Identifying the Challenges of Prehospital Emergency Centers in Providing Care in Wartime and Proposing Strategic Solutions: A Qualitative Study Publisher



Miadfar J ; Arab MA ; Nourisari H ; Sarwar M ; Dehghanpour R ; Bijani M
Source: Health Science Reports Published:2026

Abstract

Background and Aims: Emergency Medical Services (EMS) centers, as the primary providers of urgent medical care, play a vital role in preserving lives during crises. Among the most complex and high-risk scenarios affecting prehospital EMS performance is wartime conditions. Accordingly, the present study sought to identify the principal challenges encountered by prehospital emergency centers in providing care during wartime conditions and to propose strategic, context-specific solutions aimed at enhancing their effectiveness in Iran. Methods: This qualitative study examines the difficulties prehospital Emergency Medical Services (EMS) centers in providing care in in Iran faced throughout the war and suggests tactical remedies. 26 participants, including top management and frontline EMS staff, participated in semi-structured interviews using purposive sampling. Graneheim and Lundman's content analysis methodology was used to examine the data. Results: Four major themes emerged from the results: (1) Organizational and governance issues (inadequate infrastructure and resources and a lack of thorough wartime procedures), (2) Communication and dispatch issues (lack of wartime telephone triage protocols and GPS disruptions), (3) Professional issues (insufficient competencies in incident scene management and psychological preparedness), and (4) Cultural issues (low public awareness and crowding at incident scenes). Conclusion: The study comes to the conclusion that the safety, promptness, and efficacy of prehospital emergency care in wartime contexts may be greatly improved by addressing these issues through focused policy formulation, specialized training, enhanced communication systems, and public education. The results are a significant addition to emergency and disaster medicine in Iran and offer useful, context-specific insights for EMS leaders and policymakers. © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC.