Pedestrian safety - Global Road Safety Partnership

Implementing pedestrian safety interventions
Figure 4.1 The chain of trauma care for injured pedestrians
Bystander
first aid
Rehabilitation
Access to
emergency
medical
services
Intensive care
Prehospital
care at
roadside
Specialist
intervention
Appropriate
transportation
to hospital
Early
resuscitation
Rapid
diagnosis
Source: adapted from the Life Saving Chain (see reference 52)
Pre-hospital care
The majority of deaths from road traffic injuries occur prior to the patient reaching
a hospital. Timely pre-hospital care and prompt transportation to an appropriate
health facility or trauma centre are crucial to the outcome of injured pedestrians.
Many high-income countries have developed complex and expensive systems for
providing emergency medical care. A formal emergency medical service (EMS),
easily accessed through an emergency telephone number, is in place, especially in
urban areas, to offer pre-hospital care by professionally trained staff. The injured
patient is transported by ambulance equipped with monitoring devices, a wide
range of medicine and wireless communication, that is staffed by a physician or
non-physician paramedics to render advanced pre-hospital trauma care. The goal of
such a service is to quickly identify and treat life-threatening injuries until the patient
arrives at a definitive care centre. Triage and direct transfer to a trauma centre has
been shown to reduce mortality rates among severely injured patients, including
pedestrians (53). In many communities, bystanders and other first responders such as
police, rescue workers and firemen are trained in first aid to help such victims before
the medical help arrives at the scene.
It should be noted that a majority of the world’s population does not have access to
such an advanced level of pre-hospital care. In many countries, few victims receive
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