Save people with the wages of death and swearing and beatings

Pain cuts their joints. Their souls are full of heartbreaking scenes and the cries of grieving families who are sometimes beaten and forced to endure their insults and humiliations. Despite their many shortcomings, from power shortages to medical equipment, they sometimes have to work 240 hours a month.

Their problems are so great that they do not know where to start. Since last year, about 10 emergency personnel have lost their lives during the mission or due to a car accident and do not even have accident insurance. In the heat of summer and the cold of winter, they roam the streets to save lives.

“The biggest problem of this job is its risks and work pressure, and it should be one of the hard and harmful jobs, especially since the admission of female students in the field of emergency medicine took place last year, and these loved ones will soon enter the operational cycle.

Our colleagues in hospitals and medical centers work in a safe and stable environment, but emergency medical personnel are called to areas where they do not know what has happened; From explosions to clashes and quarrels, in cold and heat and difficult roads; Therefore, one of the most important issues in the pre-hospital emergency is the security of the mission scene, the security of the rescue force and, of course, the security of the clients.

Many of them had accidents while driving to save the lives of their clients or at the scene of the accident, and some had car accidents on the way home after the end of the heavy night shift. This year, about 12 emergency medical personnel lost their lives due to a car accident on a mission and more than 10 young people due to cardiac arrest, and no concessions were made to them.

Even special liability insurance or privileges are not granted to their families. During this time, dozens of our colleagues have been seriously injured in accidents and beatings. “All of this is normal, and you add the number of coronary heart disease and deaths in the last two years to get the depth of the story.”

These are the words of Scarlett, who has 18 years of experience in emergency operations. He and his colleagues at the Association are pursuing occupational emergencies.

Although their association does not have much executive power, they do a lot of follow-up and try to bring the problems of their colleagues across the country to the attention of the authorities.

They also provide public emergency and specialized first aid training for private ambulances, specialist forces and the general public, as well as welfare activities.

“The insults and mistreatment of some of the patient’s companions due to their mental condition with the emergency services and the beatings that occurred on the mission scene are only part of the stress and work problems of the pre-hospital emergency work,” Scarlett said. Rescue workers at this level should have a mental and physical health record because emergency forces are struggling with a lot of physical and mental injuries, and due to the movement of patients, some of whom are also heavy, they suffer from knee and spine problems. .

Due to the busy time of the missions, many of them miss the time to eat and suffer from digestive problems and stomach ulcers. These forces are present at the scene of many events and see many terrible events.

They even witness the cries and mourning of the families of the victims, which is why they need psychological recovery. “According to the standard, when an emergency medical force goes to the C.P.R. mission or someone who has died, he should be taken out of operation that day for psychological rehabilitation, but this does not happen due to the lack of troops in our country.”

According to Scarlett, the pre-hospital emergency department is facing a shortage of manpower: “According to the standards, there is more than 50% shortage of manpower in the field of medical emergencies and I do not know why they are not recruiting new staff.

The Administrative and Employment Affairs Organization and other institutions should be held accountable in this regard. Emergency managers say the necessary permits need to be issued so that we can recruit, and why employment permits are not issued by different governments is questionable.

No clear answer has been given to us in this regard. According to the law, medical emergencies should be considered as hard and harmful jobs, but unfortunately, in practice, neither hard and harmful insurance has been assigned to it, nor has its working hours been reduced.

Nurses working in the burn and psychiatric wards of hospitals are subject to the Hard and Harmful Occupations Act and have 60 days of annual leave. They also retire with 20 years of experience.

While the emergency forces, which in addition to burn and mental patients face many horrible accidents and in addition to psychological pressures, many accidents endanger their bodies and lives, are not covered by this law. There is verbal violence and the dangers of wireless radio waves for message and dispatch center nurses. “In addition, the dangers of behavioral and physical violence threaten the operational forces.”

Under the current law, 25-year-old emergency workers must retire, but Karabakh says: “I have not seen anyone retire after this period, and everyone retires after 30 years with a lot of injuries.

