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

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, particularly in low- and
middle-income countries (LMICs) with a high rate of RTIs such as Iran. The current study aimed to explore prehospital
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.
Methods: A qualitative study design using a grounded theory approach was selected. The data, collected via indepth
interviews with 15 pre-hospital trauma care professionals, were analyzed using the constant comparative
method.
Results: Seven 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.
Conclusions: Improving 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