Amir Nejati

• Associate Professor of Emergency Medicine
• Professor (Associate) at Tehran University of Medical Sciences

Background: The evidence shows that the need for emergency evacuation in hospitals has arisen. Designing an emergency evacuation decision making tool increases the confidence of hospital managers in the decision made. Therefore, this study was aimed at the development, and the psychometric properties, of the decision-making scale for emergency hos...

IntroductionClimate change is among the most renowned concerns of the current century, endangering the lives of millions of people worldwide. To comply with the United Nations Climate Change Conference (COP21), hospitals should be on track to reduce greenhouse gas emissions. Although hospitals contribute to climate change by emitting greenhouse gas...

Background Disasters may result in mass casualties and an imbalance between health care demands and supplies. This imbalance necessitates the prioritization of the victims based on the severity of their condition. Contributing factors and their effect on decision-making is a challenging issue in disaster triage. The present study seeks to address c...

Purpose Timely identification and treatment of intracranial hematomas in patients with brain injury is essential for successful treatment. This study evaluates Infra-scanner as a handy medical screening tool for diagnosing, on-site, cerebral hematomas in patients with head injury. Materials and methods Patients referred to the emergency department...

Introduction: An ethical plan is required to make decisions regarding setting the priority for assisting injured patients through triage. The aim of this study was to explore the measures used to sort patients for ethical decision-making in disaster triage. Method: The participants were 54 clinicians and non-clinicians among the Iranian experts....

Context: Hospitals usually are at risk of potential hazards, which may necessitate emergency hospital evacuation (EHE). Deciding about hospital evacuation is of the critical task and is affected by numerous factors. Aims: The aim of this study then was to explore the factors behind the decision for EHE in disasters. Setting and Design: This is a qu...

Accidents and disasters impose enormous costs on governments and nations each year, as well as causing great suffering to people affected by various disasters around the world. Today, accidents and disasters account for a large portion of government resources and programs. Iran is no exception to this rule. It is one of the ten most populated count...

Introduction: An emergency is a serious, unexpected situation which may lead to injury, loss of life and damage to property and often needs urgent interventions. Emergency calls can bring urgent life-saving intervention in such situations. Although access to emergency lines for all persons of a society is one of the effectiveness indexes of this c...

Introduction In the aftermath of mass casualty incidents, many resolutions need to be made in a fast and influential manner within high pressure environment to assign the limited resources among the numerous demands. This study was planned to rank the criteria influencing casualty’s distribution following trauma-related mass casualty incidents. M...

Background Intravenous (IV) Lidocaine can be used as analgesic in acute pain management in the emergency department (ED). Objective Efficacy of IV Lidocaine in comparison with IV morphine in acute pain management in the ED. Method This is a double-blind randomized clinical trial on adult (18–64 year) patients with right upper abdominal pain suspe...

Objective: To examine all aspects affecting the functioning of the system and the most important factors in its assessment through a systematic review during 1990 to 2017. Methods: This systematic review of the current literature study was conducted during July 2017, and all articles, books, guidelines, manuals and dissertations pertaining to th...

Objectives: Digital nerve block is a painful procedure. Several methods have been proposed to decrease the injection pain. Applying an ice pack is a pertinent choice due to its effectiveness on pain reduction, convenience, and low costs. In this study, the degree of injection pain reduction was assessed after applying an ice pack to the site of an...

Introduction: Monitoring the quality of cardiopulmonary resuscitation (CPR) could help in achieving favorable outcomes, decreasing mortality, and preventing post-CPR neurologic sequels. This study aimed to generate a user-friendly checklist for CPR quality control in emergency department (ED). Method: A qualitative study was performed between Ja...

Objective: This study was conducted to determine the effect of intramuscular ondansetron on ketamine-associated vomiting in children undergoing procedural sedation. Methods: This randomized, double-blind, placebo-controlled, parallel-group clinical trial was conducted at the emergency departments of two university-affiliated tertiary care hospit...

Background: Disasters are medically defined as events in which the demands for patients’ care far exceed the available resources. In such situations, triage and rationing of limited resources are inevitable. A decision regarding triage needs not only scientific guidelines but also an ethical framework and supporting policies. This study aims to pro...

Introduction:Prehospital emergency care is a vital and integral component of health systems, particularly in resource-constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities, and trauma caused by road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the prehospita...

Introduction: Triage is a dynamic and complex decision-making process in order to determine priority of access to medical care in a disaster situation. The elements which should govern an ethical decision-making in prioritizing of victims have been debated for a long time. This paper aims to identify ethical principles guiding patient prioritizati...

