ACCIDENTS AND INJURIES: ACCIDENTS AND INJURIES Dr. Muhammedirfan H. Momin Assistant Professor Community Medicine Department Government Medical College, Surat. PowerPoint Presentation: Marriage Shadi karke …. DEFINITIONS: DEFINITIONS ACCIDENT Unexpected, unplanned occurrence of an event which may involve injury. In 1956 WHO advisory group defined accidents as Unpremeditated event resulting in recognizable damage. Occurrence in a sequence of events which usually produce unintended injury, death or property damage. DEFINITIONS: DEFINITIONS INJURY A bodily lesion due to acute exposure to energy beyond the physiological tolerance . PowerPoint Presentation: Accidents are the part of prize we are paying for technological advances. Like other diseases accidents are also having – Natural history of disease and Agent, Host and Environmental factors PowerPoint Presentation: Epidemiology of Injuries Injury as a disease Pathologic condition Host Agent Vector /vehicle Inter-action Malaria Human Plasmodium vivax Mosquito Bite Skull fracture Human Mechanical Energy Motorcycle Crash Leading contributor in global diseases: Leading contributor in global diseases 1990 1.Lower Rasp. Infec. 2.Diarrhoea 3.Prenatal condition 4.Unipolar major depression 5.IHD 6.Stroke 7.TB /HIV 8.Measles 9.Road traffic Injury 10.Congenital 2020 1.IHD 2.Major Depression 3.Road Traffic Injury 4.Stroke 5.COPD 6.Lower Resp. Inf. 7.TB 8.Perinatal condition 9.Diarrhea Diseases 10.HIV How to Measure the Problem of Accident: How to Measure the Problem of Accident Mortality: Proportionate Mortality Rate Number of deaths due to accidents out of 100 total deaths Number of deaths per million population Killed in Road Traffic Accident (RTA) is defined as any person who was killed outright or who died within 30 days as a result of accident. Death Rate per 1000 registered vehicles per year Number of accidents or fatalities as a ratio of number of vehicles per km OR passenger per km. PowerPoint Presentation: Morbidity: Measured in terms of Slight injury and Serious injury Disability: Disability is one of the important outcome of accidents Temporary or Permanent disability Partial or Total disability Problem statement: Problem statement World: Accidents are endemic all over the world Accidents are major cause of deaths in the age-group of 10-24 yrs In developed countries - 57% of male death and 43% of female death in 10-24 yrs are due to accidents. RTA and drowning are the main causes of death in that age-group. PowerPoint Presentation: In SEAR: Out of total 5.1 million accident deaths in the world 1/4 th in SEAR. So thousands of children saved from Nutritional and infectious disease are killed by accidents. India: Increasing trends in India due to Mechanization in agriculture and industries Increase in vehicular traffic Plus factors like Overcrowding Lack of awareness and Poor implementation of safety precautions Types of accidents: Types of accidents Road Traffic Accidents (RTA) Domestic accidents Drowning Burns Falls Industrial Accidents Railway accidents Violence Causes of accidents: Causes of accidents Accidents are complex phenomena with multiple causation Etiological factors are classified to Human Environmental Psychosocial factors PowerPoint Presentation: Age Sex Education Psychological factor Lack of body protection Relating to road Relating to vehicle Bad weather Mix traffic Increase vulnerability and risk situation Precipitating factor ACCIDENT Human factor Environmental factor Human factor: Human factor Age:15-44 yrs(50% mortality) Sex: More in males Education: Low educational status Medical condition Sudden illness Heart attack Impaired vision Fatigue Lack of protection Helmet Safety belts Psychosocial : Psychosocial Lack of experience Risk taking behavior Impulsiveness Defective judgment Delay in decision Aggressiveness Poor perception Family dysfunction Environmental : Environmental Related to Roads: Defective and narrow roads Defective lay out of cross-roads, speed breakers Poor lighting Environmental : Environmental Related to Vehicles: High speed Poorly maintained vehicles Large number of 2-3 wheelers Overloaded bus Low driving standards Bad Weather Environmental : Environmental Inadequate laws Mixed Traffic Pedestrian Animals and vehicles Precipitating factors: Precipitating factors Increased emotional tension Use of Alcohol during driving Precipitating factors: Precipitating factors Stolen vehicle Group traveling Road Traffic Accident: Road Traffic Accident “Road Safety is No Accident” – was the slogan given by WHO for World Health Day – 2004. 