Table 1 Structural Characteristic of Prehospital Emergency Care in Iran

Population coverage (Iran’s population)^a (based on the 2017 census)

Total population (79926270), Sex (Male 50.7%, Female 49.3%), Residence (Urban 79.4%, Rural 25%, other 0.6%)

PEC^b history

In 1975, as the fourth country worldwide, Iran launched PEC with seven sites.

EMS^c Provider Organization

Dependent on Disaster and Emergency Medical Management Centers (DEMMCs), National Emergency Organization, and Ministry of Health

EMS Call Number

115, free call

EMS have Independent CC^d

Yes

Composition of EMS Dispatch

Center’s staff and Qualification

1-Paramedic Call Taker (having BSc in EMS)

2- Paramedic (having BSc in EMS/ Nursing)

3- Supervisor (M.D.)

Type of Ambulance Crews and Qualification

1- Paramedic (having BSc in EMS/ Nursing)

2- Driver (license in BLS as the first responder)

TATV^e

Ambulance Buses: 5500

Ambulance Motorcycles: 500

Ambulance Helicopters: 42

Ambulance Emergency relief boats:2

Emergency Stations

2190

Number of missions per year

3.8 to 4 million

Process

1. Call 115 for help: This number is the same throughout the country and rings in the control room of the emergency station

2. Triaged in CC: The command room staff includes a physician, nurse, and wireless operator, in which nursing experts respond to calls. The task of these experts is to take a telephone history of the patient’s condition, and if the patient’s history shows a state of emergency, they will try to get the location of the accident, then send the rescue unit.

3. Send the nearest rescue unit to the scene: The emergency command room calls the nearest rescue unit to the location of accident, to do the mission. The geographical area covered by each center is defined by distances (in rural and urban roads) and population (in cities).

4. Reach the relief unit to the location of accident and take immediate actions in the scene

5. Putting the patient in the ambulance and move toward the medical center: Immediately after this step, the patient’s history is communicated by the doctor of the command room, using a telephone or wireless machine, and the doctor guides the personnel regarding the required care and medication.

6. Delivery of the patient to the medical center: When the rescue unit arrives at the medical center, the patient is handed over to the doctor or emergency manager by giving history and filling out the mission report form, and this is where the rescue unit’s mission ends.