Barriers and facilitators to provide effective pre-hospital trauma care for road traffic injury victims in Iran: a grounded theory approach

Hassan Haghparast-Bidgoli,Hamidreza Khankeh,Eva Johansson,Marie Hasselberg,Davoud Khorasani-Zavareh

doi:10.1186/1471-227x-10-20

Abstract

BackgroundRoad traffic injuries are a major global public health problem. Improvements in pre-hospital trauma care can help minimize mortality and morbidity from road traffic injuries (RTIs) worldwide, particularly in low- and middle-income countries (LMICs) with a high rate of RTIs such as Iran. The current study aimed to explore pre-hospital trauma care process for RTI victims in Iran and to identify potential areas for improvements based on the experience and perception of pre-hospital trauma care professionals.MethodsA qualitative study design using a grounded theory approach was selected. The data, collected via in-depth interviews with 15 pre-hospital trauma care professionals, were analyzed using the constant comparative method.ResultsSeven categories emerged to describe the factors that hinder or facilitate an effective pre-hospital trauma care process: (1) administration and organization, (2) staff qualifications and competences, (3) availability and distribution of resources, (4) communication and transportation, (5) involved organizations, (6) laypeople and (7) infrastructure. The core category that emerged from the other categories was defined as "interaction and common understanding". Moreover, a conceptual model was developed based on the categories.ConclusionsImproving the interaction within the current pre-hospital trauma care system and building a common understanding of the role of the Emergency Medical Services (EMS) emerged as key issues in the development of an effective pre-hospital trauma care process.

Highlights

Road traffic injuries are a major global public health problem
The pre-hospital trauma care process consists of six key steps: detection, reporting, response, on-scene care, care in transit and transfer to definitive care [12] (The six steps inspired from the Emergency Medical ServicesEMS-symbol or so-called ‘Star of Life’ symbol created by the US National Highway Traffic Safety Administration which presents six EMS functions[13])
With the aim of exploring the process of pre-hospital trauma care for road traffic injuries (RTIs) victims in Iran and identifying potential areas for improvements, the current study explores different aspects of providing pre-hospital trauma care based on the experience and perceptions of pre-hospital trauma care professionals

Summary

Introduction

Road traffic injuries are a major global public health problem. Improvements in pre-hospital trauma care can help minimize mortality and morbidity from road traffic injuries (RTIs) worldwide, in low- and middle-income countries (LMICs) with a high rate of RTIs such as Iran. Road traffic injuries (RTIs) are a major public health problem globally causing more than a million deaths and almost 50 million injuries every year [1]. As the majority of trauma deaths in LMICs occur in the prehospital setting [4,5,6], it is suggested that improvements in pre-hospital trauma care can contribute to a decrease in crash-related mortality and morbidity [4,7,8,9,10,11]. The World Bank [15] has presented an overview of

Results

Discussion

Conclusion