Contents

Preface

References

Chapter 1

The Role of Occupant Protection Safety Restraints in the Prevention of Neurotrauma

Abstract

Introduction

Parameters of Effectiveness

Physics of Injury in an RTA

Limitations of Occupant Protection Safety Restraints

Insufficiencies in Injury Reporting and the Role of OPSR

Motorcycle Helmets

Role of Legislation in Promoting Occupant Protection Safety Restraint Usage

Conclusion

References

Chapter 2

Examining the Perceptual Consequences of Traffic Complexity for Vulnerable Road Users

Abstract

Introduction

Complex Scene Perception Theory

Background Research on Driver Perceptions of Hazards

Early Scene Perception

Scene Complexity and VRU Detection

Methods for Sanocki et al. (2015)

Results and a Further Experiment

Do Two Fewer Words Make a Difference?

Conclusions

Rapid Scene Perception

Rapid Scene Perception and Public Safety

References

Chapter 3

The Use of Seat Belts for Reducing the Number of Road Traffic Deaths

Abstract

Introduction

1.1. National Seat Belt Law

1.1.1. Existence of National Seat Belt Laws in Africa

1.1.2. Existence of National Seat Belt Laws in Antarctica

1.1.3. Existence of National Seat Belt Laws in Asia

1.1.4. Existence of National Seat Belt Laws in Europe

1.1.5. Existence of National Seat Belt Laws in North America

1.1.6. Existence of National Seat Belt Laws in Oceania

1.1.7. Existence of National Seat Belt Laws in Seven Seas (Open Ocean)

1.1.8. Existence of National Seat Belt Laws in South America

1.2. Seat Belt Wearing Rates

1.2.1. Seat Belt Wearing Rates in Africa

1.2.2. Seat Belt Wearing Rates in Antarctica

1.2.3. Seat Belt Wearing Rates in Asia

1.2.4. Seat Belt Wearing Rate in Europe

1.2.5. Seat Belt Wearing Rates in North America

1.2.6. Seat Belt Wearing Rates in Oceania

1.2.7. Seat Belt Wearing Rates in Seven Seas (Open Ocean)

1.2.8. Seat Belt Wearing Rates in South America

1.3. The Moran’s Index

1.3.1. Definition of Terms

1.4. Data Management

1.4.1. Shape Files for Each Continent

1.4.2. Adding Variables to the Attribute Table

1.4.3. Geoprocessing

1.4.4. Data Analysis

1.5. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles

1.5.1. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Africa

Front Seat Belt Wearing Rates in Africa

Rear Seat Belt Wearing Rates in Africa

Drivers Only Seat Belt Wearing Rates in Africa

All Occupants Seat Belt Wearing Rates in Africa

Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Africa

1.5.2. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Antarctica

1.5.3. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Asia

Front Seat Belt Wearing Rates in Asia

Rear Seat Belt Wearing Rates in Asia

Drivers Only Seat Belt Wearing Rates in Asia

All Occupants Seat Belt Wearing Rates in Asia

Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Asia

1.5.4. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Europe

Front Seat Belt Wearing Rates in Europe

Rear Seat Belt Wearing Rates in Europe

Drivers Only Seat Belt Wearing Rates in Europe

All Occupants Seat Belt Wearing Rates in Europe

Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Europe

1.5.5. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in North America

Front Seat Belt Wearing Rates in North America

Rear Seat Belt Wearing Rates in North America

Drivers Only Seat Belt Wearing Rates in North America

All Occupants Seat Belt Wearing Rates in North America

Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in North America

1.5.6. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Oceania

Front Seat Belt Wearing Rates in Oceania

Rear Seat Belt Wearing Rates in Oceania

Drivers Only Seat Belt Wearing Rates in Oceania

All Occupants Seat Belt Wearing Rates in Oceania

Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Oceania

1.5.7. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Seven Seas (Open Ocean)

Front Seat Belt Wearing Rates in Seven Seas (Open Ocean)

Rear Seat Belt Wearing Rates in Seven Seas (Open Ocean)

Drivers Only Seat Belt Wearing Rates in Seven Seas (Open Ocean)

All Occupants Seat Belt Wearing Rates in Seven Seas (Open Ocean)

Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in Seven Seas (Open Ocean)

1.5.8. Concentration Type, Moran’s Index, Z Score and the Corresponding Probability Value for Seat Belt Wearing Rates and Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in South America

