Road Traffic Injuries - thaipediatrics.org · Road traffic injuries are defined as: “Fatal* or...
Transcript of Road Traffic Injuries - thaipediatrics.org · Road traffic injuries are defined as: “Fatal* or...
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Road Traffic Injuries
พญ. รชดา เกษมทรพย
สถาบนสขภาพเดกแหงชาตมหาราชน
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สถาบนการแพทยฉกเฉนแหงชาต เปดสถตเดกเจบปวยฉกเฉนในป พ.ศ. 2556 มากถง 899,817 คน
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Road traffic injuries are defined as:
◦ “Fatal* or non-fatal injuries incurred as a
result of a road traffic crash.”
◦ Pedestrians, bicyclists, motorcyclists, or
vehicle occupants (cars or large vehicles)
* Fatal: those individuals that die within the 30
days
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The Burden of Road Traffic Injuries
Nearly 1.3 million annual deaths
worldwide
A leading cause of death globally
Up to 50 million people are non-fatally
injured or disabled
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For children aged 15-17 years, there is no greater threat to their lives than a road traffic crash.
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Every four minutes a child is prematurely lost on the roads of this world. Many more are injured,
often severely.
สลด แมพาลกวย 3 ขวบ ซอนดานหนารถจกรยานยนต ขณะจอดรอเพอขามแยก ลกชายบดคนเรงเครองพงเสย 18 ลอ ลกเสยชวตคาท แมเจบสาหส
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การประมาณการตายของเดกอายต ากวา 15 ปจากการขบขและโดยสารยานพาหนะตางๆในป 2556
รวม
% จ ำนวน % จ ำนวน
จกรยาน 13.68 39 0.78 3 42
จกรยานยนต 85.26 242 57.36 223 465
รถยนตทก ประเภท 1.05 3 35.66 139 142
รวม 284 365 649
ผขบข ผโดยสาร
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การประมาณการบาดเจบของเดกอายต ากวา 15 ปจากการขบขและโดยสารยานพาหนะตางๆในป 2556
รวม
% จ านวน % จ านวน
จกรยาน 26.59 2945 6.61 728 3673
จกรยานยนต 72.87 8071 70.42 7752 15823
รถยนตทกประเภท 0.3 33 18 1981 2015
รวม 11049 10461 21510
ผขบข ผโดยสาร
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Injuries occur as the result of events that can be predicted and prevented
Injuries are not “accidents”
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Children are Not Small Adults
21% of all road traffic deaths are children
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Nonfatal Road Traffic Injuries
in Children
10 million children injured or permanently
disabled each year
Psychological, social and family
consequences.
Children can be orphaned or enter severe
poverty at the loss of their adult caregivers
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Factors Affecting Child Injury
Age
&
Development
Physical characteristics (small body, difficult to see surrounding areas,
and others to see the child.)
Cognitive abilities
(inappropriate judgment)Dependence
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Risks Associated with the Child
Child development
◦ physical characteristics
◦ cognitive abilities
Child degrees of dependence and
behaviours
Child gender
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Development
Physical characteristics:
◦ Larger and relatively softer heads
◦ Smaller physical stature
Cognitive abilities:
◦ sensory facilities and ability to synthesise
information is less developed
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ศรษะเดกน าหนกมากถงรอยละ 30 ของน าหนกตว ขณะทผใหญมน าหนกศรษะเพยงรอยละ 6 ของน าหนกตว เวลาพงกระเดนกระดอน เดกจะพง
เหมอนลกแบดมนตน!
ศรษะเดก
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Infant neck muscles are not well developed.
Risk to C-spine injury
กลามเนอตนคอออนแอ
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Degrees of Dependence & Behaviour
Very young children and infants are entirely
dependent on adult caregivers
Older children and adolescents have
increasing independence, and may engage in
risky or unsafe behaviours
Peer pressure can increase risk taking
behaviour
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Gender
Male children have nearly 2 times as many
road traffic injury deaths as female
children
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Risks Associated with Road Use
Pedestrians
Occupants
Bicyclists
Motorcyclists
Young driver
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Pedestrians
Single largest category of road traffic
injuries involving children worldwide
HIC: 5-10%
LMIC: 30-40%
Risk: mixed traffic where it is common to
walk along side roads
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Occupants
50% of child road traffic injury deaths in
HIC
Emerging problem in LMIC
Risks:
◦ Lack of appropriate restraints
◦ Child being placed in the front seat of the car
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Bicyclists and Motorcyclists
Bicyclists:
3-15% of child road traffic injuries
Up to 33% of child road traffic injury deaths
Motorcyclists:
A leading cause of mortality
Risks:
Lack of helmet use
Mixed traffic use
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Young Drivers
Major cause of road traffic injury death in HIC
A 16 year old is 4 times more likely to have
fatal car crash than a 25-29 year old
Risks:
◦ Drink driving
◦ Speeding
◦ Non-use of seat belts
◦ Distraction
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System’s Approach to
Road Traffic Injury Prevention
The Child
The Environment The Vehicle
Education
Engineering
Enforced Legislation
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The Child
Education can improve skills and improve behaviour
◦ Road and bicycle skills
◦ Driver education with phased licensure
Engineering protective equipment decreases injury
risk
◦ Child restraints
◦ Helmets
Enforced legislation improves uptake and effectiveness
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The Vehicle
Engineering cars for safety prevents injury
Crash-protective:
◦ crumple zones
◦ side impact bars
◦ redesign front bumpers
◦ alcohol interlock systems
◦ speed governors
Enforced legislation improves uptake and effectiveness
Improving visibility:
– reversing cameras
and alarms
– daytime running lights
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The Environment
Engineering modifications to roads decreases risk
◦ Reducing speeds
◦ Separating mixed traffic
◦ Pedestrian walkways
◦ Safe routes to school
◦ Safe play areas
Enforced legislation improves uptake and effectiveness
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Decade of Action for Road Safety
By 2020, road traffic injuries will become
the 3rd leading cause of death
The UN ‘global plan’ aims to save 5
million lives from road traffic injuries in
the decade between 2011 – 2020.
