[Show abstract][Hide abstract] ABSTRACT: To evaluate the impact of animal model based medical training courses for village healthcare workers on prehospital physiologic condition and prognosis of patients with penetrating injuries.
This study was carried out in Mehran city and its neighbouring rural districts in western part of Iran from 2002 to 2004.
Seventy-six village healthcare workers were trained and equipped to deliver in-field medical first cares. First group (226 patients) consisted of those who received this cares by the trained group and second group (245 patients) were those who received no in-field cares and were transported directly to the trauma center in provincial capital, Ilam. Physiologic Severity Score (PSS) was calculated to determine the physiologic condition of patients in both groups.
The most prevalent cause of trauma in both groups was car accidents (61.6%). Controlling of hemorrhage was the most frequent provided initial medical care (40.6%). A significant improvement regarding the PSS score was observed in the first group of patients compared to the second group (7.505 vs. 6.799, 95% CI for difference: 0.3 to 0.9). The mortality rates of the first and second group of patients were 3% and 7.3%, respectively (p=0.051).
Performing life support courses in rural areas of low-income countries where there is no pre-hospital triage and emergency medical system and provision of classic resuscitative measures are limited, has a significant impact on improvement of pre-hospital physiologic condition and prognosis of patients with penetrating injuries.
No preview · Article · Oct 2008 · Journal of the College of Physicians and Surgeons--Pakistan: JCPSP
[Show abstract][Hide abstract] ABSTRACT: On 26 December 2003, a catastrophic earthquake measuring 6.6 on the Richter scale devastated large areas of the city of Bam in southeastern Iran. More than 40,000 people died, tens of thousands were injured, and almost 20,000 homes were destroyed. Many national and international search-and-rescue teams were dispatched to the area to provide medical and health services and assist in the evacuation of survivors to undamaged areas.
The purpose of the study was to evaluate the opinions of survivors about medical responses provided, and the process of reconstruction of health infrastructures.
This was a descriptive study performed two years after the earthquake. Stratified, two-stage area sampling was used to enroll 211 survivors into the survey. A designed questionnaire was applied to evaluate the respondents' opinions about medical and health responses. The respondents were asked to score their satisfaction on a variety of services on a five-point scale, with 1 being "very poor" and 5 being "very good".
Family members and relatives comprised the majority of first responders for those injured or trapped (127, 60.2%). Field hospitals deployed by the Red Crescent, international relief teams, and military forces were the first medical facilities for 98 (46.4%) of the casualties. As denoted by the mean values for the satisfaction scores, transportation by aircraft to the backup hospitals received the highest score (4.2), followed by international assistance (4.1), first medical care (3.5), search and rescue (3.3), primary transportation (3.1), and reconstruction and the quality of access to the infrastructures of the city (2.6). Two years after the earthquake, 151 (71.5%) respondents still were living in connexes (temporary accommodations or shelters for victims to live in; resemble a small hotel), only 33 (15.6%) had access to safe drinking water, and 44 (20.9%) did not have sufficient supplies of sanitary food.
In addition to reinforcing the medical and health infrastructures of a society in accordance with geographical and architectural characteristics, effective air evacuation and relief missions carried out by experienced international relief teams can play an important role in the appropriate management of approximately 30,000 casualties after a catastrophic event, such as experience with the Bam Earthquake.
Preview · Article · Jan 2008 · Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation
[Show abstract][Hide abstract] ABSTRACT: An earthquake measuring 6.5 on the Richter scale devastated Bam, Iran on the morning of 26 December 2003. Due to the great health demands and collapse of health facilities, international aid could have been a great resource in the area. Despite sufficient amounts and types of resources provided by international teams, the efficacy of international assistance was not supported in Bam, as has been experienced in similar events in other countries. Based on the observations in the region and collecting and analyzing documents about the disaster, this manuscript provides an overview of the medical needs during the disaster and describes the international medical response. The lessons learned include: (1) necessity of developing a national search and rescue strategy; (2) designing an alarm system; (3) establishing an international incident command system; (4) increasing the efficacy of the arrival and implementation of a foreign field hospital; and (5) developing a flowchart for deploying international assistance.
Full-text · Article · Jun 2006 · Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation