Background Road traffic injuries are a major public health problem, especially in low- and middle-income countries. Postcrash management can play a significant role in minimising crash consequences and saving lives. Iran has one of the highest mortalities from road traffic injuries in the world. The present study attempts to fill the knowledge gap and explores stakeholders' perceptions of barriers to and facilitators of effective postcrash management in Iranian regions.

Methods Thirty-six semistructured interviews were conducted with medical services personnel, police officers, members of Red Crescent, firefighters, public-health professionals, road administrators; some road users and traffic injury victims. A qualitative approach using grounded theory method was employed to analyze the material gathered.

Results The core variable was identified as “poor quality of post crash management”. Barriers to effective postcrash management were identified as: involvement of laypeople, lack of coordination, inadequate prehospital services, shortcomings in infrastructure. Suggestions for laypeople included: (1) a public education campaign in first aid, the role of the emergency services, cooperation of the public at the crash site, and (2) target-group training for professional drivers, police officers and volunteers involved at the crash scene. An integrated trauma system and infrastructure improvement also is crucial to be considered for effective postcrash management.

Conclusion To sum up, it seems that the involvement of laypeople could be a key factor in making postcrash management more effective. But system improvements are also crucial, including the integration of the trauma system and its development in terms of human resources (staffing and training) and physical resources as well as the infrastructure development.