Introduction: Health care need after a disaster usually is much more than available resources. Given that triage models presented the only basis for decision making about casualties' prioritization. Then, decisions about which injuries should be prioritized is very difficult and can create ethical challenges for triage officers. Although utilitaria...

Background: Low dose ketamine can be used as analgesic in acute pain management in the emergency department (ED). Objective: Efficacy of IN ketamine in acute pain management in the ED. Method: This is a double blind randomized clinical trial on patients older than 15 years who needed digital nerve block (DNB). Participants randomly received IN...

Background One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to presen...

Introduction: Mass casualty incidents impose a large burden on the emergency medical systems, hospitals and community infrastructures. The pre-hospital and hospital capacities are usually bear the burden of casualties large numbers. One of the challenging issues in mass casualty incidents is the distribution of casualties among the suitable health...

Introduction: Emergency department (ED) is usually the first line of healthcare supply to patients in non-urgent to critical situations and, if necessary, provides hospital admission. A dynamic system to evaluate patients and allocate priorities is necessary. Such a structure that facilitates patients' flow in the ED is termed triage. Objective:...

Introduction The present study is a survey to assess the pros and cons of emergency medicine (EM) from the viewpoint of the scholars from other medicine disciplines to improve the efficiency of EM in the healthcare system. Methods This is a semi-structured qualitative study. Face-to-face interviews with various physicians with different specialtie...

Objectives: The aim of this study was to survey systematically experts' opinion on field hospital site selection (FHSS) criteria in order to identify optimum locations for stockpiling them in preparedness phase of disaster management. Design: A Delphi consensus technique, directed by a systematic review of the published articles on the permanent ho...

Background Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-h...

Introduction: Emergency physicians should secure Endotracheal tubes (ETT) properly in order to prevent unplanned extubation (UE) and its complications. Despite various available endotracheal tube holders, using bandages or tape are still the most common methods used in this regards. Objective: This study aimed to compare adhesive tape (AT) versu...

Context: Disasters are increasing worldwide, with more devastating effects than ever before. Hospitals must maintain their normal functions or have an evacuation plan due to the rate of damages at the time of a sudden disaster. The present study was conducted to determine the effective determinants and components in hospital evacuation decision- ma...

Background One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to presen...

Introduction Hospitals should be safe and remain functional in emergencies and disasters as it is mentioned in the Sendai Framework. Proper selection of a hospital location has a direct effect on survival of affected population in disasters as well as cost and benefit of the hospital in non-emergency situation. Different studies applied different c...

The original article [1] contained an error whereby the author Davoud Khorasani-Zavareh's name was not presented correctly. This error has now been corrected.

Background The Kampala Metropolitan Area (KMA) is the fastest developing region in Uganda. Over recent years, this has placed exponential demand on the road sector, which consequently has contributed to rapid growth in motorized vehicles which, predisposes the region to a high risk of road traffic incidents (RTIs). A number of concerted road safety...

Background: Over the years, Uganda has been one of the low and middle-income countries bearing the heaviest burden of road traffic incidents (RTI). Since the proclamation of the United Nations Decade of Action for Road Safety 2011 - 2020, a number of measures have been taken to reduce the burden. However, they ought to be premised on existing evid...

Introduction Pain is the most common complaint of patients referring to emergency department (ED). Considering the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of ultrasound-guided nerve blocks in this setting. Methods 46 patients who came to the ED with injured extremities were enrolled in the...

Background: Tolerance to opioids among opium-dependent patients creates obstacles for proper pain management of these patients in the emergency department (ED). The aim of the present study was to investigate the efficacy of intramuscular (IM) haloperidol plus midazolam on morphine analgesia among opium-dependent patients. Methods: Opium-dependent...

Background: Ketamine has been used widely in emergency departments for different procedures, prescribed only as a single dose or dose per weight. We compared single dose of ketamine with dose per weight ketamine for procedures done in cases with acute musculoskeletal pain. Methods: This randomized double blind clinical trial, was conducted in the e...

Introduction: Pain is the most common complaint of patients referring to emergency department (ED). Considering the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of ultrasound-guided nerve blocks in this setting. Methods: 46 patients who came to the ED with injured extremities were enrolled in the...

Clinical assessment and classification of shock is extremely difficult to conduct on critically ill patients especially upon arrival at the emergency department. Resuscitative point-of-care ultrasound could be used for rapid initial diagnosis and better management. In this study, the results of using the RUSH (Rapid Ultrasound in Shock) exam to det...

Discussion: Our study showed that 50 mg single dose of ketamine is the same as the 0.75 mg/kg dose per weight for reducing pain in cases with traumatic and non-traumatic musculoskeletal injuries. Introduction Pain is the most common complaint of patients referred to emergency departments (ED) [1], but there is no defined protocol for pain managemen...