Even the hard work rate of our emergency medical staff is lower than that of hospital nurses. While our hospital staff work in a safe environment, pre-hospital emergency staff are on the streets and in the middle of summer and winter.

Accidents are busy. “In the emergency room, two emergency personnel have to resuscitate a patient, while we have seen many times that a team of several doctors, nurses and paramedics is present in the hospital to resuscitate a patient.”

“Many of the rules that apply to my colleagues in hospitals have not been sabotaged for emergency workers,” he said. An example of this is the law on improving the productivity of clinical staff in the health system, which is still facing many problems after 12 years.

According to the law, the working hours of operational staff must be reduced in order to provide optimal services to the people.

This law has been approved by the parliament, and even in the Court of Administrative Justice, a unanimous vote has been taken, but the law on the promotion of limited productivity and broken limbs is still applied in medical emergencies.

According to the Productivity Promotion Law and service record, the activity of emergency medical forces should be between 140 and 167 hours per month, but outside this law, they work up to 240 hours, and many are even forced to work up to 480 hours due to low income and high expenses! Imagine how many hours a month has for these forces to work 480 hours? This will definitely reduce the efficiency of people’s work and increase the possibility of medical errors.

The Productivity Promotion Act states that medical emergencies should improve the health of medical emergencies and work efficiency to reduce medical error.

Their leave is like the labor law, but due to lack of manpower, they make the least use of their leave because they have to introduce an alternative force and then go on leave. “According to the productivity promotion law, one month of extra leave must be given to the emergency medical forces, which is not observed, and usually the forces can not use one month of their own leave because they do not have the power to replace them.”

“Crisis management is not embedded in families and events,” Scarlett points to the cultural issue in their work.

When we are faced with a shortage of manpower, the staff has to work twice as much as normal hours, which is why their fatigue multiplies. On the other hand, because the number of our bases is small compared to the population, the time interval for the emergency to arrive at the scene of the accident also increases, which can lead to conflicts. For example, it has happened many times that our colleague has been sent from a farther place and has been beaten and has suffered fractures and injuries. We have had similar incidents in the city.

The other issue is unnecessary contacts with the emergency services, and I think that the media should cultivate and educate the emergency services in coordination with the country’s emergency organization and the Medical Emergency Association, so that people do not call the emergency services in any case.

False calls cause the ambulance that should be sent for real missions to be sent to non-emergency missions. “Many times they called the emergency services for a simple headache or a family dispute, and a force was sent to find out that there was no emergency.”

“We have a depleted operational fleet due to high missions, especially in metropolitan areas,” says Scarlett.

The lifespan of ambulances is 10 years, but this process takes place in metropolitan areas due to the high number of calls and dispatches of ambulances without interruption and 24 hours, whose useful life is less than seven years. As a result, many ambulances have become obsolete and have not been replaced by new equipment.

I think we have about 40 active air rescue helicopters in the country, one of which is active in the metropolis of Tehran and on long distances that may be life-threatening for the injured or in case of heavy traffic, amputation, or severe injuries to “Helicopters are used to vital organs of the body.”

Most of the staff at the Emergency Message Center are nurses and have an academic background. Also in the field of pre-hospital emergency operations are the fields of emergency medicine, nursing, operating room and anesthesia, and the number of physicians among them is limited.

Jessica recently cited a shortage of equipment and manpower as one of the problems in the field: “No ambulance has entered the fleet for three years, and half of the 5,700 ambulance fleet is more than 10 years old, and if the fleet is tired and worn out, the ambulance Do not import part of our services will be challenged.

Of course, we have a contract for a thousand ambulances, but its budget has not been determined, and we request that its budget, which is about 1,100 billion tomans in the 1401 budget, be considered as a necessity. There are still 500 bases in the barracks, which is both a place to live and a place of work for the staff, which does not really meet our conditions and is not in the dignity of manpower.

Approximately 70% of missions are completed in 10 to 12 metropolises, which are the most deprived, and traffic and time management are our most important challenges. We have 24,000 staff and we have provided 18 during the corona. “Our jobs are hard jobs, and in densely populated cities our colleagues carry out more than 10 missions.”

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