Outcomes from trauma at the major referral hospital Hospital Nacional de San Benito (HNSB) in El Petén, Guatemala, have not been analyzed. Empirical evidence demonstrated a high number of motorcycle ...accidents (MAs). We hypothesized a large incidence of head trauma with poor outcomes in MAs compared to all other forms of blunt trauma.
Our hypothesis was tested by performing a community observational study and a retrospective chart review in El Petén, Guatemala. An independent observer catalogued 100 motorcycle riders on the streets of El Petén for riding practices as well as helmet utilization. HNSB does not have electronic medical records. For this study, we performed a retrospective chart review of randomly selected nonconsecutive trauma admission at HNSB between March 2018 and June 2023. Blunt trauma was compared between MAs versus all others. Variables were examined by parametric and nonparametric tests as well as contingency table analyses.
Most motorcycles riders involved multiple individuals (2.61 ± 0.79/motorcycle). Seventy riders included children (median = 1.0 Q1-Q3 range = 1.0-3.0/motorcycle). Overall, only three riders were wearing helmets. Forty-one were women. Of patients presenting to HNSB with trauma, 91 charts were reviewed (33.0 20.0-37.0 y old; male 89%), 76.7% were blunt, and 23.3% were penetrating trauma. Within blunt trauma, 57.1% were MAs versus 42.9% all others; P = 0.13. MAs were younger (29.5 20.0-37.0 versus 34.0 21.8-45.8 y old; P < 0.05) and of similar gender (male 82.5% versus 96.6%; P = 0.1). More MAs had a computed tomography (70.0% versus 30.0%; P < 0.01) and they were more likely to present with head trauma (72.5% versus 46.7%; P = 0.04) but similar Glasgow Coma Scale (15.0 13.5-15.0 versus 15.0 12.5-15.0; P = 0.7). MAs were less likely to require surgical intervention (37.5% versus 56.7%; P = 0.05) but had similar hospital length of stay (4.0 2-6 versus 4.0 2-10.5 d; P = 0.5).
Unsafe motorcycle practices in El Petén are staggering. Most trauma at HNSB is blunt, and likely from MAs. More patients with MAs presented with head trauma. However, severe trauma might be transferred to higher level hospitals or mortality might occur on scene, which will need further investigations. Assessment of mortality from trauma admissions is ongoing. These findings should lead to enforcement of safe motorcycle practices in El Petén, Guatemala.
Background and Aim: The deaths caused by traffic accidents are one of the three leading causes of death in Iran. Considering that all deaths from traffic accidents in the forensic organization are ...undergoing autopsy and also in the treatment centers under oral autopsies, the cause of death is determined, we determined that the cause of reported death from oral autopsy and medical autopsy Compare the law. Methods & Materials: In this descriptive study, patients who were admitted to the forensic medical center during the year 1395 admitted to the Vali-e-Asr Hospital in Arak, were referred. The causes of death in Vali-asr Hospital were evaluated and compared with the outcome of the forensic oral hearing. Ethical Considerations: This study ethcally approved by the ethics committee of the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.226). Results: In this study, 109 patients (1.33%) died from a total of 8153 patients with traffic accidents referred to Valiasr hospital in Arak. Of these, 68.8% were male and 31.2% were women. The Mean±SD age of the patients died was 44.03±22.43 years. Also, 59.6% of the dead died during the first 24 hours of the accident. The most common cause of death, according to the results of oral autopsy, was “multiple injuries,” accounting for 49.5% of the patients in 45 patients. Conclusion: Abundance of deaths among patients with road traffic accidents and they referred to Valiasr hospital, which was 1.33%. According to the existing standards and considering that the mortality rate in this center is less than 1.5%. It seems that the level of service delivery in this center is favorable.
India is in the process of strengthening the trauma care system, and assessment of the current situation using standard guidelines has immense use. This study reports the status of trauma care ...facilities in India, with a broad framework of guidelines for essential trauma care by the World Health Organization.
This study is part of a multicentric intervention study to standardize structured trauma care services in five Indian cities. Thirty trauma care facilities (five level I, 10 level II, and 15 level III facilities) were included. Data on the availability of equipment and manpower were collected. Availability of knowledge + skills and equipment + supplies was assessed based on the guidelines for essential trauma care by World Health Organization.
There is almost 100% availability of services and equipment in level I hospitals, but availability varied between 50% and 100% at level II facilities. Very fewer number of services are available at level III facilities. Inadequacy of equipment is reported in level II and III facilities. Only level I facilities have required human resources. Availability of resources in terms of knowledge and equipment of different skills indicated that overall optimal level is observed in level I hospitals. Level II facilities are more deficient in nursing and paramedic staff, and level III facilities reported deficiencies in all categories.
A significant imbalance between recommended resources and the resources that are available in the trauma care facilities was noted. Hence, the study warrants urgent strengthening of trauma care facilities, particularly of level II and III facilities.
