Safety Interventions

Improved Emergency Response

Prompt and effective treatment may transform a potentially fatal crash into a serious injury crash. Emergency response consists of collision notification, sending a response, at-scene treatment, and in-hospital treatment.

McDermott et al. (1996) found that system inadequacies contributed relatively more to pre-hospital treatment problems and patient management inadequacies contributed relatively more to in-hospital treatment problems. The pre-hospital system inadequacies were identified as:

• too long at scene
• unduly long time to or from scene
• inappropriate triage
• no dual response (Mobile Intensive Care Ambulance [MICA] plus normal ambulance)
• attending officers not qualified in Advanced Trauma Life Support (for example, patient was not intubated or given intravenous fluids when required).

Studies have shown that changes to trauma management systems (integration, coordination, and inclusiveness of providers, designation of hospitals to receive major trauma, concentration of expertise in trauma management, and agreed triage and transport protocols) can reduce the potentially preventable outcome rate from levels similar to the 36% found in Victoria to figures as low as 3% (Cales, 1984; Shackford, Mackersie, Hoyt, Baxt, Eastman, Hammill, Knotts and Virgilio, 1987; Davis et al., 1992, cited in Review of Trauma and Emergency Services — Victoria 1999).

Most of the research thus far has focussed on the possible increases in survivability of crashes due to improvements in emergency medical services. There is a need for more information about the effects of improved emergency medical services on the severity (and long-term consequences) of non-fatal crashes. The Major Trauma Management Study (Danne et al., 1998) found preventable or potentially preventable outcomes among 8% of survivors of trauma from all causes (not just road trauma) with adverse outcomes (major complications or central nervous system disability at discharge). These survivors with adverse outcomes are likely to have continuing medical and other costs.

Li and colleagues (2009) investigated the characteristics of various motorcycle crashes in Taiwan and found that a high rate of motorcycle crashes occurred in rural areas, which was related to a higher likelihood of fatality. The authors suggest that collaboration of hospital and roadway authority systems could help increase treatment at crash sites, which would reduce the risk of fatality for crashes in such areas.

Information sourced from A review of potential countermeasures for motorcycle and scooter safety across APEC (Full report and References [PDF, 304KB]).