But, in many countries, few victims receive treatment at the crash scene and fewer still can hope to be transported to

hospital by ambulance, promptly or at all [10]. Transport, when available, is usually provided by untrained people; e.g., relatives, taxi drivers, truck drivers, or by police officers [11,12]. Conversely, in spite of it contributing to saving lives or reducing consequences, the involvement of untrained people at the crash scene may engender serious neurological injuries, severe sequels or fatal Quisinostat supplier consequences occasioned either when extricating victims from vehicles or when transporting them without adequate immobilization [11,13-15]. PCM Inhibitors,research,lifescience,medical leaves much to be desired especially – but not exclusively – in low-and middle-income Inhibitors,research,lifescience,medical countries [11,12,16]. In Iran, according to a national

survey from 2003, only 14% of RTI victims were transported by ambulance and 10% were rescued by trained personnel [17,18]. As road traffic injuries are a major cause of death in the country[17,19,20], substantial efforts have been made in recent years to improve Emergency Medical Services [21], not only by increasing the number of ambulances and ambulance dispatch sites but also by providing better equipment, more staff, and educational Inhibitors,research,lifescience,medical plans for emergency team members. Whether additional and context-relevant efforts are needed is uncertain, however, and how to move forward is unclear. Studies in the field performed in settings other than Iran have used mainly quantitative designs that have helped to quantify needs more than to obtain new perspectives.

Inhibitors,research,lifescience,medical The few in-depth qualitative studies available [22-27] have focused on specific groups of road users and were limited in scope. These studies do not provide much information as to various stakeholders’ perceptions regarding how PCM can be made more effective. But stakeholders’ perceptions are indeed important for quality improvement [28-33]. The present Inhibitors,research,lifescience,medical study attempts to fill this knowledge gap and explores stakeholders’ perceptions of barriers to – and facilitators of – effective PCM in Iranian regions. Method The study was performed using Grounded Theory, which is a suitable method when new areas are to be those investigated in an explorative manner or if it has been decided to explore a known area from a fresh perspective [32,34,35]. Setting Focus was placed on PCM for road traffic injuries that occurred in West Azarbaijan Province (WAP) and Tehran; both local and national stakeholders were interviewed. The province covers an area of 37,411 km2, and the population density is 77 inhabitants/km2. In 2005, the total number of fatal road traffic injuries reached 1,018, i.e., 34 per 100,000 of the population [19].