Evaluation of the status of the pre-hospital trauma care in road traffic accidents in Kancheepuram district of Tamil Nadu

The recent global estimates suggest that about 1.24 million people die while almost 50 million people are exposed to injuries every year on the roads[1]. In fact, a large proportion of the road traffic accidents (RTAs) occurs in developing nations (which are already struggling to cope with their existing morbidities), it is extremely difficult to deal with the aftermaths of RTAs (viz. handling of acute complications, rehabilitation care, etc.)[1,2]. In view of the rising incidence of RTAs, the current decade 2011–2020 has been declared as the “decade of action for road safety”[2]. Epidemiological studies performed under heterogeneous settings have indicated that a wide gamut of parameters and potential risk factors contribute towards the causation or amplification of the consequences of accidents[1,3-6]. Findings of a descriptive study revealed that the precipitating cause in most of the accidents with fatal outcome was personal problems, recent conflicts, and intake of alcohol by the deceased person and that majority of the accidents were reported either at the beginning or towards the end of their journey[7]. In a retrospective study performed in hospital settings based on the information obtained from the trauma research center, motorcycle (59.2%) was the most common mechanism of injury and about one-fourth of trauma patients had more than two injured organs (the most common site: head and neck)[8]. In an analysis of RTAs with respect to road-users in Greece, brain trauma (among motorcyclists and pedestrians); abdominal injuries/ spinal cord trauma (among car occupants); and pelvic injuries (among pedestrians) were the most common body part involved[9]. Similar sort of trends and determinants have been identified in other studies done in different settings[10,11]. In a qualitative study done in Iran to assess the functioning of prehospital trauma care, it was demonstrated that very few victims received adequate and appropriate treatment at the accident site or during transport and were generally brought to the hospital by lay persons[12]. The scenario becomes dismal in rural areas where most of the deaths result, even before the victims reach the hospital[1316]. In fact, a cohort study concluded that efficient pre-hospital trauma system can remarkably minimize the death rates attributed to RTAs[17]. These facts have seriously necessitated the need for ARTICLE INFO ABSTRACT