Breaking bad news is quite often not done in an effective manner in clinical settings due to the medical staff lacking the skills necessary for speaking to patients and their families. Bad news is faced with similar reactions on the part of the news receiver in all cultures and nations. The purpose of this study was to explore the perspectives of I...

An electrocardiogram (ECG) leads physicians to diagnose many potentially life-threatening cardiac, metabolic, electrolyte, and toxicological conditions. This study was designed to evaluate the competency of emergency medicine residents (EMRs) in comparison with cardiologists in the interpretation of ECG when an interpretation checklist is used. Thi...

Requesting non-enhanced brain CT scans for trauma and non-trauma patients in ER is very common. In this study, the impact of incorrect brain CT scan interpretations by emergency medicine team on patients' primary and secondary outcome was evaluated in the setting where neuroradiologist reports are not always available. During a 3-month period, 450...

Objective: Current study was conducted to develop a pain control protocol by Morphine Sulfate (MS) Suppository in triage ward with the main primary outcomes of first analgesic administration time, patients' satisfaction and also the changes in pain intensity. Methods: In this randomized clinical trial, 318 consecutive patients attending to an acad...

Patient safety is one of the main concepts in the field of healthcare provision and a major component of health services quality. One of the important stages in promotion of the safety level of patients is identification of medica-tion errors and their causes. Medical errors such as medication errors are the most prevalent errors that threaten heal...

This study was conducted to compare the efficacy and safety of naproxen 500 mg twice daily (BID) versus naproxen 500 mg as needed (PRN) for treatment of ankle sprain. In this seven-day, randomized, parallel group trial, 135 patients with ankle sprain occurring less than 48 hours prior to the first dose of study medication were randomized to receive...

Patient safety is one of the main concepts in the field of healthcare provision and a major component of health services quality. One of the important stages in promotion of the safety level of patients is identification of medication errors and their causes. Medical errors such as medication errors are the most prevalent errors that threaten healt...

Objective: Emergency departments (EDs) are characterized by simultaneous care of multiple patients with various medical conditions. Due to a large number of patients with complex diseases, speed and complexity of medication use, working in under-staffing and crowded environment, medication errors are commonly perpetrated by emergency care providers...

The study provides descriptive information regarding missions performed by Tehran helicopter emergency medical services (HEMS) during a 1-year period. All patients transferred by Tehran HEMS between March 2006 and March 2007 were enrolled in this descriptive study. Based on HEMS records, information was gathered on flight time, the number of patien...

Our goal was to identify the clinical criteria for requesting the chest X-ray in patients with blunt trauma and whether its findings such as clinical signs with a high sensitivity could be used to codify the final criteria. 386 patients with multiple trauma or blunt chest trauma examined by a physician and the injury mechanism, vital signs, O(2) sa...

The authors performed a prospective, double-blinded, randomized trial with emergency department (ED) patients requiring procedural sedation and analgesia (PSA) for repair of deep traumatic lacerations and reduction of bone fractures, to compare the ketamine/propofol (ketofol) combination with the midazolam/fentanyl (MF) combination. Sixty-two patie...

Background: vulnerable events could damage structural, non structural and functional components of hospitals that might lead to community crisis, accordingly. Risk assessment is the first step to develop of a hospital disaster plan. In this study, a primary phase of developing a local tool for Iran’s hospital disaster risk assessment entitled “H...

Nasogastric (NG) intubation is one of the most common procedures performed in the emergency department (ED) and other hospital settings. The aim of this study was to compare the level of pain during NG tube insertion in groups receiving local ketamine plus water-soluble lubricating gel and water-soluble lubricating gel alone (the latter is the comm...

Morning report is considered as an important educational tool in different branches of medicine. The purpose of the present study was to examine the method of case selection, the leadership, the participant's satisfaction and the educational value of morning report held in our centre. In September 2007, a formal feedback about the morning report wa...

Background: Physicians have an important role addressing the disasters and most of the times they are the first to attend triage scene and emergency departments. Since Iran is one of the countries in which natural disasters are common self reliance and confidence in disaster management are of special importance. Methods: In this descriptive cros...

Anterior shoulder dislocation is one of the most common complaints of patients referred to emergency departments. Intravenous opiates and benzodiazepines are traditionally prescribed in order to relieve the pain in this group of patients; however, complications always pose a problem. To compare the pain relief and complications following intra-arti...

Frequency of Bone Fractures among Hospitalized Patients Injured by the Bam Earthquake - Volume 20 Issue S2 - A. Hosseinnezhad, A. Bidari, M. Zare, A. Nejati, M. Tahani, S. Abbasi, M. Jallili, M. Ahangar