Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 05 27 e9 e9 Athar Rasekhjahromi Obstetrics and Gynecology Department, Jahrom University of Medical Sciences, Jahrom, Iran Zahra Jafarzadehjahromi Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran Navid Kalani Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran Zahra Zarei Babaarabi Women's Health and Diseases Research Center, Jahrom University of medical sciences, Jahrom, Iran. 2021 05 02 2021 05 09 Numerous symptoms and complications of COVID-19 include pneumothorax as a rare but potentially-lethal condition. The present case report involved a pregnant woman with COVID-19 presenting with pneumothorax. A 30-year-old pregnant woman with COVID-19 and a gestational age of 32 weeks presented to our hospital with dyspnea, coughs and fever. The rales initially heard in both lungs continued to be heard only in the left lung after 24 hours. Pneumothorax was confirmed through radiology. The emergency cesarean section performed to avoid the potential detrimental effects of the infection on the fetus caused no breathing episodes in the biophysical profile. The patient recovered postpartum without complications and both the mother and the newborn were discharged 12 days later. Spontaneous pneumothorax is a rare complication in COVID-19 pregnant patients that can emerge at any stage of the disease. https://fem.tums.ac.ir/index.php/fem/article/view/744 https://fem.tums.ac.ir/index.php/fem/article/download/744/358

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 09 26 e7 e7 Amir Ghabousian Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Saeed Safari Emergency Medicine Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Niloufar Ansari Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2021 07 12 2021 07 14 Paraquat dichloride (PQ) poisoning is a relatively rare yet critical medical condition that has a high case fatality rate. Lung tissue is highly susceptible to PQ-induced injury, and respiratory failure is the leading cause of death in these patients. Unfortunately, there is a lack of an effective therapeutic approach to ameliorate outcomes. It is well-known that PQ interferes with a variety of cell signaling pathways and induces the generation of reactive oxygen species (ROS), which ultimately results in cell injury. The traditional treatment decisions have not been able to significantly change the clinical course of PQ poisoning. Moreover, novel therapeutic strategies for PQ poisoning have centered on the inhibition of PQ-induced signaling pathways. In the current review, we sought to provide a bird’s-eye view of the available therapeutic approaches in patients with PQ poisoning. https://fem.tums.ac.ir/index.php/fem/article/view/800 https://fem.tums.ac.ir/index.php/fem/article/download/800/368

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 10 10 e1 e1 Ebraheem Albazee Faculty of Medicine, Hashemite University, Zarqa, Jordan Mohammad Alnifise Faculty of Medicine, Hashemite University, Zarqa, Jordan Lina Almahmoud Faculty of Medicine, Hashemite University, Zarqa, Jordan Ahmed Alsaeedi Faculty of Medicine, Hashemite University, Zarqa, Jordan Mohammed Al-balawi Faculty of Medicine, Hashemite University, Zarqa, Jordan Talal Alotaibi Faculty of Medicine, Hashemite University, Zarqa, Jordan Aiman Al Sharei Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Zarqa, Jordan 2021 05 29 2021 07 24 Objective: Performing basic life support (BLS) in patients with cardiopulmonary arrest decreases mortality and morbidity. In addition, BLS knowledge is a prerequisite for medical graduation. The present study was conducted to determine the awareness level of undergraduate medical students in Jordan regarding BLS and background knowledge. Methods: This cross-sectional study was conducted between 17 April 2021 and 12 May 2021. A validated questionnaire was used as an online Google form and was posted in all medical student groups and Jordanian universities through various social medias. We categorized level of awareness into two groups: adequate awareness for those who got 60% or more, and inadequate awareness for those who got less than 60% in BLS test. Chi-square test was used to compare different variables. Results: A total of 886 students with a mean age of 21.5 (± 2.2) years completed the survey, including 552 females (62.3%). Among participated students, only 281 (31.7%) had adequate awareness, whereas 605 (68.3%) had inadequate awareness, with a mean score of 10 (± 3.8) out of 20. Surprisingly, there was no statistically significant correlation (P=0.210) between grade point average (GPA) and awareness level among participated students. On the contrary, we detected statistically significant relationships (P<0.001) between various variables and awareness level. Conclusion: Overall, we found that awareness of BLS among medical students in Jordan is not adequate. We can improve the awareness of medical students in this regard through obligating them to educate the general population, especially school students, as a volunteer campaign. https://fem.tums.ac.ir/index.php/fem/article/view/765 https://fem.tums.ac.ir/index.php/fem/article/download/765/370

