Survivors and families affected by road traffic crashes have a range of physical, psychological and legal needs. Consequences of crashes
may include physical injuries and resulting disability, psychological trauma that can impair reintegration into work and family life, and a range of economic and legal sequelae. A broad and integrated approach to support can mitigate the short and long-term effects of experiencing a crash and can help those affected return to function and independence at home and at work. An effective post-crash response requires integration of injury care, mental health services, legal support and legislation, and data on crashes and injuries.
The goal of Pillar 5 is to reduce the impact of road traffic crashes, to ensure appropriate legal process, and to facilitate recovery of those affected.
ELEMENTS OF POST CRASH RESPONSE
We have focusing on Pillar 5 as set in the WHO for supporting those affected with road traffic crashes, promotes set by the improvement of healthcare and other systems to provide the key elements of post-crash support: emergency care and rehabilitation for injury, mental health care, legal support, and data on crashes and injuries.
REHABILITATION AND REINTEGRATION
Long after a crash, survivors and their families can suffer persistent physical and psychological conditions that, when not appropriately treated, restrict their ability to function normally in their work and personal lives. Adjusting to long-term physical impairment and associated disabilityor disfigurement can also put individuals at increased risk of developing psychological disability. Rehabilitation can help to alleviate suffering, prevent further risk of harm, and optimize functioning, allowing for restoration of independence and reintegration into society. Rehabilitation involves professionals from a wide range of medical and paramedical disciplines working together to help achieve treatment goals. Where no services are available, family members may provide basic rehabilitation care
Road traffic crashes, along with any resulting injury or death, have a profound psychological impact on survivors. A large proportion of crash survivors experience acute and long-term psychological conditions (15), with the most common conditions being post-traumatic stress disorder (PTSD), major depressive disorder and anxiety disorders (16). Prevalence of PTSD following road traffic crashes ranges from 6% to 45% (17) and it remains one of the most common consequences of road traffic incidents (4). Additional responses include grief, panic and bereavement. Mental health support can mitigate many of these conditions and help prevent psychological distress from becoming a disability that interferes with re-integration into work and social life.
We will respond where necessary, together with health personnel to a crash can assist in a number of ways. Not only will that provide a sense of order and security at the scene, they can also be trained to identify individuals at greatest risk for acute psychological stress and offer emotional support up to and through treatment at a facility. Beyond the immediate aftermath, the extended post-crash response will include counselling and organized support groups to help affected persons navigate a path to recovery and prevent psychological disability.
LEGAL SUPPORT AND LEGISLATION ADVOCACY
Effective post-crash response includes policy and legislation to protect the injured, their families, and bystanders who deliver first aid; to facilitate legal and financial accountability and ensure compensation; and to promote post-injury recovery and reintegration into work and home life. These may include laws that enable access to timely care; laws that ensure adequate crash investigation; laws that mandate adequate liability insurance for drivers; legal protections to facilitate civil and criminal justice processes, including reparations, and legal protections for those with disability resulting from injury.
POLICY & LEGISLATIVE ADVOCACY
Specific legislation to enable emergency care includes laws that ensure access to care without regard to ability to pay; laws that protect those who offer help (Good Samaritan Laws); first aid training mandates for drivers; mandated standards for prehospital and facility-based care; and laws designating financing or health insurance mechanisms for emergency care, including requirements for third-party liability insurance for drivers. Legislation may also mandate accreditation processes that govern licensing and scope of practice for providers, and ensure that designated trauma centres meet certain standards. Thorough crash investigation is essential both to inform prevention initiatives, including those addressing vehicle and road infrastructure, and to guide processes for compensation and civil and criminal accountability where relevant. Data from crash investigations may be linked with data from community and facility-based research efforts to better inform prevention and care improvement initiatives.