Attach <br />Pedestrian safety: a road safety manual for decision-makers and practitioners <br />Attach <br />treatment at the scene of the crash and fewer still can get transported to the hospital <br />in an ambulance. As a result, many victims may needlessly die at the scene or during <br />the first few hours following an injury. There are several ways to strengthen the pre- <br />hospital care system in resource-constrained settings by building on existing systems <br />and harnessing community resources. Many countries have trained commercial <br />drivers, community workers and other groups to offer the post-crash care to injured <br />pedestrians with varying degree of success. The strategy to create emergency rescue <br />systems should aim at ensuring availability and use of equipment, supplies and <br />organizational structures to create an effective and adaptable pre-hospital care system <br />for injured people (54). <br />Hospital-based trauma care <br />An injured person will benefit most if he is promptly brought to an appropriate <br />hospital for definitive care of injuries. Through a process of triage, the pre-hospital <br />care providers can direct the patients to an appropriate hospital that is equipped to <br />deal with the injuries sustained. Pedestrians often sustain `polytrauma or multiple <br />injuries and consequently will have better outcomes if treated at trauma centres <br />with full capabilities to deal with such patients. Many high-income countries have <br />designated hospitals or trauma centres with adequate physical resources and trained <br />health care staff to treat injured patients. Such an approach has shown to improve <br />the outcomes of the injured in several high-income countries (,S). The Advance <br />Trauma Life Support (ATLS) Guidelines of the American College of Surgeons <br />have standardized approaches to severely injured patients and implementing such <br />87 <br />