•A high prevalence of road traffic injuries in Brazil was found, with important regional disparities.•Road traffic injuries were higher in men, young people, with a low level of education and outside ...capitals and metropolitan regions.•Motorcycle drivers were more affected by road traffic injuries when compared to car drivers.
To estimate the magnitude and factors associated with self-reported road traffic injuries (RTI) in Brazil.
Cross-sectional study conducted using data from individuals aged 18 years or older, participants in the 2019 National Health Survey, a population-based conducted on 88,531 adult individuals in Brazil. Three indicators were analyzed: (i) Proportion (%) of individuals aged 18 years or older who were involved in RTI in the past 12 months; (ii) Proportion (%) of car drivers who were involved in RTI in the past 12 months; and (iii), Proportion (%) of motorcycle drivers who were involved in RTI in the past 12 months. In the inferential analysis, multiple Poisson regression was used to analyze the association between demographic and socioeconomic variables and RTI, stratified for the general population, population of car and motorcycle drivers.
The estimated prevalence of self-reported RTI in the past 12 months was 2.4%. The South, Southeast, Northeast, Central-West, and North regions of Brazil had prevalences of 2.0%, 2.1%, 2.7%, 3.2%, and 3.4%, respectively. The results also show that most developed regions (South and Southeast) showed the lowest prevalence's, the highest frequencies were observed in those with lower socioeconomic development levels (Central-West, North, and Northeast). The prevalence was also higher in the subgroup of motorcyclists when compared to car drivers. In the general sample, the Poisson model showed an association between male sex, younger age, low level of education, residing outside capitals and metropolitan regions, in the North, Northeast and South regions and the prevalence of RTI. In car drivers, similar associations were found, except for area of residence. In motorcycle drivers, young age, low level of education, living in urban areas were associated with increased prevalence of RTI.
The prevalence of RTI is still high within the country, with disparities between regions, affecting more motorcyclists, young people, males, individuals with low education, and residents of the countryside.
Background: Road traffic injuries remain a significant public health concern, contributing to a rising number of fatalities and hospitalizations, in India. Despite the proven effectiveness of ...helmets, cultural and practical barriers persist, especially among the youth in India. Objectives: To assess the perceptions and practices regarding the use of helmets among different college students of Mangalore city. Methodology: This cross-sectional study was conducted in Mangalore, Karnataka, focusing college students from selected institutions. Convenience sampling was employed, with a calculated sample size of 270, and data was collected from 273 participants. Statistical analyses, including chi-square tests and percentages, were performed using SPSS version 11.5. Results: Of the 272 respondents (97.84% response rate), 85.66% were two- wheeler users, with 56.6% regularly using helmets. Full-face helmets were the most common choice, and 43.9% began using helmets following the implementation of helmet laws. Main reasons for non-compliance included concerns about excessive heat, impact on appearance, and handling difficulties. Awareness of penalties for law violation varied, with 53% aware for riders and 33% for pillion riders. While 41.5% deemed the penalty appropriate, 65% believed no one should be exempt from the law. Surprisingly, 45.16% advocated for the abolishment of the law. Conclusion: The study found that helmet usage is primarily driven by safety concerns, but a significant portion only started using them after legislation enforcement. Barriers to compliance included heat discomfort and aesthetic concerns. Despite awareness, a significant proportion expressed a desire for helmet laws’ abolishment, highlighting a complex relationship between awareness and compliance.
•The escalating issue of road traffic injuries and fatalities has become a pressing national concern in Iran. The situation urgently calls for a thorough assessment of current policies and the ...implementation of evidence-based approaches in order to mitigate this deleterious process.•Over the past few decades, several policies regarding driving licensing have been implemented in the interest of safe driving, yet without taking into account the optimal scientific evidence.•It is of utmost importance to provide high prestige evidence in support of the predominant contentious measures and topics concerning the issuance of driving licenses.•A prudent approach towards evidence-informed policy making would involve engaging diverse stakeholders to offer viable alternatives for these contentious issues in the driving licensing system.
Licensing policies for driving play a vital role in promoting road safety and decreasing road traffic injuries. Although there have been notable improvements in driving licensing policies in recent years, some policies in Iran are still contentious and controversial. This research aims to examine these controversial driving licensing policies in Iran by using the perspectives of Iranian experts and reviewing relevant documents.
A variety of research methods were used to conduct the study, including focus group discussions (FGDs) and a review of relevant documents. Participants were selected through purposive sampling, using a diverse and comprehensive approach. To collect documents for review, national websites such as the Iranian Parliament, Traffic Police and the Ministry of Roads and Urban Development were thoroughly searched, while some documents were collected in person. The data was analysed using a thematic approach.
Over the past decades, certain policy issues have continued to pose significant challenges and controversies. These policies within the Iranian driving system have been divided into three main categories including leadership and responsiveness, driver qualifications and vehicle characteristics, and health assessment procedures and standards.
The development and implementation of evidence-based policies necessitates the thorough examination and analysis of contentious and complicated policies related to driving licensing, and ultimately contributes to an improved driving experience in Iran. It is advisable to undertake coherent and systematic initiatives, enhance transparency and accountability within the licensing policy framework, and involve policy stakeholders and diverse interest groups, while taking into account the structural, cultural and societal influences on any policy intervention in driving licensing.
