Post-crash management of road traffic injury victims in Iran. Stakeholders' views on current barriers and potential facilitators

被引：59

作者：

Khorasani-Zavareh D. ^{[1
,2
,3
]}

Khankeh H. ^{[1
,4
]}

Mohammadi R. ^{[1
]}

Laflamme L. ^{[5
]}

Bikmoradi A. ^{[2
,6
,7
]}

Haglund B.J.A. ^{[1
]}

机构：

[1] Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet

[2] National Public Health Management Centre (NPMC), Tabriz University of Medical Sciences, Tabriz

[3] Urmia University of Medical Sciences, Oroumiyeh

[4] Department of Nursing, University of Social Welfare and Rehabilitation, Tehran

[5] Division of International Health Care Research (IHCAR), Department of Public Health Sciences, Karolinska Institutet

[6] Medical Management Centre, Department of LIME, Karolinska Institutet

[7] Hamadan University of Medical Sciences, Hamadan

来源：

BMC Emergency Medicine | / 9卷 / 1期

关键词：

Police Officer; Emergency Medical Service; Emergency Service; Trauma System; Road Traffic Injury;

D O I：

10.1186/1471-227X-9-8

中图分类号：

学科分类号：

摘要：

Background: Road traffic injuries are a major public health problem, especially in low- and middle-income countries. Post-crash management can play a significant role in minimizing crash consequences and saving lives. Iran has one of the highest mortality rates from road traffic injuries in the world. The present study attempts to fill the knowledge gap and explores stakeholders' perceptions of barriers to - and facilitators of - effective post-crash management in Iranian regions. Methods: Thirty-six semi-structured interviews were conducted with medical services personnel, police officers, members of Red Crescent, firefighters, public-health professionals, road administrators; some road users and traffic injury victims. A qualitative approach using grounded theory method was employed to analyze the material gathered. Results: The core variable was identified as "poor quality of post crash management". Barriers to effective post-crash management were identified as: involvement of laypeople; lack of coordination; inadequate pre-hospital services; shortcomings in infrastructure. Suggestions for laypeople included: 1) a public education campaign in first aid, the role of the emergency services, cooperation of the public at the crash site, and 2) target-group training for professional drivers, police officers and volunteers involved at the crash scene. An integrated trauma system and infrastructure improvement also is crucial to be considered for effective post-crash management. Conclusion: To sum up, it seems that the involvement of laypeople could be a key factor in making post-crash management more effective. But system improvements are also crucial, including the integration of the trauma system and its development in terms of human resources (staffing and training) and physical resources as well as the infrastructure development. © 2009 Khorasani-Zavareh et al; licensee BioMed Central Ltd.

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