Hajiqasemi Mohsen, Hassan Zadeh Tabatabaei Mahgol Sadat, Rahimi-Movaghar Vafa
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Spinal Cord. 2025 Feb;63(2):51-57. doi: 10.1038/s41393-024-01054-w. Epub 2024 Dec 27.
Narrative review.
Neurotrauma has a considerable impact on healthcare, the economy, and human resources worldwide. In Iran, young males are especially vulnerable, with road traffic accidents (RTAs) being the major cause. Evaluating prehospital care systems is critical for detecting shortcomings and implementing improvements. This study seeks to evaluate the prehospital neurotrauma care procedure in Iran, highlighting its strengths and flaws.
We searched PubMed and Scopus databases for literature on the present condition of prehospital neurotrauma care in Iran. Consultations with an expert panel yielded additional material not previously available in the literature, particularly on Iran's emergency medical system.
Our findings indicate that the emergency dispatch system in Iran is relatively well-managed, regardless of the lack of a single emergency contact number. However, major obstacles still exist, particularly in terms of human resources, training, and equipment availability. Emergency medical technicians (EMTs) have intermediate to poor levels of knowledge and skills in dealing with neurotrauma, which might be considerably improved by ongoing training programs. Furthermore, Iranian hospitals lack specific trauma center designations and levels, resulting in overcrowded emergency rooms and delayed care delivery. National neurotrauma guidelines have been adopted in recent years, although their compliance is not consistently monitored.
Compared to developed healthcare systems, Iran's prehospital treatment system for individuals with neurotrauma has considerable limitations. Improving EMT education, recruiting more trained professionals, and simultaneous improvement of current medical facilities should be addressed as the first steps toward better care.
叙述性综述。
神经创伤对全球医疗保健、经济和人力资源产生了重大影响。在伊朗，年轻男性尤其容易受到影响，道路交通事故（RTA）是主要原因。评估院前护理系统对于发现缺陷并实施改进至关重要。本研究旨在评估伊朗院前神经创伤护理程序，突出其优势和缺陷。
我们在PubMed和Scopus数据库中搜索了有关伊朗院前神经创伤护理现状的文献。与专家小组的磋商产生了文献中以前没有的额外材料，特别是关于伊朗的紧急医疗系统。
我们的研究结果表明，尽管缺乏单一的紧急联系电话，但伊朗的紧急调度系统管理相对良好。然而，仍然存在重大障碍，特别是在人力资源、培训和设备可用性方面。紧急医疗技术人员（EMT）在处理神经创伤方面的知识和技能水平中等至较差，持续培训计划可能会大大改善这种情况。此外，伊朗医院缺乏特定的创伤中心指定和级别，导致急诊室人满为患和护理交付延迟。近年来已采用国家神经创伤指南，但其合规性并未得到持续监测。
与发达的医疗保健系统相比，伊朗针对神经创伤患者的院前治疗系统存在相当大的局限性。改善EMT教育、招募更多训练有素的专业人员以及同时改善现有医疗设施应作为迈向更好护理的第一步加以解决。
