The evaluation of treat and release attitudes of pre-hospital emergency healthcare professionals in case of hypoglycemia.

AIM: It is aimed to evaluate the knowledge of Pre-Hospital Emergency Health Services (PHEMS) staff about the treat and release criteria in hypoglycemia cases and their attitudes in the decision-making processes related to hospitalization. MATERIALS AND METHODS: The sample of this descriptive cross-sectional study consisted of 714 paramedics working in PHEMS in Turkey. A survey developed in Microsoft Forms, which includes various features such as age, gender, years of professional experience, developed in line with the literature, and questions covering treat and release in hypoglycemia cases and absolute hospital transport criteria, was used in the collection of data. Participants who agreed to participate in the study answered the online survey. FINDINGS: Of the 714 participants, 402 (56.30%) were female and 312 (43.70%) were male. 598 (83.75%) of the participants, who had a dilemma regarding the transfer of hypoglycemia cases that became stable after treatment to the hospital, decide to transfer the patient to the emergency room. 706 (98.88%) reported that the presence of another emergency that needs intervention in addition to hypoglycemia was decisive in the decision to transfer to the absolute hospital, and 586 (82.07%) reported that the patient's who did not return to his normal mental state after emergency medical intervention was decisive in the treatment and release decision. CONCLUSION: PHEMS employees have high knowledge and awareness related to treat and release criteria in hypoglycemia cases with which they have high experience. PHEMS employee, who has a dilemma related to making a treat and release decision, decides to transfer to the hospital with a high rate. PHEMS systems should define the treat and release protocols for hypoglycemia cases more clearly in order to use emergency services and health resources effectively.

Effect of the COVID-19 pandemic on violence against pre-hospital emergency health workers.

BACKGROUND: Violence against pre-hospital emergency health workers is a growing problem worldwide and negatively impacts the effectiveness of emergency services. The social distancing, isolation and quarantine measures that have been employed to reduce the spread of COVID-19 have also had economic and psychosocial effects. Therefore, it is important to explore how the negative repercussions of the COVID-19 pandemic have influenced these violent incidents that interfere with the work of emergency medical services (EMS). OBJECTIVE: This study aims to evaluate how violence against EMS workers has been impacted by the effects of the COVID-19 pandemic. METHODS: This study takes an interpretive social science approach, using the qualitative method of in-depth semi-structured interviewing. Audio of the interviews was recorded with the interviewee's consent. Sound recordings were transcribed and their content was categorised into themes. Categorised texts were then evaluated using descriptive analysis. RESULTS: Participants reported that, during the COVID-19 pandemic, they encountered more violence than usual on EMS assignments to non-emergency situations, though a sense of gratitude towards health workers at the beginning of the pandemic and positives attitudes towards health workers also contributed to reduced violence towards them. The data indicate that workplace violence among EMS employees has increased as the problems caused by the pandemic have intensified, suggesting that additional measures need to be taken to protect them. CONCLUSION: In parallel with an increase in social violence during the COVID-19 pandemic, violence against EMS workers also increased in prevalence. A multidimensional approach should now be taken to determine how violence against EMS employees will be affected by risks such as the intergenerational transmission of social violence, a psychosocial repercussion of the COVID-19 pandemic, especially considering the increasing workplace violence among EMS employees.

The role of female volunteers in disaster response organisations: A qualitative research.

