Road Traffic Crashes and Safety Strategies

Road Traffic Crashes

• 34 injuries per 100,000 people annually worldwide
• 1.35 million deaths annually worldwide
• 80% of hospital deaths in Saudi Arabia are due to road traffic injuries
• 20% of hospital bed occupancy in Saudi Arabia is related to road traffic injuries
• Young, economically productive males are the most affected by road traffic crashes

Contributing Factors

• Human Factors*
• Speeding
• Reckless driving
• Younger drivers
• Vehicle Factors*
• Vehicle factors play a minimal role in crashes
• Environmental Factors*
• Weekday rush hour
• Weather has minimal influence

Safety Strategies

• Active Safety Strategies (Prevent crashes)*
• Blind Spot Detection
• Road Sign Recognition Systems
• Lane Departure Warning Systems
• Passive Safety Strategies (Minimize injury during crashes)*
• Airbags
• Seatbelts
• Whiplash Protection Systems
• Pedestrian Safety Features

Haddon Matrix

• Primary prevention: Strategies that prevent accidents from happening in the first place
  • Examples:
    • Speed limits
    • Driver education
    • Road design improvement
    • Enforcement of traffic laws
• Secondary prevention: Strategies that minimize the severity of an accident once it has occurred
  • Examples:
    • Seatbelts
    • Airbags
    • Crash-resistant vehicle design
    • Emergency medical services
• Tertiary prevention: Strategies that minimize the long-term impact of an accident
  • Examples:
    • Rehabilitation services
    • Disability support
    • Psychological counseling

Effectiveness of Strategies

• Evidence supports the effectiveness of active and passive safety strategies in reducing crashes and injuries

Tuberculosis in Saudi Arabia

• Myths and Taboos*
• TB is hereditary: False
• TB always leads to death: False
• TB treatment is expensive: Treatment is free in Saudi Arabia and many other countries
• You can only get TB once: False
• All TB patients are contagious: False, depends on whether the patient has active TB
• Fact*: TB is spread via airborne transmission

Counseling Strategies

• Educate patients and families about TB
• Dispute myths and taboos
• **Provide emotional support for patients: ** TB patients may experience depression, feeling burdened, and isolation
• Discuss medications and side effects: TB medications can have side effects and can lead to feelings of helplessness in families.
• Address sensitive topics such as:
  • HIV
  • Substance abuse (including smoking and alcohol)

Social Factors Contributing to TB

• Poverty:
• Immigrants:
• Prisoners

TB Control

• Screening Methods*
• Mantoux (TST)
• IGRA
• MTB culture
• Microscopy
• National Tuberculosis Control Program (NTP)*
• Aims:
  • Decrease incidence rate to 1/100,000
  • Treat over 85% of TB patients
  • Detect over 70% of estimated TB cases
  • Provide BCG vaccination to all children
• Strategies:
  • Directly Observed Treatment, Short Course (DOTS)
  • Health education
  • Central Unit: in the public health agency
  • TB control manual: reference
  • Laboratory services: 3 levels: peripheral, intermediate/regional, and central/national
  • Treatment services: provided throughout treatment
  • Training: for all healthcare professionals working with NTP
  • Supervision and evaluation: evaluate implementation and manage obstacles
  • Surveillance system: to identify and register cases and notify authorities

Role of Family in TB Management

• Nutrition support: Families can help patients with nutrition to improve endurance
• Informational support: Reminders to take medication and accompanying patients to appointments
• Emotional and psychological support: Helping patients feel motivated during treatment

Preventive Measures

• For Family and Healthcare Workers*

• Administrative control: Reduce exposure to patients with infectious TB

• Environmental control: Reduce the concentration of infectious droplets

• Respiratory control: Use personal protective equipment (PPE)

Contact Tracing

• The public health nurse investigates all close contacts of a confirmed TB case
• Close contact defined as: close, regular, prolonged contact with a patient while they are infectious, without wearing proper PPE
• Screening and education for close contacts

Vaccination

• Nature of Vaccines*

• Live attenuated vaccine: weakened pathogen; chickenpox, yellow fever, MMR, Sputnik

• Inactivated vaccine: dead pathogen; hepatitis A, rabies

• Subunit/conjugate vaccine: pieces of pathogen; pneumococcal, HPV

• Toxoid vaccine: toxin of pathogen; tetanus

• mRNA vaccine: leading the body to synthesize the foreign protein; COVID-19 Pfizer

• Viral vector vaccine: antigen similar to target pathogen; COVID-19 AstraZeneca

• Impact of Vaccines*

• Herd Immunity:

• Increased life expectancy

• Economic growth promotion

• Protection against bioterrorism

• Control of morbidity and mortality

• Mitigation of disease severity

• Prevention of infection

• Vaccines Available in Saudi Arabia*

• Children and adults

  • DTaP: diphtheria, tetanus, and pertussis (at age 7)
    • Tdap: booster shot at age 11
  • MMR: measles, mumps, and rubella
  • Polio
  • Influenza
  • Meningitis
  • Pneumococcal pneumonia
  • Varicella influenza
  • HPV
  • Herpes zoster
  • HiB

Systemic Thinking in Healthcare

• Adverse Events*

• Adverse effect: an undesired harmful effect

• Side effect: secondary to a main therapeutic effect

• One in ten patients is harmed while receiving hospital care globally

• 50% of adverse events are preventable

• Serious adverse events include death, disability, permanent damage, congenital anomalies

• Medical Errors*

• Errors occur by doing the wrong thing (commission) or failing to do the right thing (omission)

• Iatrogenesis: medical errors defined as mistakes, inadvertent occurrences, or unintended events in healthcare delivery that may result in patient injury.

• Preventable causes: fatigue, user error, inexperience, human errors

• Most common preventable errors: misdiagnosis, delayed diagnosis, faulty medical device, infection

• Systemic Approach*

• Shift from blame culture to a just culture to minimize future adverse events.

• Factors leading to errors:

  • Lack of standard procedures
  • Poor communication
  • Lack of verification
  • Lack of patient involvement

• Minimizing Adverse Events*

• Mature health system: takes into account the increasing complexity in healthcare settings that make humans more prone to mistakes.

• Physician disclosure of adverse events: to patients and institutions

• Financial burden for patients: institutions should ensure patients are not burdened financially

• Root cause analysis: Conduct a root cause analysis of the adverse event and develop an action plan

• Apology: If an error occured, the institution should offer an apology

• Technology transition policies:

• Communication: The key to improving patient safety is transparent communication

This quiz explores the alarming statistics related to road traffic crashes, including injuries and fatalities. It also examines contributing factors such as human behavior and environmental conditions, while discussing various safety strategies employed to prevent accidents and minimize injuries. Test your knowledge on road safety and its impact.