Front Seat Belt Wearing Rates in South America

Rear Seat Belt Wearing Rates in South America

Drivers Only Seat Belt Wearing Rates in South America

All Occupants Seat Belt Wearing Rates in South America

Road Traffic Deaths by Drivers/Passengers of 4-Wheeled Vehicles in South America

1.6. Qualitative Data Analysis

Conclusion

References

Chapter 4

Road Traffic Safety: A Manual of Safety Measures

Abstract

Introduction

History

Incidence

Risk Factors

Effects of Speed on Crashes and Crash Severity

Effects of Alcohol on Risk of Crashes and of Crash Injury

Prevention of Accidents

Safety Measures

Safety Measures Related to Engineering

Visual Guidance to Driver

Road Reconstruction

Channelization

Road Signs

Street Lighting

Improvement in Skid Resistance

Road Markings

Guide Posts with or without Reflector

Guard Rail

Constructing Flyovers and Bypass

Regular Accident Studies

Safety Measures Related to Enforcement

Speed Control

Training and Supervision

Medical Check

Safety Measures Related to Education

Education of Road Users

Safety Drive

Pre-Hospital Care

Including by

Hospital Care

Rehabilitation

Future Direction

References

Chapter 5

Road Traffic and Safety: Risk Factors and Recommendations

Abstract

Introduction

Economic Impact of the Road Traffic Accidents

Key Risk Factors

Speed

Drinking and Driving

Distraction While Driving

Use of Seatbelts, Airbags and Child Restraints

Helmets

Preventing Road Traffic Accidents

Box 1. Actions for Road Safety (Source: Violence, Prevention, and Organization 2013)

Recommended Actions

Recommendation 1. Choose a Government Agency to Coordinate the National Road Traffic Safety Program

Recommendation 2. Identify the Challenges, Institutional Regulations and Practices Associated with Road Traffic Injury and the Potential for Road Traffic Injury Prevention in the Country

Recommendation 3. Develop a National Road Safety Model

Recommendation 4. Assign Human and Material Resources to the National Road Safety Project

Recommendation 5. Introduce Specialized Mechanisms to Prevent Road Accidents, Reduce Injuries and Contain Their Effects, and Assess the Success of These Mechanisms

Conclusion

References

About the Author

Chapter 6

An Overview of Determinants of Road Traffic Accidents

Abstract

Introduction

Determinants of Road Traffic Accidents

Over Speeding

Driving under Influence of Alcohol

Non-Use of Motorcycle Helmets

Non Use of Seat-Belts and Child Restraints

Use of Mobile Phones

Risk of Injury from Poor Vehicle Design and Maintenance

Socioeconomic Status and Location

Fatigue

Environment

Poor Road Conditions

Multifactorial Involvement

Prevention of Road Traffic Accidents

1. Epidemiological Studies

2. Setting Targets

3. Public Education

4. Safety Measures

5. Improving Public Transport System

6. Care after Accidents

A. Care before Reaching a Hospital

B. Responsibility of Bystanders

C. Availability of Emergency Services

D. Care by Emergency Services

E. Improving Hospital Care

F. Improving Rehabilitation

7. National Trauma Control Programme: Trauma Centres

8. Way Forward: Investing in Research

Conclusion

References

Chapter 7

Road Safety in Hilly Terrain

Abstract

Introduction

Epidemiology in India

Problem Areas

Road Ethics

Basic Rules

Going Uphill

Hairpins

Going Down Hill

Heavy Vehicle

High Altitudes

Fog Driving

Snow Driving

Black Spots

Suggested Remedial Measures Road Engineering

Road Ecology and Environmental Engineering

The Mobile Phone Menace

Government Initiatives

Indian Governments Current Policy

Conclusion

References

Chapter 8

Road Safety in Conflict Zones

Abstract

Introduction

Preparation

1. Mechanical Factors

Armoured Vehicles

Metals

Glass

Ceramic

Composite

Protective gear

Body Armour

Helmets

2. Human Factors

Training

Prepare with the right equipment

Planning and preparation

Clothing

Communications

3. Environmental Factors

Land mines and unexploded ordnance

4. International Humanitarian Law [10]

Advisory of Travelling in Conflict Zones

Vehicle Check-List [10]

Conflict of Interest

References

Chapter 9

Head Injury: Prevention and Management

Abstract

Introduction

Prehospital Care

First Responder Care

Basic Prehospital Trauma Care

Advanced Prehospital Trauma Care

Legal and Ethical Considerations

Injury Prevention and Control: The Magnitude of the Problem

Need for Prehospital Care

Advanced Prehospital Trauma Care

Prehospital Care in the Community

Identifying a Lead Organization

System models (Varghese et al. 2005)

Medical Direction

Ways to Prevent Brain Injuries

Wear a Helmet, and Make Sure Your Children Wear Helmets When…

Tips on Using Helmets

Avoid Falls in the Home by

Head Injury

Definitions (Gennarelli 1992, Doberstein, Hovda, and Becker 1993, Graham, Adams, and Gennarelli 1993, Biswas 2012)

Pathophysiology (Dunn and Gentilello 2000, Madikians and Giza 2006)

Type of Injuries

Scalp Injuries (Grewal and Gupta 2015)

