BACKGROUND In Iran, Road Traffic Injuries (RTIs) with mass casualties occur repeatedly. Since Road Traffic Accidents (RTAs) occur far from health facilities, EMSs play an important role in reducing the disability and mortality resulting from RTIs. Thus, the study aimed to report Iraqi pilgrims' bus which rolled over in the Malayer town. CASE PRESENTATION A mass casualty event occurred on 7 September 2017 when a bus full of Iraqi pilgrims rolled over on a road 4-km outside of Malayer, Iran. A large team of responders were dispatched including 5 ambulances with 10 EMTs along with 6 police officers serving in the area. The accident resulted in 35 injured patients (21 female and 14 male) as well as 11 deaths ranging in age from 2 to 65 years. Twenty-one of the injured were transported to the hospital and 14 patients refused transport and 12 patients sustained multiple trauma. The case has been described four phases of dispatch, on-scene, hospital and post-mission. Frequent calls made by laypeople were considered as the main challenge of dispatch phase. The response on scene was hampered by large numbers of lay bystanders. The over-crowding around the emergency units disrupted the medical care procedures in hospital phase. CONCLUSION This case highlights over-crowding and laypeople interference at the scene disrupts the relief and rescue. To solve these challenges, the public education and police monitoring and control is recommended. Establishing a unified command post at the scene can facilitate effective coordination among relief and rescue organizations.

中文翻译：

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紧急医疗系统（EMS）对伊拉克朝圣者在伊朗发生的公交车撞车事件作出的反应：一例报告。

背景技术在伊朗，大量伤亡的道路交通伤害（RTI）屡屡发生。由于道路交通事故（RTA）发生在远离医疗机构的地方，因此EMS在减少RTIs导致的残疾和死亡率方面起着重要作用。因此，该研究旨在报告在马约尔镇上空翻过的伊拉克朝圣者巴士。案例介绍大规模的人员伤亡事件发生在2017年9月7日，一辆装满伊拉克朝圣者的公共汽车在伊朗Malayer以外4公里处的一条道路上翻滚。派出大批响应者，包括5辆急救车，10辆EMT和6名警务人员在该地区服务。该事故导致35名受伤患者（21名女性和14名男性）以及11名2至65岁的死亡。其中21名受伤者被送往医院，有14名患者拒绝运输，另有12名患者遭受了多处创伤。该案件已在派遣，现场，医院和任务后四个阶段进行了描述。外行人经常打来的电话被认为是派遣阶段的主要挑战。现场的反应受到大量外行旁观者的阻碍。急诊室周围人满为患，破坏了医院阶段的医疗程序。结论该案例突显了人满为患，外行人在现场的干扰扰乱了救援工作。为了解决这些挑战，建议进行公共教育和警察监控。在现场建立统一的指挥所可以促进救援组织之间的有效协调。