Exploring the perception of aid organizations’ staff about factors affecting management of mass casualty traffic incidents in Iran

A grounded theory study

Authors

  • Aidin Aryankhesal Associate Professor, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran , Associate Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

Keywords:

Mass casualty incidents, road traffic accidents, car crash, special traffic incidents

Abstract

Background: Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. 

Aim: The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. 

Methods: This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding.

Results: Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims.

Conclusion: It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.

References

Haghparast Bidgoli H, Hasselberg M, Khankeh H, Khorasani-Zavareh D, Johansson E. Barriers and

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

theory approach. BMC emergency medicine. 2010; 10(1): 1. doi: 10.1186/1471-227X-10-20.

Björnstig U. Pre-Hospital Emergency Care In SWEDEN: with Special Emphasis on Care of Traffic

Victims. IATSS research. 2004; 28(2): 24-31. doi: 10.1016/S0386-1112(14)60105-9.

Bakhtiyari M, Soori H. Epidemiology of traffic crashes outcomes and related factors. Journal of safety

promotion and prevent injuries. 2013; 1(3): 150-9.

WHO. Global status report on road safety 2013: supporting a decade of action. World Health Organization;

Rezaei S, Arab M, Karami Matin B, Akbari Sari A. Extent, consequences and economic burden of road

traffic crashes in Iran. J Inj Violence Res. 2014; 6(2): 57-63. doi: 10.5249/jivr.v6i2.191. PMID: 24045158,

PMCID: PMC4009170.

Aitken P, Leggat P. Considerations in mass casualty and disaster management. InTech. 2012.

Herman J, Ameratunga S, Jackson R. Burden of road traffic injuries and related risk factors in low and

middle-income Pacific Island countries and territories: a systematic review of the scientific literature (TRIP

. BMC public health. 2012; 12(1): 1. doi: 10.1186/1471-2458-12-479.

Razzak JA, Shamim MS, Mehmood A, Hussain SA, Ali MS, Jooma R. A successful model of Road Traffic

Injury surveillance in a developing country: process and lessons learnt. BMC public health. 2012; 12(1):

doi: 10.1186/1471-2458-12-357.

Gorji A. The first international congress of road safety in Mashhad, Iran. J Inj Violence Res. 2012; 4(2):

-2. doi: 10.5249/jivr.v4i2.264. PMID: 22991699, PMCID: PMC3426899.

Lankarani KB, Mahmoodi M, Heydari ST, Joulaei H, Ghaffarpasand F, Maharlouei N, et al. The second

international conference on reducing burden of traffic accidents, Shiraz, Iran. J Inj Violence Res. 2013;

(1): 75-6. doi: 10.5249/jivr.v5i1.322. PMID: 23275241, PMCID: PMC3591734.

Organization WH. Mass casualty management systems: strategies and guidelines for building health sector

capacity. 2007.

Leow J, Brundage S, Kushner A, Kamara T, Hanciles E, Muana A, et al. Mass casualty incident training in

a resource‐limited environment. Br J Surg. 2012; 99(3): 356-61. doi: 10.1002/bjs.7762. PMID: 22190046.

Saadat S, Yousefifard M, Asady H, Moghadas Jafari A, Fayaz M, Hosseini M. The most important causes

of death in Iranian population; a Retrospective Cohort Study. Emerg (Tehran). 2015; 3(1): 16-21. PMID:

, PMCID: PMC4614603.

khankeh HR, co-authors. Disaster Hospital Prepardness. 2, editor. Iran: University of Welfare and

Rehabilitation Sciences; 2013.

Education MoHaM. Reportable special events. In: Centre DaEM, editor. Iran: Disaster and Emergency

Management Centre; 2015.

Emergency and disaster management center. Occurance 11.5 MCI in IRAN daily. 2015. Available from:

http://isna.ir/fa/news/93103016907.

Bigdeli M, Khorasani Zavareh D, Mohammadi R. Pre-hospital care time intervals among victims of road

traffic injuries in Iran. A cross-sectional study. BMC public health. 2010; 10(1): 1. doi: 10.1186/1471- 2458-10-406.

Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, et al. World report on road traffic injury

prevention. Geneva: World Health Organization; 2004.

Tscherne H. The classic. Review article: Traffic accidents. 1966. Clin Orthop Relat Res. 2013; 471(9):

-9. doi: 10.1007/s11999-013-3012-9. PMID: 23633185, PMCID: PMC3734421.

Coats T, Davies G. Prehospital care for road traffic casualties. BMJ. 2002; 324(7346): 1135-8. doi:

1136/bmj.324.7346.1135. PMID: 12003887, PMCID: PMC1123093.

Strauss A, Corbin J. Basics of qualitative research: Techniques and procedures for developing grounded

theory: Sage Publications; 1998.

Al-Busaidi ZQ. Qualitative research and its uses in health care. Sultan Qaboos Univ Med J. 2008; 8(1): 11- 9. PMID: 21654952, PMCID: PMC3087733.

Khorasani-Zavareh D, Khankeh HR, Mohammadi R, Laflamme L, Bikmoradi A, Haglund BJ. Post-crash

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

facilitators. BMC Emerg Med. 2009; 9(1): 8. doi: 10.1186/1471-227X-9-8. PMID: 19435521, PMCID:

PMC2692975.

Lockey D. Prehospital trauma management. Resuscitation. 2001; 48(1): 5-15. doi: 10.1016/S0300- 9572(00)00313-0.

Hussain L, Redmond A. Are pre-hospital deaths from accidental injury preventable? BMJ. 1994;

(6936): 1077-80. doi: 10.1136/bmj.308.6936.1077. PMID: 8173428, PMCID: PMC2539951.

Khankeh HR, Mohammadi R, Ahmadi F. Health Care Services at Time of Natural Disasters: A Qualitative

Study. Iran Journal of Nursing. 2008; 51: 85-96.

Holgersson A. Review of on-scene management of mass-casualty attacks. Journal of Human Security.

; 12(1): 91-111. doi: 10.12924/johs2016.12010091.

Kobusingye OC, Hyder AA, Bishai D, Hicks ER, Mock C, Joshipura M. Emergency medical systems in

low-and middle-income countries: recommendations for action. Bull World Health Organ. 2005; 83(8):

-31. doi: 10.1590/S0042-96862005000800017. PMID: 16184282, PMCID: PMC2626309.

Mock C, Arreola-Risa C, Quansah R. Strengthening care for injured persons in less developed countries: a

case study of Ghana and Mexico. Inj Control Saf Promot. 2003; 10(1-2): 45-51. doi:

1076/icsp.10.1.45.14114. PMID: 12772485.

Tiska M, Adu-Ampofo M, Boakye G, Tuuli L, Mock C. A model of prehospital trauma training for lay

persons devised in Africa. Emerg Med J. 2004; 21(2): 237-9. doi: 10.1136/emj.2002.002097. PMID:

, PMCID: PMC1726295.

Motevalian A. Road safety and traffic medicine in Iran: Achievements and challenges. J Local Glob Health

Sci. 2015; 2015(2): 88. doi: 10.5339/jlghs.2015.itma.88.

Published

2022-01-18

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