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 11 16 e13 e13 Jerry W. Jones Chief Instructor, Medicus of Houston, Texas, USA 2021 11 15 2021 11 15 One of the most difficult decisions for many physicians and advanced practice providers occurs when having to distinguish between simple atrioventricular (AV) dissociation and AV dissociation caused by a third degree AV block. Third degree AV block is only one cause of AV dissociation and it is a very infrequent cause. The majority of simple AV dissociations are caused by variations in the balance of sympathetic and parasympathetic inputs from the autonomic nervous system. All of us probably experience an occasional episode of simple AV dissociation while we are asleep. Treatment for simple AV dissociation may be as simple as having the patient get out of bed and walk around the room a few times, while AV dissociation caused by a third degree AV block is going to require an emergent placement of a permanent pacemaker. In order to make this decision properly and confidently, you must have a very clear understanding of the difference. Here, in this educational paper, we aim to discuss more in this regard. https://fem.tums.ac.ir/index.php/fem/article/view/893 https://fem.tums.ac.ir/index.php/fem/article/download/893/377

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 09 01 e2 e2 Reza Azizkhani Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Farhad Heydari Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Ahmad Sadeghi Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran Omid Ahmadi Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Azita Azimi Meibody Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2021 06 16 2021 07 23 Objective: Healthcare workers (HCWs) are among the highest groups impacted by the COVID-19 pandemic. This study aimed to analyze professional quality of life (ProQOL) and its association with emotional well-being in HCWs during the pandemic. Methods: This cross-sectional study was conducted on HCWs being in close contact with COVID-19 patients in Iran. The questionnaires assessing ProQOL, emotional well-being, and demographic and occupational characteristics were recruited via email or social media. The ProQOL was used to measure compassion fatigue (CF), burnout (BO) and compassion satisfaction (CS). Results: Among the respondents, 705 HCWs were enrolled, including a higher proportion of physicians 449 (63.7%), females 452 (64.1%), and married 486 (68.9%). The mean of participants’ work experience was 8.41 ± 8.91 years. Almost all of HCWs showed moderate to high levels of CS (98.3%). Also, most of HCWs showed a moderate level of CF (96.3%), and the majority of them (76.6%) had a moderate level of BO. There were significant differences in the duration of contact with COVID-19 patients for all three components of ProQOL and emotional well-being score. Women had a higher level of BO than men (P=0.003). CS was significantly higher in married HCWs than in singles (P=0.007). Pearson correlation coefficient showed that CS had a negative relationship with CF and BO. However, there was a direct correlation between emotional well-being and the CS. Conclusion: During the COVID-19 pandemic, Iranian HCWs showed to have moderate to high levels of CS, and a moderate level of both CF and BO, and showed that emotional well-being had a direct correlation with CS. https://fem.tums.ac.ir/index.php/fem/article/view/772 https://fem.tums.ac.ir/index.php/fem/article/download/772/366

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 09 28 e10 e10 Debkumar Chowdhury Emergency Department, Royal Blackburn Hospital, Blackburn, United Kingdom 2021 07 28 2021 08 19 Phlegmasia cerulea dolens is an uncommon complication of deep venous thrombosis. This is associated with high rates of morbidity if not treated effectively. We present a young lady 13 weeks pregnant with one-day history of left lower limb swelling with pain and discolouration. Bedside ultrasonography revealed thrombosis occluding the common femoral vein and collateral femoral vein. She had history of neonatal alloimmune thrombocytopaenia (NAIT), and had immunotherapy previously. The safest option was to give low molecular weight heparin (LMWH) on an inpatient basis. Anticoagulation with LMWH has been well established as thromboprophylaxis during pregnancy, however, the safety profile of systemic anticoagulation is matter of debate. As highlighted in this scenario the management needs to be tailored on an individual basis. The cause for the extensive deep vein thrombosis could be possibly due to the recent immunoglobulin therapy, undiagnosed prothrombotic state (outwith pregnancy) or the procoagulant state associated with pregnancy. https://fem.tums.ac.ir/index.php/fem/article/view/820 https://fem.tums.ac.ir/index.php/fem/article/download/820/369

