Pre-hospital response to traffic accidents with mass casualties: qualitative content analysis

One of the biggest challenges of the emergency medical system is to respond to accidents with a large number of injured people. In Iran, despite the great progress made in pre-hospital emergency services, there are many problems and shortcomings. Therefore, the purpose of the present study was to determine the factors affecting the pre-hospital response to traffic accidents with a large number of casualties.

The present qualitative study was conducted using a semi-structured method with the participation of 31 officials and personnel of the pre-hospital emergency, Red Crescent and the police, as a purposeful sampling from June 2017 to September 2018 using the contractual content analysis method. Since the researchers was trying to explain the factors affecting the pre-hospital response in traffic accidents with a large number of casualties, the qualitative research method with the contractual content analysis approach was used. The first participant was selected using the goal-based method, and the other participants entered the qualitative interview process using the snowball sampling method. The main question of the interview was "Describe the factors influencing the response to the MCTI mass casualty traffic accidents in which you have been involved". Sampling ended when the participants did not add new data to the previous data and no new codes were created. The Elo and Kingas analysis method was used, which includes open coding, classification of codes, creation of the main class or within the theme. The collected data were analyzed using statistical tests.

In the present study, the researchers achieved information saturation with 31 participants (27 men and 4 women) who were at most 50 and at least 26 years old (average 35 years) and their work experience was at least 2 and at most 28 years (with an average of 13.2) year), the content of "pre-hospital response" consists of three layers: information management, evaluation, and incident scene management. This theme was extracted from the different experiences of the participants in responding to accidents with a large number of injured people, from the moment the accident was announced by the pre-hospital emergency dispatch center, the provision of relief and treatment services at the scene of the accident, the transfer of the injured to the hospital and their delivery to the trauma center.

Consolidation of relief organizations leads to their coordination at the scene of the accident and better services to the injured. Holding joint 6-month training courses for all relief organization employees provides the basis for more interaction, coordination and service delivery to the injured.