Prehospital Care in Road Traffic Accident Cases

Abstract

Abstract Background: Rapid population growth, industrialization and an increase in road vehicles, have led to a drastic increase in the number of Road Traffic Accidents (RTA).Pedestrians, motorized two wheeled vehicle (MTV) users, and cyclists are the most vulnerable road user groups in terms of injuries and fatalities resulting from road traffic crashes in India. At least one-third of potentially preventable deaths occur prior to arrival at hospital and over half occur during the hospital reception and resuscitation phase of care. Prehospital emergency care in India is only beginning to develop. Thirty per cent of emergency patients in India die before they reach a hospital. Persons who shift the victims are usually untrained members of the public. Crash victims are often taken to the nearest hospital, regardless of the hospital’s capabilities for dealing with trauma. The vast majority of ambulances are used for inter-hospital transfer, not for primary response. This highlights the need of urgent steps for establishing good pre-hospital care and trauma services at site in India. Aims and Objectives: The study attempts to know the status of provision of pre hospital care to RTA victims and to suggest measures for improving hospital and pre-hospital care to the same. Methods: The study was conducted on patients of RTI admitted at Trauma Centre of King George’s Medical University UP (KGMU), Lucknow. A semi-structured questionnaire was used gather information about the socio demographic profile of RTA victims and the status of provision of pre hospital care to them. Results: It was seen in the present study that only eight percent cases had some sort of pre-hospital care given, or some interventions done before victim was taken to the hospital. Majority of these interventions were given by the bystanders and included measures like shifting the victim from the accident site (76.5%), water splinting/fanning/water given to drink (8.8%), or wound covered with cloth (5.9%) or medications (8.8%). In 9.7 percent cases, it was not known whether any pre hospital intervention was given. Out of the total cases who died, 66.7 percent had not received any intervention before hospitalization. The proportion of mortality was 2.5 percent in cases where no interventions were given, while there was no mortality in cases where some interventions were given before hospitalization. Conclusion: It was seen that very few cases got some intervention before hospitalization and a number of cases were referred from government health facilities due to unavailability of beds, equipment or medical staff. About thirty percent interviewees were not aware of ambulance emergency number. Lower proportion of mortality was seen in cases that got intervention at a health facility within an hour.