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

Haghparast‐Bidgoli, Hassan; Hasselberg, Marie; Khankeh, Hamid Reza; Khorasani‐Zavareh, Davoud; Johansson, Eva · 2010 · OpenAlex-citations

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

archive: archived pipeline: cataloged verified

Get this paper ↗ (DOI — opens at the source; we link to it, we don't host it)

Summary

This study investigates the barriers and facilitators affecting the provision of effective pre-hospital trauma care for road traffic injury (RTI) victims in Iran. Motivated by the high mortality and morbidity rates associated with RTIs in low- and middle-income countries, particularly Iran, the research aims to identify areas for improvement based on the perceptions of pre-hospital trauma care professionals. The authors note that while EMS capabilities have improved, crash-related mortality statistics have not significantly decreased, suggesting systemic inefficiencies in the pre-hospital care process. The researchers employed a qualitative grounded theory approach, conducting in-depth interviews with 15 pre-hospital trauma care professionals, including physicians, nurses, and emergency medical technicians from the Tehran and national EMS centers. Data collection occurred between 2007 and 2009, utilizing purposeful and theoretical sampling until saturation was reached. The interviews were recorded, transcribed, and analyzed using the constant comparative method, involving open, axial, and selective coding to identify categories and relationships. Rigor was ensured through member checks, peer reviews, and triangulation of researchers. The analysis revealed seven categories influencing the pre-hospital trauma care process: administration and organization, staff qualifications and competences, availability and distribution of resources, communication and transportation, involved organizations, laypeople, and infrastructure. These were grouped into factors inside and outside the EMS. Key barriers included misconceptions about the EMS role among policymakers, inefficient management structures, inadequate staff training and low economic incentives, resource deficiencies such as lack of rescue equipment and GPS, and poor coordination with other organizations like the Police and Red Crescent. Additionally, interference from laypeople and substandard road infrastructure hindered effective care. The core category emerging from the data was “interaction and common understanding,” highlighting that fragmented communication and lack of shared understanding among all stakeholders impede optimal care. The study concludes that improving interaction within the pre-hospital trauma care system and building a common understanding of the EMS role are critical for development. The authors propose specific interventions, including integrated communication systems with a single emergency number, clearer protocols for staff responsibilities, and public education campaigns to clarify the roles of EMS and other organizations. These findings provide a conceptual model for enhancing pre-hospital trauma care in Iran and potentially other similar settings by addressing both internal EMS inefficiencies and external systemic barriers.

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed.

Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• post crash care delays