Accidents & Injuries - Prevention and control

Accidents & Injuries - Prevention and control

1. Accidents & Injuries Dr Ubaid N P Community Medicine Dept Pariyaram Medical College

2. Introduction An unexpected and unplanned occurrence which may involve injury Accidents represent a major epidemic of non communicable disease Follow epidemiological pattern Majority of accidents are preventable

3. Measurement of the problem Mortality Proportional mortality rate Deaths per 1000 registered vehicles per year Number of deaths per million population Morbidity Serious injuries/ slight injuries Abbreviated injury scale Disability Temporary/ permanent Partial/ total

4. The Problem RTA ranks 4 th among the leading causes of deaths in the world from all causes Injuries are responsible for approx. 9% of all causes of deaths and 16% of the disabilities are reported due to injuries Major cause of death among young persons aged 10 – 24 years RTA, self inflicted injuries, violence etc are the leading causes of loss of lives Increased mechanization, induction of unskilled or semiskilled, rapid increase in vehicular traffic, overcrowding, poor implementation of safety precautions, poisoning

5. Global estimates of injury related deaths by cause (2008) Cause Total no of deaths(000) % of all causes of death Unintentional 3619 6.4 RTA 1209 2.1 Poisoning 252 0.4 Falls 510 0.9 Fires 195 0.3 Drowning 306 0.5 Other injuries 1146 2.0 Intentional 1510 2.7 Self inflicted 782 1.4 Violence 535 0.9 War 182 0.3 Total 5129 9.0

6. Types of Accidents 1. Road Traffic Accidents Ranks 1 st among all fatal accidents in many countries For every death, 20-50 non fatal injuries & 10-20 serious injuries Higher in younger age group Males > females Nearly half of those dying from RTA are vulnerable road users like pedestrians, cyclists and motorcyclists Low socio economic background

7. Risk factors Speed Drink driving – BAC:0.04g/dl Motorcycle helmets Seatbelts & child restraints Distracted driving Semi urban & rural areas contribute 60-80% RTAs Multiple causation

8. Prevention Data collection Safety education Promotion of safety measures – seatbelts, helmets, children, vehicle design etc Alcohol & other drugs Primary care Elimination of causative factors – improvement of roads, marking of danger points, imposition of speed limits Enforcement of laws Rehabilitation services – medical, social, occupational Accident research – Accidentology

9. 2. Domestic accidents An accident which takes place in the home or its immediate surroundings, and, more generally, all accidents not connected with traffic vehicle or sport, Eg : drowning burns falls Poisoning injuries from sharp or pointed instruments bites and other injuries from animals

10. Drowning Process of experiencing respiratory impairment from submersion/ immersion in liquid Victim loss consciousness after approx. 2 mins of immersion Irreversible brain damage can take place after 4 – 6 mins 3 rd leading cause of unintentional injury/death Also common method of suicide

11. Risk factors Age Gender Access to water Others – unsupervised child in bathtub, unsafe transportation vessels, alcohol use near water, medical condition, natural calamities

12. Prevention Engineering methods – to remove the hazard Legislation to enforce prevention Assure decreased exposure Education for individuals & communities to build awareness of risk and to aid in response if a drowning occurs

13. Burns Injury to the skin or organic tissue resulting from exposure to heat due to radiation, radioactivity, electricity, friction or chemicals Non fatal burns – prolonged hospitalization, disfigurement, disability, stigma, rejection Over 1 million people are moderately or severely burnt every year in India

14. Risk factors Gender Age Socio economic factors Other Occupation that increase exposure to fire poverty; overcrowding Placement of young girls in household works Underlying medical condition Alcohol, smoking Easy access to chemicals used for assault Use of kerosene as fuel source Inadequate safety measures for LPG & electricity

15. Prevention First Aid Do’s: Stop the burning process by removing clothing & irrigating the burns Use cool running water to reduce the temperature of the burn Extinguish flames – roll on the ground, applying blanket, using water or fire extinguisher In chemical burns: remove or dilute Wrap patient in a clean cloth & transport to the nearest medical facility

16. Dont’s : Ensure your safety first; switch off electric current, wear gloves for chemicals etc Do not apply paste, oil, turmeric or raw cotton to the burn Do not apply ice; it deepens the injury Avoid prolonged cooling with water; may lead to hypothermia Do not open blisters until topical antimicrobials can be applied

17. Falls 2 nd leading cause of unintentional injury death after RTA Deaths rates are highest among adults >60 years Falls from rooftops, balconies, windows & stairs are common Specific to SEAR are fall from trees, children while flying kites, construction workers etc Alcohol or substance use Underlying medical condition

18. Prevention Children – modification of nursery furniture, play ground equipment etc Screening within living environments for risks of falls Clinical intervention to identify risk factors – low BP, visual impairment, Bone conditions Home assessment & environment modification Assistive devices for physical & sensory impairments

19. Snake bite About 5 million snake bites per year, 2.4 million envenomings , >1 lac deaths and 4 lac amputations & other disabilities Asia, Africa & Latin America – most cases Outcome depends upon Species of snake Area of body bitten Amount of venom injected Health condition of the victim Type of venom: neurotoxic & cytolytic

20. First Aid(National Snake Bite Protocol 2007) Reassure the patient Immobilize the limb. Do not apply pressure or block the blood supply Do not give alcoholic beverages or stimulants Remove any items (rings, watch, foot wear) or clothing's which may constrict the bitten limb if it swells Do not incise or manipulate the bitten site. Do not apply ice Transport the patient to a medical facility Antivenoms Still the only effective treatment for envenomation Given intravenously, neutralizes venom enzymes Polyvalent available Anaphylaxis is an ADR

21. Poisoning: Responsible for 2.5 lac deaths worldwide in 2008 Pesticides, kerosene, prescription drugs & household chemicals Intentional & unintentional mortality & morbidity Industrial Accidents: Violence:

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