Barriers and challenges to emergency medical services response to disasters and mass casualty incidents in the Middle East

Background: Efficient response by Emergency Medical Services (EMS) mitigates the risk of associated high mortality and morbidity in disasters. This scoping review aims to explore the extent, range and nature of the existing literature on barriers and challenges faced by the EMS in responding to disasters and Mass Casualty Incidents (MCIs) in the Middle East. Methods: A scoping review utilising Arksey and O'Malley's six-step framework was undertaken. Results: A total of 2858 publications were identified in the initial search. After the removal of duplicates, 2668 papers remained. Consensus was reached on 11 publications for final review. After full-analysis of the papers, communication and preparedness were the two major barriers or challenges identified in the literature. Conclusion: The development of education, communication strategies, and standardised policies for EMS across all phases of disasters and MCIs are essential to improve the service in the future.