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How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran.
West J Emerg Med. 2020 Sep 25; 21(6):110-116.WJ

Abstract

INTRODUCTION

Coronavirus disease 2019 (COVID-19) has substantially impacted the healthcare delivery system in Tehran, Iran. The country's first confirmed positive test for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was on February 18, 2020. Since then, the number of cases has steadily increased in Iran and worldwide. Emergency medical services (EMS) quickly adapted its operations to accommodate a greater number of patients, and it worked to decrease the risk of COVID-19 spread among EMS personnel, given the disease's high transmissibility.

METHODS

We evaluated the chief complaint as well as the pattern and number of EMS calls and dispatches during the 28-day intervals before and after the February 18, 2020, COVID-19 outbreak in Iran.

RESULTS

EMS calls increased from 355,241 in the pre-outbreak period to 1,589,346 in the post-outbreak period, a 347% increase (p<0.001). EMS dispatches rose more modestly from 82,282 to 99,926, a 21% increase (p<0.001). The average time on telephone hold decreased from 10.6 ± 12.7 seconds pre-outbreak to 9.8 ± 11.8 seconds post-outbreak, a 7% decrease (p<0.001). The average length of call also decreased from 1.32 ± 1.42 minutes pre-outbreak to 1.06 ± 1.28 minutes post-outbreak, a 20% decrease (p<0.001). The highest number of daily dispatches occurred during the second and third weeks of the four-week post-outbreak period, peaking at 4557 dispatches/day. After the first reported case of SARS-CoV-2, there were significant increases in chief complaints of fever (211% increase, p<0.001) and respiratory symptoms (245% increase, p<0.001).

CONCLUSION

The number of EMS calls and dispatches in Tehran increased 347% and 20%, respectively, after the outbreak of COVID-19. Despite this, the time on hold for EMS response decreased. The Tehran EMS system accomplished this by increasing personnel hours, expanding call-center resources, and implementing COVID-19-specific training.

Authors+Show Affiliations

Tehran University of Medical Sciences, Prehospital and Hospital Emergency Research Center, Tehran, Iran. Tehran University of Medical Sciences, Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran, Iran.UC Irvine School of Medicine, Department of Emergency Medicine, Orange, CA, United States of America.Tehran University of Medical Sciences, Prehospital and Hospital Emergency Research Center, Tehran, Iran. Tehran University of Medical Sciences, Shariati Hospital, Department of Emergency Medicine, Tehran, Iran.Tehran Emergency Medical Service Center, Tehran, Iran.Iranian Emergency Medical Service Organization, Tehran, Iran. Khatamol Anbia Hospital, Shefa Neuroscience Research Center, Tehran, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33052824

Citation

Saberian, Peyman, et al. "How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran." The Western Journal of Emergency Medicine, vol. 21, no. 6, 2020, pp. 110-116.
Saberian P, Conovaloff JL, Vahidi E, et al. How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran. West J Emerg Med. 2020;21(6):110-116.
Saberian, P., Conovaloff, J. L., Vahidi, E., Hasani-Sharamin, P., & Kolivand, P. H. (2020). How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran. The Western Journal of Emergency Medicine, 21(6), 110-116. https://doi.org/10.5811/westjem.2020.8.48679
Saberian P, et al. How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran. West J Emerg Med. 2020 Sep 25;21(6):110-116. PubMed PMID: 33052824.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran. AU - Saberian,Peyman, AU - Conovaloff,Joseph L, AU - Vahidi,Elnaz, AU - Hasani-Sharamin,Parisa, AU - Kolivand,Pir-Hossein, Y1 - 2020/09/25/ PY - 2020/06/12/received PY - 2020/08/12/accepted PY - 2020/10/15/pubmed PY - 2020/10/15/medline PY - 2020/10/14/entrez SP - 110 EP - 116 JF - The western journal of emergency medicine JO - West J Emerg Med VL - 21 IS - 6 N2 - INTRODUCTION: Coronavirus disease 2019 (COVID-19) has substantially impacted the healthcare delivery system in Tehran, Iran. The country's first confirmed positive test for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was on February 18, 2020. Since then, the number of cases has steadily increased in Iran and worldwide. Emergency medical services (EMS) quickly adapted its operations to accommodate a greater number of patients, and it worked to decrease the risk of COVID-19 spread among EMS personnel, given the disease's high transmissibility. METHODS: We evaluated the chief complaint as well as the pattern and number of EMS calls and dispatches during the 28-day intervals before and after the February 18, 2020, COVID-19 outbreak in Iran. RESULTS: EMS calls increased from 355,241 in the pre-outbreak period to 1,589,346 in the post-outbreak period, a 347% increase (p<0.001). EMS dispatches rose more modestly from 82,282 to 99,926, a 21% increase (p<0.001). The average time on telephone hold decreased from 10.6 ± 12.7 seconds pre-outbreak to 9.8 ± 11.8 seconds post-outbreak, a 7% decrease (p<0.001). The average length of call also decreased from 1.32 ± 1.42 minutes pre-outbreak to 1.06 ± 1.28 minutes post-outbreak, a 20% decrease (p<0.001). The highest number of daily dispatches occurred during the second and third weeks of the four-week post-outbreak period, peaking at 4557 dispatches/day. After the first reported case of SARS-CoV-2, there were significant increases in chief complaints of fever (211% increase, p<0.001) and respiratory symptoms (245% increase, p<0.001). CONCLUSION: The number of EMS calls and dispatches in Tehran increased 347% and 20%, respectively, after the outbreak of COVID-19. Despite this, the time on hold for EMS response decreased. The Tehran EMS system accomplished this by increasing personnel hours, expanding call-center resources, and implementing COVID-19-specific training. SN - 1936-9018 UR - https://www.unboundmedicine.com/medline/citation/33052824/How_the_COVID_19_Epidemic_Affected_Prehospital_Emergency_Medical_Services_in_Tehran_Iran_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/33052824/ DB - PRIME DP - Unbound Medicine ER -