Source: Asia Development Bank
For a post-crash response to be effective, it requires a systematically coordinated, well-integrated, and geographically organized approach. It demands a seamless delivery of inclusive and comprehensive care across the continuum—from the time of injury to transport to acute facilities, and to rehabilitation.
Key approaches to improve trauma-care response are as follows:
Prehospital care (provided at the scene of the crash):
- Communication – An effective emergency response system relies on a single, universally-recognized, and easy-to-remember emergency number. Many low and middle-income countries face fragmented emergency services, often operating multiple systems with different contact numbers, which hampers timely response.
- Emergency Transport – A well-organized system facilitates timely dispatch of appropriately equipped ambulances based on accurate information from the scene. A clear guideline on different types of transportation available depending on the severity and urgency of the case can minimize the risk of resource overuse. Many low and middle-income countries lack sufficient and properly equipped emergency transport services.
- Triage – Efficient triage systems help assess the severity of injuries, prioritize treatment needs, and allocate medical resources accordingly. This process ensures that patients receive the right care at the right time for improved overall outcomes.
- First aid management – In the absence of trained personnel, immediate care may be provided by bystanders or lay first-responders to stabilize victims quickly in remote or underserved areas. Therefore, community health literacy and basic first-aid training for the general public are essential.
Hospital care:
- Human Resources – An adequate number of staff who are well trained and equipped in the case of emergency crisis, and who receive appropriate administrative support can provide timely and effective care.
- Infrastructure – Hospitals equipped with appropriate trauma facilities, medical equipment, and sufficient supplies can manage a wide range of injuries and conditions effectively.
- Definitive care – Clear protocols that guide hospital admission, treatment, and discharge, or guidelines on stabilizing the patient and transferring to a higher-level facility for treatment can make post-care more effective.
Posthospital care (care provided at follow-up, focused on recovery and restoring of functions):
Rehabilitation should be integrated in the system. Rehabilitation care needs to be an integral part of the treatment plan to improve the long-term wellbeing and functionality of injured persons. It could include physical and occupational therapy but also extends to mental health services and other rehabilitation care that will improve functioning.
Surveillance systems
Such devices are essential tools for the health and transport sector alike, to monitor road traffic injuries, assess patient outcomes, and pinpoint high-risk groups or locations. These insights inform targeted enhancements in trauma care, guide effective resource allocation, and support coordinated responses among emergency services.
Multiagency collaboration
Multiagency involvement across the system can make response more effective. The transport sector may ensure the development and availability of emergency transport vehicles and accessible transport routes (roads, air transport), while the health sector may ensure the development and availability of health infrastructure, resources, emergency services, facilities, supplies, and human resources, among several others.