Aim.To determine the regularities and features of the formation of indicators of fatal outcomes in the Moscow region as a result of injuries caused by road accidents.Material and methods.We studied ...the dynamics of indicators of road traffic injuries with fatal outcomes in the Moscow region for the period 20152019. The study is continuous. The scope of the study is 5.112 cases of fatal traffic injuries. Research methods: documentary, statistical, graphic, and comparative analysis. Descriptive statistics are presented in the form of relative intensive and extensive coefficients.Results.It was found that in the Moscow region in the period 20152019 there was a decrease in the number of deaths from road accidents by 1.7 times. At the same time, there is a 2.2-fold decrease in the number of deaths with the presence of ethyl alcohol in the blood.Conclusion.During the five-year observation period, the structure of the dead showed a predominance of young people with a tendency to decrease their number in dynamics, changing the structure of the dead at the place of registration due to an increase in the share of dead residents of the Moscow region and a decrease in the share of dead residents of Moscow and other regions of the Russian Federation.
BACKGROUNDBeing under the influence of psychoactive substances increases the risk of involvement in and dying from a traumatic event. The study is a prospective population-based observational study ...that aims to determine the prevalence of use and likely impairment from psychoactive substances among patients with suspected severe traumatic injury.METHODThis study was conducted at 35 of 38 Norwegian trauma hospitals from 1 March 2019 to 29 February 2020. All trauma admissions for patients aged ≥ 16 years admitted via trauma team activation during the study period were eligible for inclusion. Blood samples collected on admission were analysed for alcohol, benzodiazepines, benzodiazepine-like hypnotics (Z-drugs), opioids, stimulants, and cannabis (tetrahydrocannabinol).RESULTSOf the 4878 trauma admissions included, psychoactive substances were detected in 1714 (35 %) and in 771 (45 %) of these, a combination of two or more psychoactive substances was detected. Regarding the level of impairment, 1373 (28 %) admissions revealed a concentration of one or more psychoactive substances indicating likely impairment, and 1052 (22 %) highly impairment. Alcohol was found in 1009 (21 %) admissions, benzodiazepines and Z-drugs in 613 (13 %), opioids in 467 (10 %), cannabis in 352 (7 %), and stimulants in 371 (8 %). Men aged 27-43 years and patients with violence-related trauma had the highest prevalence of psychoactive substance use with respectively 424 (50 %) and 275 (80 %) testing positive for one or more compounds.CONCLUSIONThe results revealed psychoactive substances in 35 % of trauma admissions, 80 % of which were likely impaired at the time of traumatic injury. A combination of several psychoactive substances was common, and younger males and patients with violence-related injuries were most often impaired. Injury prevention strategies should focus on high-risk groups and involve the prescription of controlled substances. We should consider toxicological screening in trauma admissions and incorporation of toxicological data into trauma registries.
In the world, deaths and injuries caused by traffic collisions have been considered a public health problem. In Colombia, 7.238 fatalities were recorded in 2021, with motorcycle riders representing ...the largest group of victims at 59.7%.
The aim of this qualitative phenomenological study is to describe the risky experiences and deliberate actions of diverse road users that influence the self-management of the risk of traffic collisions.
Data were obtained from 22 participants: motorists, pedestrians and drivers. The content analysis describes various human conditions that affect self-management of the risk of traffic accidents, such as unsafe behaviors, non-compliance with traffic regulations by the different road actors, competitive culture among drivers, eagerness, among others. Additionally, factors related to care were determined: healthy recreational activities, promoting the value of one's own life and that of others, adequate time management and preventive behaviors by some road users.
This research provides information on social and cultural aspects, experiences and risky behaviors of different road actors that influence the incidence of traffic accidents in Colombia.
Proclaiming the second Decade of Action for Road Safety 2021-2030 with the ambitious target of preventing at least 50% of road traffic deaths and serious injuries by 2030, in continuation of the ...first UN call for the Decade of Action on Road Safety (2010-2020) encouraged countries to intensify national, regional and international collaboration, with a view to meeting the ambitious road safety-related targets. In this regard, Iran has implemented the national road safety strategy and action plan under the supervision of the road safety commission as the lead agency in which the MOHME is one of the members. Moreover, as the main burden of road traffic injuries is on the health sector, to ensure universal access to health care services in the pre-hospital, hospital, post-hospital, and rehabilitation centers for road traffic victims and families, the road traffic injuries sub-committee affiliated with the Iranian Non-Communicable Diseases Committee (INCDC), developed the National Service Framework for Road Traffic Injuries through a multi-sectoral mechanism. The aim of this paper is to share Iran's experience in terms of policy implications for RTI prevention and control. Sharing the lessons learned on the role of the health sector in meeting the ambitious road safety targets will help other countries to strengthen political commitment to road safety and move toward setting regional and global road traffic casualty reduction targets.
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