Skull Fractures (Grewal and Gupta 2015)

Brain Injuries

Traumatic Brain Injury (TBI)

Brain contusions (Brookhuis, de Vries, and De Waard 1991)

Extradural Hemorrhage (EDH) (Pang et al. 1983)

Subdural Hemorrhage (Aoki, Oikawa, and Sakai 1996)

Subarachnoid Hemorrhage (Cantu 1996)

Intracerebral Hemorrhage (Baratham and Dennyson 1972, Bullock et al. 2006)

Intraventricular Hemorrhage (Berry and Rice 1994, Jayakumar et al. 1990, Lee, Lui, and Chang 1991)

Classification

Pupillary Status and Optic Nerve Function

Eye Movements

Motor Examination and Reflexes

Sensory Examination

Local Examination

Investigations

Imaging Modalities Useful In Head Trauma

Skull Radiography

Findings

Limitations

Computed Tomography

Limitations

Magnetic Resonance Imaging

MRI is Sensitive in Detecting

Cerebral Angiography

Other Imaging Modalities

Indications for Admission to the Intensive Care Unit (ICU)

Neurosurgical Indications

Non-Neurosurgical Indications

Care in the ICU

Monitoring in ICU

Indications for ICP Monitoring

Techniques of ICP monitoring

Managing in the ICU

General

Barbiturates

Diuretic

Ventilatory Support

Surgical Measures

Hypo/Hyperthermia

Seizures

References

Chapter 10

Physicians’ Perspectives on Road Traffic Safety

Abstract

Introduction

Global and Indian Statistics

World Statistics

Indian Statistics

Components of Road Traffic Safety

Infrastructure and Vehicle

Drivers

Health System & Road Traffic Safety

Cardiac Diseases

Ophthalmic Diseases

Neuropsychiatric Illness

Geriatrics and Road Traffic Safety

Unseen Effects of Traffic Congestion

Physicians Role in Management of Road Traffic Accident Victim

Conclusion

Acknowledgment

Disclosures

References

Chapter 11

Bicycle-Related Injuries: Prevention and Challenges in Latin America

Abstract

Introduction

Overview

Demographics

Type of Injuries

Latin America

Conclusion

References

Chapter 12

Pre-Hospital Care in Traumatic Brain Injury

Abstract

Introduction

Pre-Hospital Care: Overview

Pre-Hospital Care Goals

Pre-Hospital Management of TBI

Our Experience

Conclusion

References

Chapter 13

Road Traffic and Safety: A Qualitative Study on Experiences and Expectations of Persons with Paraplegia in India

Abstract

Introduction

Handling of the Victim at the Site of Accident

Speed of the Ambulance

Riding A Bike Under the Influence of Alcohol

Accident at Hilly Area

References

Chapter 14

Quantifying the Burden of Road Traffic Accidents

Abstract

Introduction

Health Burden of RTAs

Universal Outcome Scales

Organ-Related Outcome Scores

Problems and Pitfalls

Burden of Injury

Psychological Consequences of Traffic Accidents and Economic Impact on Society

Impact on Families

Social and Economic Loss

Preventing RTAs

Conclusion

References

Chapter 15

Road Traffic Injuries in India: A Systematic Review of the Current Research Scenario

Abstract

Introduction

Low to Middle Income Countries (LMIC) and South East Asia

The Problem of RTIs in India

Materials and Methods

Results

General Epidemiology of RTIs in India

Review of Literature with Regional Representation in India (State-Wise/Regional Epidemiology of Articles)

The Use of ‘Crash Helmets’

The Epidemiology of ‘Alcohol Related RTIs’

Discussion

National Data of RTIs in India

Development and the Increasing Urban Rural Divide

Data Surveillance

Accident Data Collection

Under-Reporting

Developing a ‘Trauma Questionnaire’

Population/Community Based Studies

Consolidating Surveillance

Trauma Registry

General Epidemiology

Differences in Regional Topography and Demography

Age/Sex

Time of Day RTIs

The Seasonal Variation of RTIs

Victim’s Socioeconomic Profiles and Literacy Levels

Vulnerable Road Users

The Problem of Illegal Drivers

Reckless Behaviour of Drivers

Reconsidering Road Design

Types of Vehicles/Speed

Seatbelts

Drunk Driving and the Impact of Alcohol

Motorized Two Wheeler RTIs and the Use of Crash Helmets

The ISI Standard for Helmets

Public Awareness and the Potential to Inculcate Positive Road Traffic Behaviours

Mandatory Helmet Law [MHL] Enforcement

Financial Implications of RTIs in India

Role of the Health Sector and Health Professionals

Pre-Hospital Care

Transportation of Patients

Disabilities and RTIs

Legislation and RTIs

Limitations of Studies

Recommendations

Conclusion

Acknowledgments

References

About the Editors

Index

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