Abstract
:Background:Pre-hospital time management provides better access to victims of road traffic crashes (RTCs) and can help minimize preventable deaths, injuries and disabilities. While most studies have been focused on measuring various time intervals in the pre-hospital phase, to our best knowledge there is no study exploring the barriers and facilitators that affects these various intervals qualitatively. The present study aimed to explore factors affecting various time intervals relating to road traffic incidents in the pre-hospital phase and provides suggestions for improvements in Iran.Methods:The study was conducted during 2013-2014 at both the national and local level in Iran. Overall, 18 face-to-face interviews with emergency medical services (EMS) personnel were used for data collection. Qualitative content analysis was employed to analyze the data.Results:The most important barriers in relation to pre-hospital intervals were related to the manner of cooperation by members of the public with the EMS and their involvement at the crash scene, as well as to pre-hospital system factors, including the number and location of EMS facilities, type and number of ambulances and manpower. These factors usually affect how rapidly the EMS can arrive at the scene of the crash and how quickly victims can be transferred to hospital. These two categories have six main themes: notification interval; activation interval; response interval; on-scene interval; transport interval; and delivery interval.Conclusions:Despite more focus on physical resources, cooperation from members of the public needs to be taken in account in order to achieve better pre-hospital management of the various intervals, possibly through the use of public education campaigns.
Highlights
Pre-hospital management is unsatisfactory in many parts of the world and in low- and middle-income countries (LMICs).[1,2] In addition, the majority of trauma deaths occur in the pre-hospital phase.[3]
This study looked at the experience of stakeholders in relation to various intervals formulated in six main categories
Two main issues were identified; namely a lack of cooperation from laypeople and problems relating to city infrastructure, in particular relating to traffic congestion
Summary
Pre-hospital management is unsatisfactory in many parts of the world and in low- and middle-income countries (LMICs).[1,2] In addition, the majority of trauma deaths occur in the pre-hospital phase.[3]. Results: The most important barriers in relation to pre-hospital intervals were related to the manner of cooperation by members of the public with the EMS and their involvement at the crash scene, as well as to pre-hospital system factors, including the number and location of EMS facilities, type and number of ambulances and manpower. These factors usually affect how rapidly the EMS can arrive at the scene of the crash and how quickly victims can be transferred to hospital. Conclusions: Despite more focus on physical resources, cooperation from members of the public needs to be taken in account in order to achieve better pre-hospital management of the various intervals, possibly through the use of public education campaigns
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