Root Causes of Preventable Prehospital Deaths in Road Traffic Injuries: A Systematic Review

Context: The prehospital care system depends on many factors. If all factors contributing to prehospital care are handled correctly, many fatalities occurring in this phase will be prevented. Objectives:We aimed to identify root causes and factors contributing to preventable deaths in the prehospital phase of road traffic injuries. Data Sources: In this study, a systematic review was performed on the Web of Science, Scopus, and PubMed databases, as well as Google Scholar Search Engine, using keywords “preventable mortality/fatality”, “road traffic injuries”, “prehospital” and a combination of them to find papers published from May 10, 2018, to August 30, 2018. The quality of the finally retrieved papers was investigated by two researchers independently and in the case of any disparities, a third researcher explored the papers. The PRISMA checklist was used to analyze the quality of the papers. Study Selection: All documents and papers were included in the initial investigation regardless of the type of the paper. If a paper dealt with preventable fatalities of road traffic injuries in both prehospital and hospital phases, only were the prehospital phase results analyzed. Results: Based on the findings, 14 articles and records were included in the review. The precise assessment of the papers using content analysis resulted in the emergence of three themes, six subthemes, and 45 codes. The main themes including “systemic deficiencies, human errors, and patient’s clinical condition,” and the subthemes including “educational deficiencies, managerial deficiencies, errors/delay in diagnosis, therapeutic deficiencies, technical deficiencies, and trauma types” were extracted. Conclusions: Various factors were rendered effective in preventable fatalities of road traffic injuries in the prehospital phase. The identification of these factors and resolving the identified problems can reduce the fatalities of road traffic injuries.