CHARACTERISTICS OF ROAD TRAFFIC ACCIDENTS CAUSES, INJURIES AND OUTCOMES ENCOUNTERED IN FAISALABAD BETWEEN 2016-2019

METHODOLOGY: All Road Traffic crashes and victims in Faisalabad city of Pakistan which were initially managed by Rescue 1122 between 2016 to 2019 were included in the study. Total sample size was 101995. It is descriptive cross-sectional study which includes patients of different ages, sex and motor-vehicles accidents having different injury sites. BACKGROUND & OBJECTIVE: Road traffic accidents are the ninth leading cause of death worldwide, contributing significantly to global disease burden. Emergency Medical services(EMS) play a role in minimizing the morbidity and mortality. Our objective was to determine the characteristics of injury pattern and causes encountered in Road Traffic crashes (RTCs) managed by 1122 in Faisalabad Pakistan and to access the outcome of these accidents.

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According to latest WHO data published in 2017 Road Traffic Accident death reached 27,081 or 2.2% of total deaths. Recently in Lahore we have seen a dramatic increase in the traffic load. About 132,504 victims of road traffic accidents [4] have been reported in between 2005-2010 . An epidemiological survey of Karachi Pakistan largest city reported 1130 road traffic accidents [5] fatalities in 2013 .Several studies indicate that use of phones during driving results in road [6] traffic accidents .According to Pakistan Bureau of Statistics (PBS) 10779 cases were reported to police in 2018-19, out of which 5932 died and in Punjab 4823 cases were reported and 3423 people died.
The disability and death rate is more common in males approximately 83% due to road traffic crashes. Economic loss in developing countries due to road traffic accidents estimated to cost 1 to 4 % of country's GNP per annum. It is projected that globally in 2020 RTCs will cause 20 million deaths and will be upgraded from rank ninth to third leading cause of death and [8] 10 to 30% of Hospital admissions .

INTRODUCTION:
Weather is also important factor and driving should be a matter of great concern in bad [7] weather .
However very few studies have been conducted in our setting about RTA outcomes and importance of post-crash or prehospital care in preventing the disabilities and fatalities.
T h e r e f o r e t h i s r e s e a r c h w i l l f o c u s o n preventable injuries, their characteristics and associated factors encountered by RTA victims. It will help medical professionals to reduce RTA related fatalities and disability and will also enable policy maker to develop better strategies to minimize the human loss and preventable injuries by improving the road safety measures. It may also increase general awareness about pre-Hospital care.
All Road Traffic crashes and victims in Faisalabad city of Pakistan which were initially managed by Rescue 1122 between 2016 to 2019 were included in the study. Total sample size is 101995. The data collected was registry base and collected from rescue 1122 control room. It is descriptive cross sectional study. Pedestrians were not included in this study. All males and females having vehicle accident due to over speeding carelessness, wrong U turn, tyre burst and one wheeling which were having spinal cord, head, minor major fracture injuries are included. Data is presented through excel version 2016.

RESULTS:
The  (Table-I

DISCUSSION:
This study focused on injuries encountered by Road traffic crashes victims and their outcomes reported to Rescue1122 in Faisalabad.This study and its finding can be used as a window to preview into high alarming situation of RTCs in Faisalabad and its periphery. Males suffered from accidents more than females similar to previous studies conducted in other region of [9] world like in Ethiopia .
Most prevalent age group injured in our study b e t w e e n 2 1 -3 0 ye a r s . T h i s i s a l s o i n correspondence with studies conducted in [10,11] Tanzania and other country . This is the most energetic yet inexperienced age group of population. Several factors likes rash/reckless driving, one wheeling bike races on main road are commonly observed in young people. [12] Motorcyclists are common effected . They are highly indulged in dangerous activities than any other age group. Our study showed that over speeding is the most common cause of RTCs (56.8%). Although it has not been mentioned in our study but alcohol is an important factor and [13,14] associated with a lot of causalities .
However a study conducted in Karachi few years ago showed higher incidence of head injuries in RTCs victims contrary to pattern observed in our [16] research .
Most of the accidents occur as the result of collision with another vehicle which is consistent with the result of a research conducted in [17] Yemen due to haphazard driving seen in the road users in haste to reach their destination as soon as possible neglecting many road rules. This is the preventable factor since laws can be made to control traffic and its flow especially in developed countries but unfortunately these rules are not followed in our country. Musculoskeleton injuries are more prevalent in study with fractures are most common injury encountered. Minor and single fractures are more common injuries in our study. A research conducted in Lahore show similar results in this regard fracture and musculoskeletal injuries [18] being highest in RTCs victims they studied .
Although some people lost their lives while others suffered from permanent disability but outcome of our research showed that most people were alive but unstable.This study has few limitations; the reported RTCs did not include pedistarian, cyclist or the severity. Therefore various proportions of victims and their attributes may not represent the full picture of RTCs in Faisalabad.
Motorcyclists were the most injured of the road user group in this study. This finding is also similar to researches conducted in developing [ 1 5 ] countries like Tanzania . The use of motorcycles in our country strikingly increased in last few decades as motorcycle being the fastest and cheapest mean of transportation. But this two wheeled vehicle is unstable as hamlet use is also very minimal in motorcyclists it increases the risk of RTCs and puts the rider's life on stake.
Accidents are increasing year by year as our research shows a 0.4% increase in accidents as compared to 2016, that was rose to 12.5% in 2019. This result also correlates with the [16] research conducted in Lahore . Several studies indicates that developing countries are affected more due to cultural issues and road [19,20] conditions .

CONCLUSION:
Pre-Hospital care has been proved an important factor in preventing the fatalities as result step should be taken to provide this facility in every setting. First aid education should be given in every institute. This will help in improving the quality of life in causality victims.
The burden of RTCs emergencies attended by the Faisalabad Rescue1122 ambulance services is increasing with the passage of time and this research has provided important information about the causes and its associated factors. Most of them are preventable and policy makers should make and enforce proper laws to ensure proper safety. Helmet use must be ensured in motorcycle users to prevent head injuries and traffic rules should be strictly followed.

ACKNOWLEDGMENT:
Rescue 1122 Faisalabad office has given the detailed data regarding the road traffic accident characteristics injuries, causes and their outcomes encountered in Faisalabad in between 2016-2019.