for medical response to mass chemical exposure. Emerg Med Clin North Am. 2007;25(2):527-48; abstract xi.

Zhong S, Clark M, Hou XY, Zang Y, FitzGerald G. Progress and challenges of disaster health management in china: A scoping review. Glob Health Action. 2014;7:24986.

Bobko JP, Harris WJ, Thomas S. The first care provider system: Improving community resilience for unexpected disasters. Why civilians should be prepared to act in mass-trauma events. EMS World. 2016;45(3):32, 4-8.

Bahreini Moghadam SA, Hamzeh Pour S, Toorchi M, Sefidi Heris Y. Knowledge and attitude of iranian red crescent society volunteers in dealing with bioterrorist attacks. Emerg (Tehran). 2016;4(1):16-20.

Alinia S, Khankeh H, Maddah SS, Negarandeh R. Barriers of pre-hospital services in road traffic injuries in tehran: The viewpoint of service providers. Int J Community Based Nurs Midwifery. 2015;3(4):272-82.

Pourshaikhian M, Abolghasem Gorji H, Aryankhesal A, Khorasani-Zavareh D, Barati A. A systematic literature review: Workplace violence against emergency medical services personnel. Arch Trauma Res. 2016;5(1):e28734.

Chang SE, McDaniels T, Fox J, Dhariwal R, Longstaff H. Toward disaster-resilient cities: Characterizing resilience of infrastructure systems with expert judgments. Risk Anal. 2014;34(3):416-34.

Nates JL. Combined external and internal hospital disaster: Impact and response in a houston trauma center intensive care unit. Crit Care Med. 2004;32(3):686-90.

Fredricks K, Dinh H, Kusi M, Yogal C, Karmacharya BM, Burke TF, et al. Community health workers and disasters: Lessons learned from the 2015 earthquake in nepal. Prehosp Disaster Med. 2017;32(6):604-9.

Godschalk D. Urban hazard mitigation: Creating resilient cities2003.

Tavakoli N, Yarmohammadian MH, Safdari R, Keyvanara M. Designing a model of patient tracking system for natural disaster in iran. J Educ Health Promot. 2017;6:77.

Redmond AD, Mardel S, Taithe B, Calvot T, Gosney J, Duttine A, et al. A qualitative and quantitative study of the surgical and rehabilitation response to the earthquake in haiti, january 2010. Prehosp Disaster Med. 2011;26(6):449-56.

Khankeh HR, Khorasani-Zavareh D, Johanson E, Mohammadi R, Ahmadi F, Mohammadi R. Disaster health-related challenges and requirements: A grounded theory study in iran. Prehosp Disaster Med. 2011;26(3):151-8.

Juffermans J, Bierens JJ. Recurrent medical response problems during five recent disasters in the netherlands. Prehosp Disaster Med. 2010;25(2):127-36.

Abolghasemi H, Poorheidari G, Mehrabi A, Foroutan G. Iranian military forces in the bam earthquake. Mil Med. 2005;170(10):859-61.

Nilsson H, Vikstrom T, Jonson CO. Performance indicators for initial regional medical response to major incidents: A possible quality control tool. Scand J Trauma Resusc Emerg Med. 2012;20:81.

Klein KR, Nagel NE. Mass medical evacuation: Hurricane katrina and nursing experiences at the new orleans airport. Disaster Manag Response. 2007;5(2):56-61.

Adini B, Aharonson-Daniel L, Israeli A. Load index model: An advanced tool to support decision making during mass-casualty incidents. J Trauma Acute Care Surg. 2015;78(3):622-7.




DOI: https://doi.org/10.22037/emergency.v6i1.20465

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The theme is developed by: Gostaresh Afzar Hamara