The cultural background factors relating to laypeople’s involvement that were raised during the interviews included: a willingness to help, humanitarian assistance, individual curiosity, people’s sense of haste, excitement, and disorganized cooperation (leading to a find more crowded crash scene and poor coordination). It was also mentioned that laypeople feel that removing victims from the crash scene and taking them to hospital quickly is better for the victims. Laypeople’s

limited knowledge related to: how to interact at a crash scene; what information needs to be given to the emergency service; how to use different emergency numbers; and how to provide first aid. Whereas all participants commented Inhibitors,research,lifescience,medical on the above, professionals in the EMS and police officers pointed out that such knowledge limitations Inhibitors,research,lifescience,medical affected the quality of the information provided (incomplete or wrong) to the emergency services. Police officers, representatives from the Road & Transportation Office and some victims added that laypeople’s worries about whether ambulances would arrive on time

also influenced the quality of the interactions. (EMS/1)People want to help casualties, but they usually don’t know first aid, aren’t sure what to do before the ambulance arrives and what kind of detailed information they need to give the Inhibitors,research,lifescience,medical emergency services when they call them. This can lead to incorrect phone-calls and the wrong information being conveyed. Invariably, laypeople are the first to arrive Inhibitors,research,lifescience,medical at a crash site. According to most stakeholders, laypeople are often stressed and can easily interfere with the activities of ambulance personnel. They usually remove victims too quickly

and take them to hospital in their vehicles. Their involvement is regarded as necessary to alert the emergency services and seen as useful in rural and remote areas. However, members of the EMS and police officers consider that laypeople, when too involved in crashes occurring in urban areas, may easily contribute to wasted time, hamper Inhibitors,research,lifescience,medical the emergency services, cause secondary injuries to victims and even provoke new crashes. (PO/3) A common problem at crash scenes is the gathering of too many people and their emotional behaviour, which could at worst out lead to new crashes and new injuries to the victims. (EMS/2) An example of the latter might be potential spinal cord injuries caused by the victim being moved too fast. Lack of coordination Different opinions were gathered concerning crash management and delayed victim transport. At many crashes, the police must be present to take statements, which is important for insurance and legal purposes. According to EMS members, this task wastes precious time and delays the transportation of victims to hospital. Members of other organizations stated that an insufficient number of ambulance dispatch sites could also result in delayed transportation.