The prevalence of Staphylococcus aureus contamination in the ambulances and on-call emergency medical service personnel of Kashan city in Iran

Objective: Emergency medical services systems are at the first line of dealing with patients who suffer from various infections. Conducting investigations on the bacterial contamination of emergency ambulances play a crucial role to improve the occupational health of staff as well as the quality of patient care. Therefore, the aim of the present study was to investigate the presence of Staphylococcus aureus and other life treating bacteria in the urban and rural ambulances and their on-call emergency medical service personnel. Methods: This descriptive cross-sectional study was conducted on 12 front line prehospital emergency urban and rural ambulances in Kashan, Iran, in 2015. A total of 18 sites were sampled in each ambulance and from the nose of personnel. Grown colonies were confirmed based on colony morphology on mannitol salt agar plates, gram stain reaction and biochemical characteristics reactions. Results: The S. aureus contamination was only isolated from the nose of on-call emergency medical service providers of 12 urban and road ambulances, while no sign of contamination was found in 18 sampling sites of these front-line ambulances. Also, further evaluation of these sampling sites revealed the contamination with coagulase-negative staphylococci in all of them and oxygen tank was introduced as the most contaminated site inside the ambulances. Moreover, the prevalence of equipment contamination was significantly higher in urban ambulances. Conclusion: Identifying the rate of pathogens in clinical settings like the pre-hospital ambulance setting is an important issue which should be carefully considered.

Knowledge of triage in the senior medical students in Shiraz University of Medical Sciences

INTRODUCTION

Triage is a response to the problem of overcrowding in Emergency Departments (EDs) and accuracy of decisions made by the triage unit affects the ultimate outcome of EDs. This study was conducted to evaluate the knowledge of triage among last year medical students in Shiraz University of Medical Sciences.

METHODS

This is a cross-sectional analytical study whose subjects were all the senior students of medicine (62) in the last year of medicine from January to June 2013 who attended emergency medicine course in the screen room of 2 University Hospitals. This questionnaire was designed in 3 sections including personal data, 15 questions on knowledge of triage and 10 case scenarios for triage decision making and completed by the students. Statistical analysis was performed in SPSS statistical software (version 14) using independent sample t-test, one way ANOVA, and Pearson correlation coefficient (p≤0.001).

RESULTS

The total mean score of the participants was 10.6±1.5, ranging from 7 to 13. 58(93.5%) students had poor triage knowledge. In the scenario's section, the percentage of correct triage by students was 49.2% and those of over and under triage were 28.1% and 22.7%, respectively. There was a significant relationship between the triage accuracy and level of triage (ESI 4) (p≤0.001).

CONCLUSION

The level of knowledge of triage in the last year medical students was poor, although most of them had passed a course in the screen room. It is recommended that medical students' educational courses should include sections on the knowledge of triage in emergency rooms.