en Nursing Orginal research <span style="line-height:2;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><b><i><span new="" roman="" times="">Background:</span></i></b></span><span style="color:#000066;"> </span><span new="" roman="" times="">Prehospital paramedics played a critical role in the COVID-19 pandemic crisis. </span></span></span><br> <span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><b><span new="" roman="" times=""><em>Objectives:</em></span></b></span><span style="color:#000066;"><b><span new="" roman="" times=""> </span></b></span><span new="" roman="" times="">This study aimed to evaluate paramedic performance and background factors in the outbreak of this emerging disease.</span></span></span><br> <span new="" roman="" times=""><span style="color:#2980b9;"><em><b>Methods:</b></em></span><span style="color:#000066;"> </span><span style="color:black">This cross-sectional study recruited 335 paramedics selected from 49 emergency medical services stations in Urmia and Tabriz cities, Iran. Data was collected using a questionnaire to assess the demographics and performance of paramedics in caring for COVID-19 patients. The response rate for the questionnaires was 90%. Data were analyzed using descriptive statistics and regression analysis in SPSS version 21. The level of statistical significance was considered less than 0.05.</span></span><br> <span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><em><b><span new="" roman="" times="">Results:</span></b></em></span><span new="" roman="" times=""><span style="color:#2980b9;"> </span>The average age of the paramedics was 32.81 years (71.3% were 35 years old or younger). Results showed that assessing patients&#39; vital signs, checking for COVID-19 symptoms/signs, administering oxygen and IV fluids, recommending home care, and transporting patients to the emergency department were the most common actions taken by paramedics. Invasive procedures performed by paramedics included cardiopulmonary resuscitation (60.9%), intubation (53.1%), and suctioning (38.8%). However, 15.5% of paramedics reported not performing physical exams on patients due to fear of COVID-19. A statistically significant correlation was observed between paramedics&#39; performance and their education level, educational qualifications, and history of COVID-19 disease (p< 0.001).</span></span></span><br> <span style="unicode-bidi:embed"><span calibri=""><span style="color:#2980b9;"><em><b><span new="" roman="" times="">Conclusion:</span></b></em></span><span new="" roman="" times=""> Study results provide insight into paramedic performance during the COVID-19 pandemic. During emerging disease outbreaks, further training and the provision of necessary personal protective equipment could help paramedics perform all tasks without undue concern for personal safety.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><span style="font-size:8.0pt"><span style="font-family:"MyriadPro-Light","serif""></span></span></span></span></span></span> COVID-19, Emergency Medical Service, Paramedics, Pre-Hospital Emergency Care 1 10 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-973-1&slc_lang=en&sid=1 Karim Javanmardi javanmardiems@gmail.com 100319475328460013769 100319475328460013769 No MSc in Emergency Nursing, School of Nursing & Midwifery, Tabriz University of Medical Sciences Tabriz, Iran Abbas Dadashzadeh ddshzd@yahoo.com 100319475328460013770 100319475328460013770 No Department of Medical-Surgical Nursing, School of Nursing &Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran Hossein Feizollahzadeh feizollahzadehh@tbzmed.ac.ir 100319475328460013771 100319475328460013771 Yes Department of Medical-Surgical Nursing, School of Nursing &Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran Neda Gilani neda.gilani@gmail.com 100319475328460013772 100319475328460013772 No Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran Mansour Ghafourifard m.ghafori@yahoo.com 100319475328460013773 100319475328460013773 No Department of Medical-Surgical Nursing, School of Nursing &Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran Javad Dehghannejad feizollahzadehh@gmail.com 100319475328460013774 100319475328460013774 No Department of Medical-Surgical Nursing, School of Nursing &Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran