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How the Covid-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran Publisher Pubmed



Saberian P1, 2 ; Conovaloff JL3 ; Vahidi E1, 4 ; Hasanisharamin P5 ; Kolivand PH6, 7
Authors
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Authors Affiliations
  1. 1. Tehran University of Medical Sciences, Prehospital and Hospital Emergency Research Center, Tehran, Iran
  2. 2. Tehran University of Medical Sciences, Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran, Iran
  3. 3. UC Irvine School of Medicine, Department of Emergency Medicine, Orange, CA, United States
  4. 4. Tehran University of Medical Sciences, Shariati Hospital, Department of Emergency Medicine, Tehran, Iran
  5. 5. Tehran Emergency Medical Service Center, Tehran, Iran
  6. 6. Iranian Emergency Medical Service Organization, Tehran, Iran
  7. 7. Khatamol Anbia Hospital, Shefa Neuroscience Research Center, Tehran, Iran

Source: Western Journal of Emergency Medicine Published:2020


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. © 2020 Saberian et al. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/