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Effective Interventions to
Child Road Traffic Injury
Prevention
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Effective Interventions
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Engineering
Using appropriate child
restraints & seat belts
Wearing bicycle and
motorcycle helmets
Environment modifications
to slow speeds
Separating mixed traffic
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นางเลกทนงซอนทายไดอมนองดาว อาย 9 เดอน มาดวย แตจ ๆ ชายผาเชดตวนองดาวไดหลดออก และถกดงเขาไปในลอรถจกรยานยนตทดานหลง ท าใหนองดาวเขาไปตดอยระหวางโชคอพกบลอรถ เมอหยดรถนายรสและนางเลก ทอยในอาการตกใจ ไดพยายามชวยนองดาวออกมาแตไมส าเรจ พลเมองดจงโทรศพทแจงเจาหนาทกภย ซงเจาหนาทตองลงมออยางระมดระวง และใชเวลารวม 20 นาท กวาจะชวยเหลอออกมาได จากนนจงน าตวนองดาวสงโรงพยาบาลใกลเคยงเพอใหแพทยท าการรกษาอยางเรงดวน
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• หมวกนรภยลดการตายจากอบตเหตได 29%• ลดการบาดเจบทศรษะได 40%
พรบ จราจร มาตรา 122 ผขบขรถจกรยานยนต และผโดยสารตองสวมหมวกนรภย รวมทงเดกทกวย
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เพอลดการตายของเดกจากการโดยสารรถยนต การนงรถยนตทกประเภทตองบงคบใหเดกใชระบบยดเหนยวเพอยดตวเดกไวไมใหกระเดนออกนอกรถ หรอกระแทกกระทนโครงสรางภายในตวรถ ระบบยดเหนยวดงกลาวประกอบดวยเขมขดนรภยและทนงนรภย
ทงนตองครอบคลมทกทนงในรถยนต
ขอแนะน าราชวทยาลยกมารแพทยแหงประเทศไทย
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เขมขดนรภย?
ส าหรบเดกนนจะใชเขมขดนรภยไดเหมาะสมปลอดภยกตอเมอ ...มอาย 9 ปขนไป หรอ มน าหนกมากกวา 30
กก หรอความสงตงแต140 ซ.ม. ขนไป...เทานน มฉะนนเขมขดนรภย อาจกลายเปนตวการท าอนตรายตอเดกๆอยางรนแรง
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ในเดกอายนอยกวา 9 ป ตองใชทนงนรภยใหเหมาะสมตามวย และตองยดเหนยวใหถกวธตามค าแนะน าของแตละผลตภณฑ
ขอแนะน าราชวทยาลยกมารแพทยแหงประเทศไทย
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ทนงนรภยส าหรบเดกอายนอยกวา 2 ปหรอน าหนกนอยกวา 12 กก.
ตองใชทนงทหนหนาไปทางดานหลงรถ (rearward facing seat) หรอ ทนงส าหรบทารกและเดกเลก (convertible seat) ทสามารถใชกบเดก แรกเกดถงอาย4 ปไดดวย แตตองใชบนทนงดานหลงและหนหนาไปทางดานหลงเทานน
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Never have a child in the Front Seat
with an Airbag
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เดกอาย 2-6 ป ใชทนงนรภยส าหรบเดกเลก• โดยใหนงเบาะหลงและหนหนาไปทางดานหนารถตามปกตได (forward facing seat) ทนงนรภยส าหรบเดกวยนยงคงมเขมขดนรภยในตวเปนแบบยดเหนยวรางกายเดกไว 5 จด
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เดกอาย 4-11 ป ใหใชทนงทนงเสรม (booster
seat) เพอยกตวใหสงพอทจะใชเขมขดนรภยของรถยนตได ซงจะราคาประหยด ไมมเขมขดนรภยในตว ใชเขมขดนรภยรถยนตเปนอปกรณยดเหนยว
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ในรถเกงทมทนงตอนหลงเดกอายนอยกวา 13 ปควรใหนงทางดานหลง การนงเบาะทนงตอนหลงจะลดความเสยงตอการบาดเจบรนแรงเมอเกดอบตเหตลงไดถง 5 เทา
ยกเวนทนงตอนหลงของรถปคอพ(สวนแคป) ซงความกวางไมเพยงพอ เมอเกดอบตเหตพบวาอตราการบาดเจบไมแตกตางจากผนงตอนหนา
ขอแนะน าราชวทยาลยกมารแพทยแหงประเทศไทย
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เปาหมายแรก..
ในโรงพยาบาล..
ฝากครรภ หลงคลอด
และคลนกเดกสขภาพ
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เปาหมายตอไป..ในโรงเรยน
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Enforced Legislation
Drink driving laws
Motorcycle helmets
Graduate car driver licensing systems
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Emergency and Trauma Care
Improving or creating pre-hospital care
infrastructure and delivery
Improving the organisation, training and access to
in-hospital trauma care
Strengthening rehabilitation services and access
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