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 11 01 e8 e8 Mojtaba Chardouli Emergency Medicine Department, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Mohammadreza Yasinzadeh Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Mohammad Meshkini Emergency Medicine Department, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Hadi Jalilvand International Safe Community Support Center, Research Center for Road Traffic Injury, Tabriz University of Medical Sciences, Tabriz, Iran Hamed Basir Ghafouri Emergency Medicine Department, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Homayoun Sadeghi-Bazargani International Safe Community Support Center, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Sayyed Mohammadreza Mirkarimi Emergency Medicine Department, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran 2021 05 16 2021 07 15 This study reviewed the former studies conducted on the usefulness of accuracy of focused assessment with sonography for trauma (FAST) or any plain ultrasonography (US) scan in pediatric blunt abdominal trauma (BAT), to assess its accuracy, sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Searches were conducted using the predefined keywords and Medical Subject Headings (MeSH) terms across MEDLINE (PubMed), Scopus, Web of Science, Cochrane Collaboration Library, Embase, ClinicalTrials.gov, Magiran and SID.ir databases. Duplicate publications were excluded; then the titles and abstracts of eligible studies were reviewed for how they report blunt trauma, pediatric patients, and ultrasound modality in their text. Cochrane RevMan version 5.3 was used for the results analysis and assessing the risk of bias in the studies. Out of 923 studies, 902 were excluded, and only 19 articles were included in this review, out of which one was a randomized clinical trial (RCT), three were cohort studies, two were contrast-enhanced US (CEUS) studies, and 13 were prospective or retrospective descriptive studies. The total population studied in the articles was 3454 patients. The results showed that the specificity of US in pediatric BAT was 93%, the sensitivity was 54%, and the PPV in comparison to clinical examination was 73% versus 37%. CEUS protocol achieved 100% in both sensitivity and specificity analysis. The only RCT study which included about 28% of the studies population also reached a sensitivity and specificity of 97% and 98%, respectively using a combinational protocol of clinical examination, laboratory investigation, and US assessment. Ultrasonography does not provide more results than clinical examination, though better PPV results. A combination of follow-up, US examination, and laboratory requests may also have more accurate results. Moreover, a CEUS protocol may reach that goal with an acceptable time-saving outcome, but it needs more studies to be confirmed. https://fem.tums.ac.ir/index.php/fem/article/view/751 https://fem.tums.ac.ir/index.php/fem/article/download/751/372

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 1 2021 07 27 e73 e73 Mahnaz Yadollahi Trauma Research Center, Shahid Rajaee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Zahra Ghaedsharaf Trauma Research Center, Shahid Rajaee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Kazem Jamali Trauma Research Center, Shahid Rajaee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Mohammad Hadi Niakan Trauma Research Center, Shahid Rajaee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Forough Pazhuheian Trauma Research Center, Shahid Rajaee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Mehrdad Karajizadeh Health Human Resources Research Center, School of Management & Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 2019 07 29 2019 11 27 Introduction: Trauma scoring systems help physicians and nurses to be informed of injuries to a patient and assist their decision making in the cases of trauma and importantly prediction of their outcome and prognosis.  Objective: This study aimed to compare the accuracy of GAP and MGAP scoring systems as predictors of mortality in trauma patients.  Methods: This diagnostic accuracy study was conducted amongst 1861 trauma patients admitted to Rajaee Hospital in Shiraz, Iran, during 2017. The data on demographic features were extracted from the patients’ records. Then, trauma scoring systems including injury severity score (ISS), GAP, MGAP, and Glasgow coma scale (GCS) were compared to evaluate their accuracy in predicting mortality. Area under the receiver operating characteristic (ROC) curve was used to evaluate the accuracy of different trauma scoring systems and detect the sensitivity and specificity in order to predict status of discharge after 24 hours.  Results: Based on the results, the area under the ROC curve was 0.8 for GCS. Moreover, Area Under Curve (AUC) of GAP was 0.91 and amongst different values, GAP value of ≤18 was selected as the cut-off point, since it exhibited the best sensitivity and specificity (72.99 and 95.52, respectively). In addition, the area under the ROC curve was 0.9 for MGAP, and value of ≤23 was selected as the cut-off point because it showed the best sensitivity and specificity (81.04 and 87.70, respectively). Additionally, AUC of ISS was 0.88.  Conclusion: Both GAP and MGAP methods were able to appropriately predict mortality and were not significantly different; hence, both can be used for the right triage of patients and to predict the severity of injuries and subsequent mortality. Moreover, GAP and ISS had the best specificity and sensitivity, respectively. https://fem.tums.ac.ir/index.php/fem/article/view/230 https://fem.tums.ac.ir/index.php/fem/article/download/230/255

