REGIONAL AUDIT OF PEDESTRIAN ACCIDENT CARE

In all, 160 serious pedestrian accidents (ISS > 15 or death), were rec orded during a 12-month prospective study of all trauma in a populatio n of 3.2 million. Of these, 35 died at scene, 125 arrived at hospital alive and 68 (54 per cent) subsequently died. There were 35 (22 per ce nt) children, and 62 per cent (39) were more than 60 years of age. Pre hospital care significantly delayed transfer to hospital. In the accid ent and emergency department, only 38 per cent of those unconscious ha d a cervical collar applied, and only 67 per cent were intubated. Of t hose transferred for neurosurgical care, 34 per cent were not intubate d. The Median Injury Severity Score for each outcome group was similar between age groups. The Revised Trauma Score and APACHE II score show ed significant differences between those who lived and died. TRISS ana lysis revealed that 32 per cent of deaths and 12 per cent of survivors were unexpected. ATLS treatment protocols should be instituted for pr ehospital care and in all accident and emergency departments (A&E).