About Medicine: Trauma on the roads

William Torres Jr.
EMS Department Head
Marcus Daly Memorial Hospital
1200 Westwood Drive
Hamilton, MT 59840
wtorres@mdmh.org


Trauma on the Roads
As first responders, we are often called to highways or intersections for motor vehicle collisions. Depending on the service or agency dispatched the roles may be a little different. One common role is to respond safely and work together to provide care if needed and eliminate any hazard or potential hazard.

Law Enforcement will protect the scene and first responders while documenting and, if necessary, investigating the scene. Preserving evidence is also critical when a fatality has or likely will occur. Fire departments respond to provide extrication when necessary, stabilization of vehicles, and fire suppression. There are so many components on newer cars and they remain current with the potential hazards.

EMS agencies respond to motor vehicle collisions when injuries have have been sustained. They can provide a patient assessment, treatment, and transportation to an emergency department. When pain is present it usually means that further assessment by an health care provider is required. Additional diagnostic testing including x-ray is not available at the scene. Law Enforcement and fire departments often assist EMS when needed.

Towing companies and air medical services also play a role at motor vehicle collisions. They are contacted when necessary to clear roadways and provide rapid transportation when serious injuries have occurred.

Montana has experienced seven fatalities this year compared to five this time last year. There were one-hundred ninety in 2016. The Montana Department of Transportation has developed a mufti-faceted initiative, Vision Zero, to reduce or eliminate fatalities. By developing safer roads and safer people we can work toward this goal. Being aware of the speed limit and wildlife crossings are just two examples of safer roads.

Educating our driver's and other users of the road are important parts of any injury reduction program. Wearing a seatbelt will keep you safer in a vehicle and reduce the likelihood of an injury during a collision. The use of a helmet when riding a bike or motorcycle is also an important part of injury prevention.

Another important factor is driving under the influence of alcohol or drugs. Driving is considered a privilege and not a right. When you drive under the influence it reduces your reaction time and drastically reduces your ability to react and avoid a collision.

The stereotype is driving with an open container. However, there has been an increase of prescription use causing impairment. It is always important to discuss driving while on a medication with your health care provider or pharmacist. Having this discussion will inform you of the potential increased risk.

Distracted driving is also a huge factor when reviewing causes of collisions. Texting while driving, eating, applying makeup, and phone use are some of the multitasking that increases our risk of being involved in a motor vehicle collision. Even map reading or changing the radio station can be a distraction and increase your risk for a collision. Another possible cause of distraction is the passenger in your vehicle. Their use of electronic devices can often distract a driver.

One law that has saved lives is mandating that traffic slows down and change lanes if possible when passing a stopped emergency vehicle with activated emergency lights. This law protects first responders while operating at a scene. There are many responders at a scene providing assistance and this law assists with their safety. The risk of a fine for not slowing down and changing lanes fails to compare to the risk to our first responders operating at a scene.

Passing vehicles only when clearly marked or appropriate is important. There are many factors used when deciding when passing vehicles are appropriate and marked. Blind spots, speed, and weather should also be considered even when passing is allowed.

The trauma system deploys resources that will prevent injuries on our roads.

Motorcycle and bike safety are two of the programs in progress. Bike safety entails using resources to educate drivers and families on bike safety. Many areas have bike helmet programs that provide helmets to children who bike. There is a dramatic reduction in risks for a head injury when utilizing a helmet.

The trauma system in Montana was created in 2006 and has shown improvement with the likelihood of surviving a motor vehicle collision. This is due to emphasis on prevention including helmet programs. It also focused on emergency medical services and hospitals being trained and working together to transport patients to the closest most appropriate facility. We continue to improve our response to and treatment of patients both in the pre-hospital and hospital setting.

By working together to share the road and accept the responsibility for its use, we can improve our safety and the safety of our first responders.

The health column is a brought to you by collaboration amongst the Ravalli Republic and Marcus Daly Memorial Hospital. For questions and or comments about this week's health column, please contact Willie Torres, Jr., EMS Department Head, wtorres@mdmh.org at Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton MT 59840. Working together to build a healthier community!
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