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Background & Aim: Improving clinical decision-making is one of the challenges of the pre-hospital emergency system. Therefore, the aim of this study was to determine the effect of pre-hospital trauma management training program on the capability of clinical decision- making in emergency medical technicians.
Methods & Materials: In a randomized controlled field trial study, 64 pre-hospital emergency technicians from Gonabad University of Medical Sciences, were randomly assigned to either intervention or control groups by the stratified sampling method in 2018. For the intervention group, a pre-hospital trauma management training program was administered based on existing domestic and global standards in a two-day crash course with a combination of learning techniques including lecture and simulation. The research instruments were a demographic questionnaire and a researcher-made questionnaire on clinical decision-making, completed before the course, immediately and one month after the completion of the course. Data were analyzed by the SPSS software version 19 using independent t-test, the repeated analysis of variance and Bonferroni's post-test.
Results: The mean changes in clinical decision-making scores before and immediately after the intervention (9.31 vs. 0.3), before and one month after the intervention (7.86 vs. 1.1) and immediately after the intervention and follow-up one month after the intervention (1.62 in. vs. 1.39) were significantly higher in the intervention group than in the control group (P<0.001).
Conclusion: The pre-hospital trauma management training program can improve clinical decision-making in pre-hospital emergency medical technicians. Therefore, this program can be integrated into the technicians’ training programs.
Clinical trial registry: IRCT20180802040677N1
 

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Background & Aim: Diabetic neuropathy is found in 50% of people with diabetes and refers to a group of diseases that affect all nerves such as peripheral, autonomic and spinal nerves. This study aimed to investigate the effect of topical heat therapy on clinical symptoms of peripheral neuropathy in patients with type 2 diabetes.
Methods & Materials: The present study was a randomized controlled clinical trial conducted on 52 patients with type 2 diabetes with peripheral neuropathy referred to the clinic of Allameh Behlool Gonabadi Hospital in 2018. The participants were randomly divided into two groups of intervention and placebo. The intervention group received heat therapy using a hot pack at 40 ° C twice a day for 20 minutes for a week. The control group received all routine care similar to the intervention group. A demographic information form and NSS questionnaire were used to collect the data through interview. Data were analyzed using the SPSS software version 23 at a significance level of less than 0.05.
Results: The mean scores of neuropathy symptoms before and after the intervention were 5.46±1.90 and 4.12±1.55 respectively for the intervention group, and 4.88±1.53 and 5.08±1.52 for the control group that no significant difference was observed between the both groups before the intervention (P=0.23), but there was a statistically significant difference after the intervention (P=0.03). Also, the comparison of the mean scores of two groups after the intervention showed a significant difference (P<0.001).
Conclusion: The findings showed that topical heat therapy can improve the clinical symptoms of peripheral neuropathy. Since this technique is easy to learn and inexpensive, it can be used to reduce treatment costs and drug side effects, as well as to improve patient self-care.
Clinical trial registry: IRCT20181015041354N1

 

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Background & Aim: Patients undergoing hemodialysis commonly experience discomfort due to the insertion of needles into their arteriovenous fistula. The aim of the study was to compare the effect of EMLA ointment and lidocaine spray, along with the use of rhythmic breathing on the intensity of pain caused by the insertion of needles in the arteriovenous fistula among hemodialysis patients.
Methods & Materials: This study was a randomized clinical trial conducted on a total of 80 patients who were referred to Imam Khomeini and Golestan hospitals in Ahvaz in 2022. The numerical pain measurement scale was used as the data collection tool. The participants were selected using the convenience sampling method and then randomly allocated into two groups. In the EMLA ointment group (n=39), a total of 2 grams of EMLA ointment was applied to the target area 60 minutes before the hemodialysis procedure. In the lidocaine spray group with rhythmic breathing (n=41), 2 puffs of lidocaine spray were administered along with rhythmic breathing 5 minutes prior to needle insertion. The pain intensity was then measured and recorded. The collected data was analyzed using descriptive and inferential statistics in SPSS version 20, with a significance level set at 0.05.
Results: The group receiving EMLA ointment and the group receiving lidocaine spray, with rhythmic breathing had mean pain scores of 1.95±1.09 and 2.12±1.10, respectively. Although the mean pain score in the EMLA ointment group was lower than that in the lidocaine spray group with rhythmic breathing, the difference was not statistically significant (P=0.479).
Conclusion: The findings of this study indicate that both EMLA ointment and lidocaine spray, along with the use of rhythmic breathing, have comparable efficacy in reducing pain among hemodialysis patients. Therefore, considering the patient's condition, the utilization of either of these methods is recommended.
Clinical trial registry: IRCT20220512054826N1