Bigdeli et al. BMC Public Health 2010, 10:406 http://www.biomedcentral.com/1471-2458/10/406 R E S E A R C H A R T I C L E Open Access Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study Maryam Bigdeli1,2, Davoud Khorasani-Zavareh1,2*, Reza Mohammadi1 Abstract Background: Road traffic injuries (RTIs) are a major public health problem, requiring concerted efforts both for their prevention and a reduction of their consequences. Timely arrival of the Emergency Medical Service (EMS) at the crash scene followed by speedy victim transportation by trained personnel may reduce the RTIs’ consequences. The first 60 minutes after injury occurrence - referred to as the “golden hour"- are vital for the saving of lives. The present study was designed to estimate the average of various time intervals occurring during the pre-hospital care process and to examine the differences between these time intervals as regards RTIs on urban and interurban roads. Method: A retrospective cross-sectional study was designed and various time intervals in relation to pre-hospital care of RTIs identified in the ambulance dispatch centre in Urmia, Iran from 20 March 2005 to 20 March 2007. All cases which resulted in ambulance dispatches were reviewed and those that had complete data on time intervals were analyzed. Results: In total, the cases of 2027 RTI victims were analysed. Of these, 61.5 % of the subjects were injured in city areas. The mean response time for city locations was 5.0 minutes, compared with 10.6 minutes for interurban road locations. The mean on-scene time on the interurban roads was longer than on city roads (9.2 vs. 6.1 minutes, p < 0.001). Mean transport times from the scene to the hospital were also significantly longer for interurban incidents (17.1 vs. 6.3 minutes, p < 0.001). The mean of total pre-hospital time was 37.2 (+/-17.2) minutes with a median of 32.0. Overall, 72.5% of the response interval time was less than eight minutes. Conclusion: The response, transport and total time intervals among EMS responding to RTI incidents were longer for interurban roads, compared to the city areas. More research should take place on needs-to and access-for EMS on city and interurban roads. The notification interval seems to be a hidden part of the post-crash events and indirectly affects the “golden hour” for victim management and it needs to be measured through the establishment of the surveillance systems. Background Road traffic injuries (RTIs) are a major public health problem, requiring concerted efforts for prevention [1,2]. The best strategy for RTI control is crash preven- tion, however total prevention is obviously impossible and crashes can occur at any time [2-4]. However, it is often possible to minimize crash consequences by promptly providing effective pre-hospital services [4,5]. Each year, many of the 1.2 million lives lost globally could be saved and much of the ensuing disability suf- fered by the 50 million injured could be prevented if * Correspondence: davoud.khorasani@yahoo.co.uk 1Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran rapid and competent pre-hospital services were available at the crash scene [1,6]. In most low-and middle-income countries (LMICs), transport of road traffic victims, is usually provided by relatives, taxi drivers, truck drivers, police officers and other motorists; who are usually untrained [7,8]. Ambu- lances, if available, usually exist only in urban areas [6]. Significant numbers of neurological injuries appear to be a result of the extrication process or victim transportation without adequate immobilization [3,9,10], generally by untrained people [11]. Studies have shown that the inade- quacy of public health infrastructure and poor access to health services are important reasons for the high burden of RTIs and/or their severity [3]. Many LMICs have © 2010 Bigdeli et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.