Road Traffic Accident | Traffic Injuries

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Road Traffic accidents or RTAs are as grim as any other medical emergency and one should know how to handle it. More than 1200 accidents occur every day in India.

In case of road traffic accident, the immediate step is to call a well-equipped ambulance

• If the victim is breathing, then he can be placed on his back.
• If there is any visible bleeding, the area should be covered and pressed firmly.
• The victim shouldn’t be given water or forced to sit.
• Don’t move the victim by holding his hands and legs.
• Specific care should be taken to ensure that patient’s neck doesn’t move.
• In case of any visible fracture/ deformity, the area should be supported with a hard plate or board under the affected part and immobilized using a cloth or tape.
• If the victim is not breathing, then a Cardiopulmonary resuscitation (CPR) is required. You can start CPR if you are trained in it.
• Ensure that the ambulance is on its way.

Once the ambulance arrives, the patient should be lifted upon stretcher or stiff board. This is important as lesser the movement, the lesser are the chances of worsening the injuries. The ambulance team assesses the patient and commences appropriate resuscitative measures en-route. The Emergency Room is alerted at once to await the arrival of the injured patient.

In a contemporary ER, a rapid structured assessment of patient happens on arrival by a doctor trained in advanced trauma management. Advanced resuscitative measures are commenced promptly including arresting of haemorrhage, appropriate blood product resuscitation and a need based evaluation using CT scans and other imaging modalities.

Trauma resuscitation is all about team work involving several specialists. A good ER will ensure early involvement of specialists from fields like Anaesthesia, Orthopaedics, Neuro-surgery, Cardiothoracic, etc. Ideally the doctors in the ER should be trained in Advanced Trauma Life Support (ATLS), which is the standard of care for the trauma patients.

The initial evaluation is done to:

• Identify life threatening injuries.
• Initiate adequate supportive therapy.
• Organise definitive therapy or transfer to a facility that provides definitive therapy.

The patient should be handled minimally and gently, and ideally, be transported only in an ambulance. The patient should be promptly shifted to advanced trauma care centre where a skilled ER team works together with various specialists backed by advanced investigative modalities. Timely help during the golden hour and an early goal directed therapy provided by a quick response trauma team of a well-equipped hospital can definitely change the results in a drastic way and reduce mortality and morbidity to a large extent.

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