Implementing pedestrian safety interventions <br />Attachment C <br />Attachment B <br />The chain of trauma care for injured pedestrians <br />Bystander <br />first aid <br />Access to <br />emergency <br />medical <br />services <br />Prehospital <br />care at <br />roadside <br />Appropriate Rapid <br />transportation diagnosis <br />to hospital Early <br />resuscitation <br />Rehabilitation <br />Intensive care <br />Specialist <br />intervention <br />Source: adao eu from the Life Saving Chain (see reference 52) <br />Pre-hospital care <br />The majority of deaths from road traffic injuries occur prior to the patient reaching <br />a hospital. Timely pre-hospital care and prompt transportation to an appropriate <br />health facility or trauma centre are crucial to the outcome of injured pedestrians. <br />Many high-income countries have developed complex and expensive systems for <br />providing emergency medical care. A formal emergency medical service (EMS), <br />easily accessed through an emergency telephone number, is in place, especially in <br />urban areas, to offer pre-hospital care by professionally trained staff. The injured <br />patient is transported by ambulance equipped with monitoring devices, a wide <br />range of medicine and wireless communication, that is staffed by a physician or <br />non-physician paramedics to render advanced pre-hospital trauma care. The goal of <br />such a service is to quickly identify and treat life-threatening injuries until the patient <br />arrives at a definitive care centre. Triage and direct transfer to a trauma centre has <br />been shown to reduce mortality rates among severely injured patients, including <br />pedestrians (S3). In many communities, bystanders and other first responders such as <br />police, rescue workers and firemen are trained in first aid to help such victims before <br />the medical help arrives at the scene. <br />It should be noted that a majority of the world's population does not have access to <br />such an advanced level of pre-hospital care. In many countries, few victims receive <br />86 <br />Page 232 <br />