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Motor Vehicle Incidents (motor + vehicle_incident)

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Medical Sciences	100%

Selected Abstracts

Can First Responders Be Sent to Selected 9-1-1 Emergency Medical Services Calls without an Ambulance?

ACADEMIC EMERGENCY MEDICINE, Issue 4 2003
Craig B. Key MD
Objectives: To evaluate the feasibility and safety of initially dispatching only first responders (FRs) to selected low-risk 9-1-1 requests for emergency medical services. First responders are rapidly-responding fire crews on apparatus without transport capabilities, with firefighters trained to at least a FR level and in most cases to the basic emergency medical technician (EMT) level. Low-risk 9-1-1 requests include automatic medical alerts (ALERTs), motor vehicle incidents (MVIs) for which the caller was unable to answer any medical dispatch questions designed to prioritize the call, and 9-1-1 call disconnects (D/Cs). Methods: A before-and-after study of patient dispositions was conducted using historical controls for comparison. During the historical control phase of six months, one year prior to the study phase, basic life support ambulances (staffed with two basic EMTs) were dispatched to selected low-risk 9-1-1 incidents. During the six-month study phase, a fire FR crew equipped with automated external defibrillators (AEDs) was sent initially without an ambulance to these incidents. Results: For ALERTs (n= 290 in historical group vs. 330 in study group), there was no statistical difference in the transport rate (7% vs 10%), but there was a statistically significant increase in the follow-up use of advanced life support (ALS) (1% vs 4%, p = 0.009). No patient in the ALERTs historical group required airway management, while one patient in the study group received endotracheal intubation. No patient required defibrillation in either group. Analysis of the MVIs showed a significant decrease (p < 0.0001) in the patient transport rate from 39% of controls to 33% of study patients, but no change in the follow-up use of ALS interventions (2% for each group). For both the ALERTs and MVIs, the FR's mean response time was faster than ambulances (p < 0.0001). Among the 9-1-1 D/Cs with FRs only (n= 1,028), 15% were transported and 43 (4%) received subsequent ALS care. Four of these patients (0.4%) received intubation and two (0.2%) required defibrillation. However, no patient was judged to have had adverse outcomes as a result of the dispatch protocol change. Conclusions: Fire apparatus crews trained in the use of AEDs can safely be used to initially respond alone (without ambulances) to selected, low-risk 9-1-1 calls. This tactic improves response intervals while reducing ambulance responses to these incidents. [source]

Risk factors for serious injury in Finnish agriculture

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2009
Risto H. Rautiainen PhD
Abstract Background Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. Methods We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of ,2000). Results A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. Conclusions Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls. Am. J. Ind. Med. 52:419,428, 2009. © 2009 Wiley-Liss, Inc. [source]

Farm-related fatal injury of young and older adults in Australia, 1989,1992

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2002
Rebecca J. Mitchell
Abstract: This paper describes the types of, and circumstances surrounding, unintentional farm-related fatal injuries involving young and older adults in Australia. Information was obtained from an inspection of coronial files for the period 1989,1992. Around 14% of all farm-related fatalities in Australia during 1989,1992 were of young adults aged 15,24 years and approximately one-quarter were of older adults aged , 55 years. Young adults were commonly fatally injured in motor vehicle incidents and in incidents involving firearms. Tractors were the most common agent involved in fatal incidents involving older adults. Intervention measures to prevent fatalities of older adults in agriculture should focus on the safe use of tractors, while for young adults it appears prevention efforts should centre around safe use of firearms and operation of motor vehicles on the farm. Ways to overcome barriers to the use of injury prevention measures in rural Australia should be further explored. [source]

FARM-RELATED FATAL INJURY OF YOUNG AND OLDER ADULTS IN AUSTRALIA, 1989,1992

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2002
Rebecca J. Mitchell
ABSTRACT: This paper describes the types of, and circumstances surrounding, unintentional farm-related fatal injuries involving young and older adults in Australia. Information was obtained from an inspection of coronial files for the period 1989,1992. Around 14% of all farm-related fatalities in Australia during 1989,1992 were of young adults aged 15,24 years and approximately one-quarter were of older adults aged? 55 years. Young adults were commonly fatally injured in motor vehicle incidents and in incidents involving firearms. Tractors were the most common agent involved in fatal incidents involving older adults. Intervention measures to prevent fatalities of older adults in agriculture should focus on the safe use of tractors, while for young adults it appears prevention efforts should centre around safe use of firearms and operation of motor vehicles on the farm. Ways to overcome barriers to the use of injury prevention measures in rural Australia should be further explored. [source]