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      Magnitude and Spectrum of Injuries Sustained in Road Traffic Accidents Among Two Wheeler Riders and Correlation with Helmet Use

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          Abstract

          Background:

          Helmet, as a protective gear to prevent fatal injuries while riding two-wheelers, needs to be evaluated by quality data. The aim of the study was to find out spectrum of injuries sustained with downstream outcomes in relation to acceptable ways of use of crash-proof helmet among motorized two-wheeler riders compared to nonuse following road traffic accidents.

          Methods:

          The present study was an analytical cross-sectional multicentric study conducted at three dedicated trauma care centers of India: (a) Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, (b) King George's Medical University, Lucknow, Uttar Pradesh, and (c) Narayana Medical College and Hospital, Nellore, Andhra Pradesh. Detailed information was collected on correct use of crash-proof helmets versus nonusers.

          Results:

          Among 317 traumatic brain injury victims (mean age 31.4 ± 12.5 years; range 11–70 years; highest (38%) in the 21–30 years age group), majority were from urban areas (84%), were brought directly to trauma center (76%), and were “Drivers” (73.50%), and their vision was “normal with or without using corrective lenses” (96%). Two-thirds of the victims were carrying “Formal driving licenses,” one-thirds were “Primary earning member of the family,” and one-tenths were under influence of alcohol. Half of the two-wheeler riders were using helmet, still lesser fastened helmet properly (45%), and few others used ISI quality “Crash proof” (38.5%). Helmet use during accidents had significantly better outcomes and significantly low clinical symptoms such as loss of consciousness, vomiting, ear/nose/oral bleed, headache, seizures with associated bony, abdominal, and chest injuries.

          Conclusions:

          Helmets have protective effects on riders if helmets are of crash-proof quality, fastened properly, and consistently used even for short spells and distances of rides.

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          Most cited references12

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          Effect of Italy's motorcycle helmet law on traumatic brain injuries.

          To evaluate the impact of a revised Italian motorcycle-moped-scooter helmet law on crash brain injuries. A pre-post law evaluation of helmet use and traumatic brain injury (TBI) occurrence from 1999 to 2001. Romagna region, northeastern Italy, with a 2000 resident population of 983 534 persons. Motorcycle-moped rider survey for helmet use compliance and all residents in the region admitted to the Division of Neurosurgery of the Maurizio Bufalini Hospital in Cesena, Italy for TBI. Helmet use compliance and change in TBI admissions and type(s) of brain lesions. Helmet use increased from an average of less than 20% to over 96%. A comparison of TBI incidence in the Romagna region shows that there was no significant variation before and after introduction of the revised helmet law, except for TBI admissions for motorcycle-moped crashes where a 66% decrease was observed. In the same area TBI admissions by age group showed that motorcycle mopeds riders aged 14-60 years sustained significantly fewer TBIs. The rate of TBI admissions to neurosurgery decreased by over 31% and epidural hematomas almost completely disappeared in crash injured moped riders. The revised Italian mandatory helmet law, with police enforcement, is an effective measure for TBI prevention at all ages.
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            The effectiveness of bicyclist helmets: a study of 1710 casualties.

            During the 1980s, a sustained campaign increased the rates of helmet use of Victorian bicyclists. The efficacy of helmet use was evaluated by comparison of crashes and injuries (AIS-1985) in 366 helmeted (261 Australian Standard approved and 105 non-approved) and 1344 unhelmeted casualties treated from 1987 through 1989 at Melbourne and Geelong hospitals or dying before hospitalization. Head injury (HI) occurred in 21.1% of wearers of approved helmets and in 34.8% of non-wearers (p < 0.001). The AIS scores were decreased for wearers of approved helmets (p < 0.001), face injuries were reduced (p < 0.01), and extremity/pelvic girdle injuries increased (p < 0.001) and the overall risk of HI was reduced by at least 39% and face injury by 28%. When casualties with dislodged helmets were excluded, HI was reduced 45% by approved helmets. Head injury reduction by helmets, although substantial, was less than that found in a similar study in Seattle, Washington.
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              The association of helmet use with the outcome of motorcycle crash injury when controlling for crash/injury severity.

              Many studies have reported that helmet use by motorcycle riders significantly decreases their risk of head injury, death, and disability in the event of a crash. However, these studies have not controlled for crash severity and thus do not conclusively show the value of helmet use by motorcycle riders. Using data from a statewide trauma registry, the present study examines the association of helmet use with various outcomes of motorcycle crashes, controlling for overall crash severity as measured by a modified Injury Severity Score. The results show that in crashes where the overall degree of injury was comparable, the risk of head injury in hospitalized motorcyclists was nearly twice as high for unhelmeted riders as it was for helmeted riders, thus confirming the protective effects of helmet use. However, there were no significant differences in various measurements of resource utilization, including days in hospital, hospital charges, and need for post-hospital rehabilitation. A higher incidence of extremity injuries among the helmeted riders may account for their failure to demonstrate consistently lower resource utilization, despite lower rates of head injury.
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                Author and article information

                Journal
                J Emerg Trauma Shock
                J Emerg Trauma Shock
                JETS
                Journal of Emergencies, Trauma, and Shock
                Medknow Publications & Media Pvt Ltd (India )
                0974-2700
                0974-519X
                Jul-Sep 2018
                : 11
                : 3
                : 160-164
                Affiliations
                [1]Department of Emergency Medicine, JPN Apex Trauma Centre, AIIMS, New Delhi, India
                [1 ]Department of Paediatric Orthopaedic, King George's Medical University, Lucknow, Uttar Pradesh, India
                [2 ]Department of Orthopaedic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
                [3 ]Department of Community Medicine, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India
                [4 ]Department of Emergency Medicine, University of Florida, Jacksonville, USA,
                [5 ]Department of Driver Training and International Affairs, Institute of Road Traffic Education, College of Traffic Management, Aravali Hills, Surajkund Badhkal Road, Faridabad, Haryana (NCR Delhi), India
                [6 ]Department of Neurosurgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
                Author notes
                Address for correspondence: Dr. Amit Agrawal, Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore - 524 003, Andhra Pradesh, India. E-mail: dramitagrawal@ 123456gmail.com
                Article
                JETS-11-160
                10.4103/JETS.JETS_119_17
                6182975
                30429621
                1b3b60e2-ec73-4f1d-8e38-11dda2c9586b
                Copyright: © 2018 Journal of Emergencies, Trauma, and Shock

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 27 October 2017
                : 12 March 2018
                Categories
                Original Article

                Emergency medicine & Trauma
                helmet,injuries,motorized two-wheelers,road safety
                Emergency medicine & Trauma
                helmet, injuries, motorized two-wheelers, road safety

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