Challenges of Scene Management in Traffic Collisions from the Perspective of Road Emergency Responders in East Azerbaijan, Iran, 2017

Babaie, Javad; Mostafanejad, Reyhaneh; Janati, Ali; Bazargan, Homayon Sadeghi · 2020 · Crossref

DOI: 10.21203/rs.3.rs-15460/v1

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Summary

This qualitative study investigates the challenges of scene management (SM) in traffic collisions from the perspective of road emergency responders in East Azerbaijan, Iran. Motivated by Iran’s high rate of traffic collisions and fatalities, the research addresses the critical need for effective inter-sectoral response coordination. The authors argue that inadequate SM contributes to increased casualties, secondary accidents, and traffic congestion, yet existing literature has underestimated these operational challenges. The study aims to identify specific barriers faced by pre-hospital emergency staff to inform policy and training improvements. The researchers conducted in-depth, semi-structured interviews with 20 purposively selected participants, including staff from the Red Crescent Society and road emergency stations. Data collection continued until saturation was reached, and interviews were recorded, transcribed, and analyzed using content analysis. This process yielded 167 final codes, grouped into 28 subcategories and nine main themes. The participants were primarily technicians with significant field experience, providing detailed insights into daily operational difficulties. The findings identified nine major challenge categories. First, infrastructural problems, such as narrow, unlit roads, lack of U-turns, and poor telecommunications, hindered rapid response. Second, responders lacked preparedness due to insufficient practical training and evaluation. Third, triage was difficult to implement effectively due to skill gaps and interference from bystanders. Fourth, significant deficiencies in equipment, medications, and ambulance functionality limited care capabilities. Fifth, managing accidents involving hazardous substances or smuggled goods posed unique safety risks. Sixth, communication barriers arose from the absence of a single emergency number and inaccurate location reporting by callers. Seventh, a critical lack of coordination among police, medical, and fire services led to duplicated efforts and unclear responsibilities. Eighth, responders faced psychosocial stress and physical safety threats, including aggression from spectators. Ninth, cultural and social challenges, such as bystander interference and public curiosity, complicated rescue operations. The study concludes that the most significant barrier to effective scene management is the lack of coordination between different emergency organizations. The authors recommend formulating a comprehensive response plan, designating a lead organization, and establishing a single emergency contact number. Additionally, they emphasize the need to eliminate equipment deficiencies, enhance staff training through participatory exercises, and provide psychosocial support for responders. These measures are presented as essential for reducing fatalities and improving the efficiency of emergency responses in Iran.

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• post crash care delays