Nearly twice each minute someone dies from traffic-related injuries, according to data from the WHO. These injuries are among the main causes of mortality among people aged 15 years to 44 years and the injuries are also the leading cause of death among people aged 15 years to 29 years, according to Adeloye and colleagues
Overall, 10% of global mortality can be attributed to traffic-related injuries, according to Krug and colleagues. Eighty-nine percent of such deaths occur in low-income or middle-income countries, according to Lansik and colleague. These statistics only give an overview of the problem. About 25 million people are permanently handicapped due to these types of injuries, which underscores the need for immediate, quality care following an emergency situation.
According to Peden and colleagues, there can be a 15% to 25% reduction in the mortality associated with emergency injuries when an individual is treated at an Advanced Trauma Life Support center. MacKenzie and colleagues found when hospitals met certain basic quality criteria for the structure of the care delivered and the processes used, it could reduce preventable mortality. In addition, it has been shown that patients treated in trauma centers have significantly fewer complications and lower mortality rates than patients treated in non-trauma centers.
Thus, when a patient is treated in a hospital that meets these handling and structural requirements, lives can be saved and disability may be prevented. In fact, the main problem is often not the patient’s need for emergency treatment, but whether it is possible for them to get to the right hospital in a timely manner.
Need for travel safety
The Freedonia Group reported in 2014 that the global security industry generates annual revenues of about $154 billion, about $131 billion of which is earmarked for securing physical buildings and other tangible assets. According to the Global Business Travel Association, businesses face increasing responsibilities to provide safety and security to their traveling workforces. Therefore, the focus has shifted away from securing structures and toward securing the worldwide workforce.
In a world that is more globalized than ever, more people travel to high risk destinations and are more inclined to drive automobiles when they are there. Statistics from Adeloye and colleagues showed low-income and middle-income countries have fewer than 50% of the world’s registered vehicles. However, in 2013 more than 85% of the deaths and 90% of the disabilities due to automobile crashes occurred in those types of countries. This is often due to travelers who are driving in unfamiliar locations and their lack of knowledge of the local language and how and where to obtain medical assistance. This only compounds the problems associated with obtaining qualified emergency medical care in those geographic areas.
From the perspective in Sweden, these types of problems were evident in 2004 when southern Thailand was struck by a tsunami. Many injured individuals ended up worse off because they were treated at tertiary hospitals, unaware at the time that good emergency care was available nearby.
Global ranking system
Global ranking of hospitals by the level and quality of care that is available can be invaluable. A standardized global ranking system that includes, at minimum, quality grading of emergency care centers based on the facility’s emergency structure, is long overdue. Such a system would facilitate individuals finding appropriate medical care when traveling, particularly in low-income nations. Some countries already rank their hospital and trauma care with their own three-tier or four-tier ranking scheme. For example, domestic standards for trauma care and the trauma network now exist in the United Kingdom and Germany.
Although there is clearly more insecurity among international travelers, the problem of travel in high-risk, uncertain areas of the world is not on the decline based on Global Warning Systems (GWS) statistics released in 2016. International tourist arrivals increased 4.4%, in 2015, business travel remained strong and it is expected to increase in the future.
Researchers at the University of Lund Sweden spent the past 3 years mapping the emergency structure of individual hospitals worldwide and plan to share their findings through a new service for worldwide travelers that will launch in conjunction with the Rio Olympic Games that begin 5 August.
The service — the CareFindy application — is part of the updated Olympic services of GWS. It provides precise information and navigation on a map that guides users to the best and nearest location for emergency treatment. CareFindy, to be initially released as a smartphone app, will provide online GPS routing to the nearest appropriate hospital based on the user’s location during an emergency situation, such as an automobile crash or a climatological, hydrological, geophysical or terroristic disaster. The app tags appropriate health care centers on a map and provides audio information to help visually impaired users. It calculates the distance between the current location of the user and the location of the nearest appropriate health care center using a position-based routing formula.
Developers of the app have designed features into it that will function well in emergency situations. For example, the system, map function and routing are accessible offline, which is helpful when there are overloads in cellular data traffic.
The CareFindy system will also be included in the GWS system, which is a personal security service that can be used when traveling. Once downloaded, the GWS app sends information about local disasters and other threats to a traveler’s smart phone.
- Adeloye D, et al. Bulletin of the World Health Organization. 2016;doi.org/10.2471/BLT.15.163121.
- Global Business Travel Association. Guide to travel risk management and duty of care. www.gbta.org/Lists/Resource%20Library/GBTA%20Toolkit/GBTA%20Toolkit_revised_DR7.pdf. Accessed July 8, 2016.
- http://globalwarningsystem.com. Accessed July 8, 2016.
- Krug E, et al. Am J Public Health. 2000;90:523-526.
- Lansik K, et al. Curr Opin Crit Care. 2007;13:686-690.
- MacKenzie E, et al. N Engl J Med. 2006; 354:366-378.
- Peden M, et al. (2004) World report on road traffic injury prevention. WHO, Geneva. http://whqlibdoc.who.int/publications/2004/9241562609.pdf. Accessed July 8, 2016.
- http://riosafety2016.com. Accessed July 8, 2016.
- The Freedonia Group. World Security Services report November 2014. Cleveland: The Freedonia Group; 2014.
- WHO. Global status report on road safety 2013: supporting a decade of action. Geneva: WHO; 2013.
- For more information:
- Wahid AlKharusi, MbChB, FRCS, is Ambassador Muscat Oman and chief of trauma, orthopedics & rehabilitation at Khoula Hospital. He can be reached at Al-Wattaya, Muscat, SULTANATE OF OMAN; email: firstname.lastname@example.org.
- Karsten E. Dreinhöfer, MD, PhD, is professor at Charité Universitätsmedizin and Medical Park Humboldtmühle, Berlin, Germany, and an Orthopaedics Today Europe Editorial Board member. He can be reached at email: email@example.com.
- Lars Lidgren, MD, PhD, is professor in the Department of Orthopaedics, Clinical Science, Lund University, Lund, and an Orthopaedics Today Europe Editorial Board member. He can be reached at email: firstname.lastname@example.org.
- Marcos E. Musafir, MD, is Master in Orthopedics and Trauma, Federal University of Rio de Janeiro, and State Secretary of Health of the State of Tocantins – Brazil. He can be reached at SBOT, Rua São Sebastião, 650 - CEP 04708-001, Chácara Sto. Antônio, São Paulo, Brazil; email: email@example.com.
Disclosure: Lidgren is a founder of Global Warning System Production AB and is a shareholder in the company. AlKharusi, Dreinhöfer and Musafir have no relevant financial disclosures.