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

Road traffic injuries are a major public health problem, especially in low- and middleincome
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