Leading cause among 5.1 million global deaths due to injuries
and violence,2012 (source:park 24th edition) Recent Scienerio:2018 Key Facts:- • Approximately 1.35 millions people die in road traffic accident each year worldwide. • Road traffic accidents cost 3% of Gross Domestic Product of most of countries. • More than half of road traffic deaths are among vulnerable road users-pedestrains,cyclists and motorcyclists. • 93% of world’s fatalities occur in low and middle income countries,even though they have 60% of world’s vehicles. • Road traffic accidents are more amoung children and adults aged 5- 29. Indian Scienario:- • Reported road traffic fatalities (2016) -150 785 (85% M, 15% F) • WHO estimated road traffic fatalities (2016)-299 091 • WHO estimated rate per 100 000 population (2016)-22.6 Who are at risk? • Socioeconomic Status-low and middle • Age-5-29yrs • Sex-M>F::3:1(within age limit of 25 yrs) • Medical Conditions-sudden illness,heart attack,impaired vision • Fatigue • Psycho-social factors-lack of experience,risk taking behaviour,impulsiveness,defective and delay in judgement,agressiveness,poor perception,family dysfunction • Lack of body protection-helmets and seat belts Risk Facters:- Speed- • Speed directly related to accident rate.Speed of vehicles should be reduced below 30km/hr in residential and school zones. • Pedestrains have 90% chance of surviving a car crush at a speed of 30km/hr,but <50% at a speed >= 45km/hr. • Excess speed increases car emissions which ll lead to resp. problems. Drink-driving- • Driving under the influence of alcohol and psychoactive drugs increases the accidents and case fatalities. Continued... • Risk of crash increases significantly above a BAC of 0.04g/dl • Drugs like barbiturates,amphitamines and cannabis increases chance of RTAs. Non use of motorcycle helmets,seat belts and child restrains:- • Wearing a motorcycle helmet correctly can reduce risk of death by almost 40% and risk of severe injury by over 70%. • Helmet can effectively reduce head on collision in a crash. • Seat belt wearing reduce risk of fatalities amoung front seat passangers by 40-50% and of rear seat passangers by 25-75%. Continued.... • Children remain seated in back seats of a vehicle to avoid fatalites.Therefore some countries have introduced laws which require that children of under 12-15 yrs in cars to be in the rear seats only. Distracted driving:- • Mobile phone using while driving • Text messaging Unsafe road infrastuctures:- Unsafe vehicles:-old and poorly maintaind vehicle. Continued.... Inadequate post-crash care:- • Delay in detecting and proving care Inadequate law enforecement of traffic • * Developing countries have a different environment anf mix of vehicles in traffic stream • Mixed traffic • Old vehicles • Low driving standards • Overloaded buses • Large no. of buses,motorcycles,scooters. • Defective roads,poor street light,defective lay-out cross roads and speed breakers. Prevention:- 1. Data collection- • Basic reporting system of all accidents • Integration of police records for preventive purposes 2. Safety education- • Safety education must begin with school children. • Drivers trained in proper maintenance of vehicles and safe driving. • Young people need to be educated regarding risk factors,traffic rules and safety precautions. • They should be trained in first-aid. 3. Promotion of safety measures- • Use of seat belts Continued.... • Safety helmets use • Children restrains • Use of door lock,proper vehicle design,use of laminated high penitration resistance wiindscreen 4. Alchol and other drugs 5. Primary care • Planning,organisation and management of trauma treatment and emergency care • Emergency care should begin at accident site ,continued during transportation and conclude in hospital emergency room. (“Timeline Concept”) Continued.... • Organisation of a trauma team consisting of doctors of emergency department,anaesthetics,orthopedics and general surgeons(nowadays hematologist and radiologists assist in primary dignosis) • Work according to”Code red trauma calls” • Simultaneous and effective Advanced Trauma Life Support(ATLS) should be started to avoid life threatening complications. • Damage control orthopedics should be started as- • Resuscitation • Hemorrage control Continued.... • Decompression • Decontamination • Fracture splintage • Elimination of causative factors- • Improvement of roads • Imposition of speed limits • Marking of danger points • Enforcement of laws • Rehabilitation services • Medical • Social • Occupational A WHO iniciative with SDG 3.6 and 11.2.(Save LIVES)