Post-crash Management & Data Needs
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1) The document discusses the need for better post-crash management and data related to road traffic injuries among school-aged children in India. It notes that 20 per 100,000 children aged 1-17 experience permanent disability from such crashes each year. 2) It outlines recommendations for improving first response and emergency care after traffic crashes involving children, including training first responders, ensuring transport vehicles carry first aid kits, and developing an appropriate emergency response protocol involving schools, hospitals, and other stakeholders. 3) The document calls for a simple pre-hospital emergency response system with equipped ambulances and certified staff, as well as health education programs, to improve outcomes for children injured in traffic crashes.
Post-crash Management & Data Needs
- 1. Post-crash Management & Data Needs Dr Amit Agrawal, MCh Professor of Neurosurgery Narayana Medical College and Hospital, Nellore (AP), India
- 2. According to available data, the rate of permanent disability among children aged 1 to 17 years injured as a result of a road traffic crash was 20 per 100 000 children Significant numbers of children required hospitalization or missed school as a result of their injuries Road Traffic Injuries in school-going children remain a problem and we do not have specific related data Introduction https://www.who.int/violence_injury_prevention/child/injury/world_report/Road_traf fic_injuries_english.pdf
- 3. Who are at risk? What are the type of transport modalities used? What are the mechanisms of injuries? What are the type of injuries? Who are the first responders? What is post crash care? What should be the first response? What are the warning signs? Who will be the stake holders, their roles and responsibilities? Outline
- 4. School aged children (<18 years, 2-18 years) who are prone to sustain transport related injuries during their travel from home to school and vice versa This excludes Injuries to the children at home or at school or while travelling for other reasons Who are at risk?
- 5. Bus Auto Rickshaw Cycle Rickshaw Powered Two Wheeler Bicycle Animal driven carts Pedestrian?? What are the type of transport modalities used?
- 6. Hits and falls Crush injuries Collisions Toppling of vehicle Behavior related injuries (putting hands or other body parts out of the moving vehicle) Even a big bump at a speed breaker can result in injuries (getting hit against the roof of the vehicle or to the side bar) What are the mechanisms of injuries?
- 7. Minor injuries Cuts Lacerations Bruises Major injuries Traumatic brain injury Fractures Chest injuries Abdominal injuries What are the type of injuries?
- 8. Parents Vehicle driver Vehicle attendants Teachers Senior students Passers-by (general public) Who are the first responders?
- 9. A series of time sensitive actions that are essential to provide effective care for the injured, beginning with activation of the emergency care system and continuing with care at the scene, during transportation to a healthcare center and hospital-based emergency care What is post crash care?
- 10. The first responders should be able to recognise that there is an emergency (may be minor or major) Able to decide there is a a need for first aid (in cases of minor injuries) and/or basic life support in cases of life- threatening injuries Ability to make a decision that there is a need to transfer the injured to the nearest health care facility Ensure the safety at the scene, safety to himself and safety to other children To inform to the team coordinator Not all road crash incidents lead to a medical emergency Recommendations: Training the first responders
- 11. Warning signs Unconsciousness No response or absence of breathing Chest pain or discomfort in breathing Absence of pulse Excessive bleeding Seizures Extensive burns or burns involving the head, neck, feet, hands, and genital area Injuries caused by chemicals Recommendations: Identifying the warning signs
- 12. Vehicles ferrying school-going children must carry first aid material in a dust-proof removable metal box Needs to be properly labelled and placed in a well visible and accessible location The first aid kit must contain leaflet elaborating the contents in first aid box (including their use in local language) and how to use the contents Emergency contact numbers School authorities Ambulance services Family members Nearby hospitals Recommendation: First Aid Kit
- 13. The contents of first aid box should be checked at regular intervals for their use-by dates It should be clearly explained to the participants that the purpose of first aid is not to make a diagnosis but is to provide support in emergency situation Recommendation: First Aid Kit
- 14. 1 2 3 4 2 1 3 4 3 1 2 4 4 1 2 3 Which one first?
- 15. Children Parents School authorities Transport services Co-ordinating team Ambulance services Medical management response team Traffic police Healthcare facilities Passers-by and general public Recommendations: Inventory of stake holders
- 16. Designing an appropriate crisis and emergency response protocol Details of injury patterns Details of first response Details of first aid kit First aid training for first responders The details of stake holders Their contact numbers Identifying the sources to provide financial security Ensuring legal support to avoid delay in care (Samaritan Law) Recommendations
- 17. A simple pre-hospital system that could provide timely care at the scene with adequately equipped ambulances staffed with certified care providers Health education Modes of transport Type of injuries and their consequences Baseline health care response Methods to promote self discipline and responsible behavior on the roads by all road users Summary