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 4 3 2020 01 07 e74 e74 Neda Karkeabadi Department of General Surgery, Poursina Medical & Educational Center, Guilan University of Medical Sciences, Rasht, Iran Seyed-Adel Maleknia Department of General Surgery, Poursina Medical & Educational Center, Guilan University of Medical Sciences, Rasht, Iran Moein Moghadam-Ahmadi Department of General Surgery, Poursina Medical & Educational Center, Guilan University of Medical Sciences, Rasht, Iran Sina Salimi Department of General Surgery, Poursina Medical & Educational Center, Guilan University of Medical Sciences, Rasht, Iran Hossein Torabi Department of General Surgery, Poursina Medical & Educational Center, Guilan University of Medical Sciences, Rasht, Iran Ehsan Kazemnezhad-Leili Department of Clinical Statistics, Poursina Medical & Educational Center, Guilan University of Medical Sciences, Rasht, Iran Mohammad-Nima Yadi Department of Emergency Medicine, Poursina Medical & Educational Center, Guilan University of Medical Sciences, Rasht, Iran 2019 07 22 2019 12 08 Introduction: Acute appendicitis is one of the most common emergencies of general surgery. Contrary to simple appendicitis, the complicated cases are associated with higher morbidity and mortality. Except for pathology, no accurate diagnostic test has been found to identify complicated cases.  Objective: Here in, we aim to evaluate the serum C-Reactive Protein (CRP) level in both acute simple and complicated appendicitis.  Methods: In this diagnostic accuracy study, 199 patients with acute appendicitis were enrolled. The serum CRP level was evaluated in patients. Post-operatively, the patients were divided into simple and complicated appendicitis based on histopathological examination. Eventually, analysis of the CRP level and type of appendicitis was performed.  Results: Fifty-three patients were categorized into complicated appendicitis and 146 patients into simple appendicitis. The median of CRP was significantly higher in the complicated group. Additionally, the optimal cutoff point was as follows: [65.0 (25.0) vs 25.0 (51.0); P-value< 0.001]. The optimal cutoff point for CRP was more than 42 with 81.1% sensitivity (95% CI: 68.0 to 90.6), and 67.8% specificity (95% CI: 59.6 to 75.3). The positive (PPV) and negative predictive values (NPV), based on the prevalence of complicated appendicitis (26.6%) for optimal cutoff point, were 47.8% (95% CI: 37.1 to 58.6) and 90.8% (95% CI: 83.8 to 95.5).  Conclusion: Our study revealed that evaluation of serum CRP levels could be useful and beneficial in the diagnosis of acute complicated appendicitis. https://fem.tums.ac.ir/index.php/fem/article/view/223 https://fem.tums.ac.ir/index.php/fem/article/download/223/256

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 4 3 2020 02 17 e75 e75 Niloofar Ayoobi-Yazdi Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Science, Tehran, Iran Mehran Beiraghi-Toosi Department of Pediatric Neurology, Mashhad University of Medical Science, Mashhad, Iran Farzad Ashrafi Department of Neurology, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran Atena Aliabadi Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Science, Tehran, Iran Mehran Arab-Ahmadi Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Science, Tehran, Iran 2019 12 29 2020 01 19 Introduction: The first unprovoked seizure (FUS) in children is a convulsive seizure with an unknown cause, which may be due to an underlying neurological disease or a manifestation of epilepsy.  Objective: The aim of this study was to evaluate the findings of brain magnetic resonance imaging (MRI) in pediatric patients with FUS, presenting to the emergency department (ED).  Methods: In this cross-sectional study, all children with FUS (age: >1month and<14 years), who were referred to the ED of Qaem Hospital, Mashhad, Iran from 2016 to 2019, were investigated. Medical records, brain MRI findings, electroencephalography (EEG) results, and developmental status of children were reviewed retrospectively.  Results: The brain MRI findings of 56 children with FUS were reviewed. The mean age of children was 3.92±6.05 years, and the sex distribution was equal. Seventeen (30.4%) patients had abnormal EEG findings, while 13 (23.2%) patients’ had non-specific EEG findings. Neurological examination of 4 (7.1%) children was abnormal. Overall, 6 (10.7%) patients had non-specific abnormal brain MRI findings for seizure, while 3 (5.4%) patients had specific abnormal findings. A significant relationship was observed between the developmental status of children and abnormal MRI findings (P=0.04). However, MRI findings had no significant relationship with EEG or neurological findings (P>0.05).  Conclusion: It may be useful to perform brain MRI for children with FUS presenting to ED, especially those who are suspected of developmental disorders. https://fem.tums.ac.ir/index.php/fem/article/view/322 https://fem.tums.ac.ir/index.php/fem/article/download/322/263

