Prehospital Trauma Care Challenges in Lima, Peru: A Mixed-Methods Review of Patient Perspectives

Introduction: In middle-income countries like Peru, factors such as delays in ambulance arrival and resource limitations can impact the timeliness and quality of prehospital trauma care. By assessing the experiences of hospitalized trauma patients in the capital city of Lima, this study sought to identify areas for improvement and develop targeted interventions to enhance prehospital care delivery. Methods: As part of a larger comprehensive needs assessment of the prehospital system in Lima, we conducted survey-based interviews of 112 trauma patients from four urban hospitals, selected through purposive sampling. Four participants underwent in-depth interviews, which were recorded, translated, transcribed, and thematically analyzed along with 57 narrative comments from the survey-based interview. Data were analyzed using descriptive statistics, with direct quotes included. Results: Most patients (78.6%) were male with a mean age of 36 y. Falls (34.8%), gunshot wounds (15.1%), and motorcycle collisions (12.5%) were the most common injury mechanisms. Only 34 of 112 (30.4%) patients arrived at the hospital via ambulance. Key themes included ambulance delays, with many patients seeking faster transportation alternatives; difficulty accessing emergency medical services, with uncertainty on how to contact ambulances or emergency services; and reluctance from alternative transport providers, such as taxi drivers, to assist injured individuals due to perceived liability risks. Conclusions: This study identified critical areas for intervention in Lima's prehospital trauma care that will guide the development of targeted interventions including a unified emergency contact number, enhanced public education, and legislative reforms. While implementation of these multifaceted strategies requires substantial time and resources, they provide a framework to address existing gaps in trauma care.