85% of all road accident deaths occur in developing countries and nearly half in the Asia-Pacific region. India has one of the largest highway and road networks second only to road network of U.S. PowerPoint Presentation: Road safety advertising PowerPoint Presentation: How accidents in developing countries differ from developed countries : Two wheelers are more involved Pedestrians are more involved PowerPoint Presentation: How accidents in developing countries differ from developed countries : Large number of old and poorly maintained vehicles Overloaded buses PowerPoint Presentation: How accidents in developing countries differ from developed countries : Disregard towards traffic rules PowerPoint Presentation: How accidents in developing countries differ from developed countries : Poor road standards PowerPoint Presentation: How accidents in developing countries differ from developed countries : Unusual behavior of human and animals PowerPoint Presentation: Unusual behavior of car Domestic accidents: Domestic accidents Accidents which takes place in home or in its immediate surrounding, which are not connected with traffic vehicles or sports. Common domestic accidents are- Drowning Burns by flame, hot liquid, electricity, crackers, chemicals Falls Injury by sharp objects Animal bites. Drowning : Drowning After immersion in water victim loses consciousness with in 2 min. and Irreversible brain damage occurs at 4 – 6 minutes. PowerPoint Presentation: Prevention and control of drowning Availability of life jackets and flotation devices around pools & boats Supervision of children by adults Fencing of lakes and ponds Creation of safety standards for public and private swimming pools Ensuring availability of weather reports to fishermen and to those working on rivers and seas Burns: Burns Factors associated with burns Explosion of pressure stove. Cooking on open fire Use of open fire during winter Use of inflammable material Method of suicide PowerPoint Presentation: Prevention and control of burns Stable stoves/lamps Replacement of pressure stoves with wick and gas stoves Installation of fire and smoke alarm Promotion of cold water for first aid and burns Poisoning : Poisoning Most common agents are – Kerosene Pesticides Household chemicals Drugs Kerosene poisoning common among children. Fall: Fall Large number of hospital visits among children and young adults for non-fatal injuries. Fall from Roof, balcony, stair-case, window are common. Among construction workers are common Fall: Fall PowerPoint Presentation: Prevention and control of falls 1.Safer playground (Use of mud & sand surfaces instead of paved ones) 2.Safer furniture & house designs 3.Use of grills on windows 4.Safer design of stairs, balconies and rooftops with railings and bars 5.Safer working techniques for construction workers Industrial accidents: Industrial accidents Approximately 580 million workers in SEAR. 60-80% are in small scale units PowerPoint Presentation: Prevention and control of industrial accidents Ensuring the cost effective protection measures Enforcing safety regulations and standards Creating awareness among workers Railway accidents: Railway accidents In India railway accidents are in increasing trend due to Increasing number of trains More number of passengers Violence: Violence Risk factors for violent behavior: Exposure to violence and societal acceptability of violence as a mode to solve the problem Availability of lethal weapon at home Consumption of alcohol PowerPoint Presentation: Suicide are increasing in SEAR region 36/1,00,000 in India 22/1,00,000 in Thailand 11/1,00,000 in Bangladesh 8/1,00,000 in Srilanka Common methods of suicide: Hanging Drowning 70% of cases of suicide in 15-35 yrs age M:F ratio is 1:13 to 1:3 Prevention of Accidents: Prevention of Accidents Multi-sectorial approach approach for prevention. Data collection: Reporting system for accidents Special surveys for accidents Risk factors Circumstances Chain of event No effective system of prevention without data collection. PowerPoint Presentation: Safety education: “Accident is a Disease – Education is its Vaccine” Should start from school days Drivers trained for vehicle maintenance and safe driving. Education about traffic rules Training in First Aid. Promotion of Safety measures: Helmets Seatbelts Leather clothing and boots PowerPoint Presentation: Promotion of Safety measures: Children on back seats Parking at a suitable place Low beam headlights Avoidance of mobile Door locks Proper vehicle design Avoidance of alcohol and drugs PowerPoint Presentation: Alcohol and other Drugs: Alcohol - 30-50 % of RTA Alcohol and drugs like Barbiturates, Amphetamine must be avoided Primary care Planning, Organization and Management of Trauma treatment and Emergency care Emergency care should begin at the site, continue during the transport and conclude in the hospital. Trauma care hospitals in all major cities PowerPoint Presentation: Elimination of Causative Factors: Improper roads Speed limits Marking danger points Fire guards Use of safety equipments Safe storage of drugs, poison and weapon. Enforcement of Law Medical fitness of driver Alcohol conc. In blood (80 mg/100 ml limit in India) Driving test Seat belt wearing Speed limit PowerPoint Presentation: Enforcement of Law Helmets Vehicle inspection Periodic examination of drivers Rehabilitation Medical Social Occupational Accident Research PowerPoint Presentation: THANK YOU Wish you a safe journey of Life….