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 4 3 2020 02 17 e76 e76 Soraya Siabani University of Technology Sydney, Sydney, NSW, Australia Maryam Babakhani Cardiovascular Research Centre, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Nahid Salehi Cardiovascular Research Centre, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Mohammad Rouzbahani Cardiovascular Research Centre, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Javad Azimivaghar Cardiovascular Research Centre, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Sousan Mahmoudi Cardiovascular Research Centre, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Yousef Rahmani Cardiovascular Research Centre, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran Hossein Siabani Cardiovascular Research Centre, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran 2020 01 06 2020 02 08 Introduction: Treatment of myocardial infarction (MI) has been successfully developed, especially after introducing primary percutaneous coronary intervention (PPCI) as it nowadays is the recommended treatment for ST-segment elevation myocardial infarction (STEMI).  Objective: This study aimed to evaluate the in-hospital mortality of STEMI patients treated with PPCI according to gender and other likely risk factors.  Methods: This cross-sectional study presents a part of the results of a single-center registry in Imam Ali cardiovascular center affiliated to Kermanshah University of medical science (KUMS). From June 2016 to December 2017, 731 consecutive patients undergoing PPCI registered. Data were collected using a case report form developed by European Observational Registry Program (EORP). The relationship between in-hospital mortality and predicting variables was assessed using the Chi-square test, t-test, and univariate and multivariate logistic regression models (Forward LR).  Results: Totally, 155 patients (approximately 21%) were female. The mean age of women and men was 65.2 and 57.5, respectively (p=0.001). There were differences between women and men in hypertension (58.1% vs. 30.4%, respectively, p=0.001), diabetes mellitus (26.5% vs. 14.9%; p=0.001), hypercholesterolemia (37.4% vs. 18.6%; p=0.001), and history of prior congestive heart failure (5.2% vs. 2.0%; p=0.016). Although more men were current smokers (58.7% (men) vs. 15.5% (women); p=0.001). Women had a significantly greater incidence of multi-vessel disease, thrombolysis in myocardial infarction (TIMI) flow grade of 0/1 before PPCI, and longer symptom-to-balloon time. In-hospital mortality was higher in women than in men (5.2% vs. 1.9%; p=0.024). Multivariate analysis identified age ≥ 60 years, Killip class≥ II, and post-procedural TIMI flow grade < 3, but not female sex, as independent predictors of in-hospital mortality.  Conclusion: In-hospital mortality after PPCI in women was higher than men, though this difference was likely due to the severe clinical profile in women. Also, female gender was not identified as an independent predictor of death. https://fem.tums.ac.ir/index.php/fem/article/view/327 https://fem.tums.ac.ir/index.php/fem/article/download/327/264

Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 4 3 2020 05 05 e77 e77 Roohangiz Norouzinia Health Management and Economics Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Hosein Yarmohammadian Health Management and Economics Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran Masoud Ferdosi Health Management and Economics Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran Gholamreza Masoumi Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran Abbas Ebadi Behavioural Sciences Research Centre, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran 2020 03 25 2020 05 03 Introduction: Nursing staff’s professional resilience plays an important role in overcoming the stressful and adverse situations common to the trauma emergency department and helps to achieve positive outcomes.  Objective: This study intended to explore the concept of resiliency among Iranian trauma emergency department nurses.  Methods: Data were collected using semi-structured interviews with 21 trauma emergency department nurses and analysed through a deductive content analysis based on the general conceptual model of resilience derived from King and Rothstein’s study.  Results: All codes were nested into the four main categories of the above-mentioned model including: 1) Personal characteristics; 2) Opportunities, supports and resources; 3) Self-regulatory processes; 4) Positive outcomes. Some new sub-categories including Professional abilities (sub-category of Personal characteristics) and Cooperation with colleagues and Volunteers’ declaration of readiness (sub-categories of opportunities, supports and reso