BACKGROUND: Despite a high demand for people to participate in disaster volunteering, the extent of contribution received from female volunteers in disaster response organisations constitutes an important debate. In the Elazig earthquake on 24 January 2020, the role of female volunteers in rescuing a female victim from the wreckage once again demonstrated the importance of considering female volunteers when creating response capacities for disaster risks. OBJECTIVE: This qualitative study aims to evaluate the roles of female volunteers who play an active role in disaster response organisations in a society with gender equality issues. METHODS: This qualitative study included 15 National Medical Rescue Team (UMKE) female volunteers who took an active role in the Elazig earthquake and was performed between 15.07.2020 and 16.04.2021. Data were collected using an in-depth interview method. The data were analyzed using content analysis and the comments were given descriptively. RESULTS: Based on the qualitative analysis, the following concepts were explored among the participants: Volunteering, volunteering in disasters, the effects of volunteering on social life, being a woman in disasters, volunteering female in disasters, the 'motherhood myth', gender inequality. Women are key actors in tackling disaster damage and increasing available social resilience to disasters. In addition, women can use special attributes such as motherhood, which is socio-culturally defined and taught as an advantage, for the common good of society. Moreover, special elements, such as the image of the 'superwoman' in relation to the responsibilities imposed on women in disaster response organisations, which distort gender equality against women, appear as possible factors of harm for women. CONCLUSION: This study shows that female volunteers can play a life-saving role in chaotic situations such as disasters, contribute to the empowerment of women, increase sensitivity to gender and, in connection with this, the development of democracy in societies where gender inequality is high. On the other hand, special situations such as the image of 'superwoman', which aims for excellence in both private and public spheres in the responsibilities imposed on women, can destroy gender equality against women and increase women's fragility.

Relationship of knowledge about and attitudes towards violence with recognition of violence against women among health staff in pre-hospital emergency medical services.

BACKGROUND: Domestic violence, specifically, violence against women, is prevalent in all segments of society regardless of social class, ethnicity, culture or country. In other words, domestic violence is a global concern. AIM: The study aims to investigate the relationship between the attitude and knowledge of the health staff in pre-hospital emergency medical services about violence against women and their recognition of such form of violence. METHODS: This descriptive study was conducted on 1023 paramedics and emergency medicine technicians who work in the pre-hospital emergency health setting and are members of the Paramedic and Pre-hospital Emergency Medicine Association. The Attitudes towards Violence against Women Scale (ATVAWS) and Health Staff's Recognition of Signs of Violence against Women Scale (HPRSVAWS) were used for data collection. RESULTS: The mean scores for the ATVAWS and HPRSVAWS were 46.68 ± 6.92 and 20.31 ± 3.23, respectively. Of the participants, 48.5% had been subjected to violence, 43.93% had been subjected to violence perpetrated by their mothers, 41.53% had been exposed to physical violence and 4.2% remain exposed to domestic violence. Participants who had been exposed and those who remain exposed to domestic violence produced high scores in ATVAWS, which indicates an improvement in the traditional approach (less opposing view) to violence. High scores in the ATVAWS for (a) those who were exposed to violence in their workplaces, (b) who had never attended to actual or suspected cases of violence against women in their professional life, (c) who had attended to seven or more cases of violence against women, (d) who were less competent in physically examining actual or suspected cases of violence and (e) who had not been trained on violence against women, which indicates an increase in the traditional approach to violence. CONCLUSION: The study found that health staff in emergency health stations better recognised the signs of violence against women as their attitudes towards violence were less similar to the traditional approach. That is, they mostly held non-violent views. The characteristics, attitudes, perceptions and values of health professionals were considered important factors in addressing violence.

Effects of the institutional structure and legislative framework on ambulance accidents in developing emergency medical services systems.

OBJECTIVE: Turkey is a developing country undergoing a system change in the prehospital emergency medical services (EMS). The purpose of this study was to evaluate the effects of the institutional structure and legislative framework on the number of ambulance accidents in Turkey. METHODS: During the first phase of the study, ambulance accident data was requested and obtained from the Ministry of the Interior. Similarly, data on ambulance numbers were requested and obtained from the Ministry of Health through the Right to Information law. During the second phase of the study, a survey consisting of 112 EMS personnel viewpoints about the effects of the institutional structure and legislative framework on ambulance accidents was conducted using a structured questionnaire. A total of 209 EMS personnel completed the survey. RESULTS: The number of ambulance accidents increased by 42.5% over the last five years, whereas the area of coverage increased by 57.3% during the same period. The rate of EMS personnel experiencing ambulance accidents was 69.4%. When age, sex, and profession variables were considered, the varying profiles of the ambulance operators were found to have no significant effect on the number of ambulance accidents following the system change. CONCLUSION: The rise in the number of ambulance accidents in Turkey was not significant when compared with the increase in the area of responsibility. The present system change was also found to have no effect on the number of accidents. On the other hand, problematic areas in the institutional structure and the legislative framework increased the risk of accidents.