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Transportation of traffic accident victims by t axis in Ho Chi Minh city

Transportation of traffic accident victims by t axis in Ho Chi Minh city. Dr David TRAN Afravietmur Trung Vuong Emergency Conference November 10 th 2011. Particular context of HCM. Megalopolis with about 10 millions inhabitants About 5 millions of motorbikes and a growing number of cars.

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Transportation of traffic accident victims by t axis in Ho Chi Minh city

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  1. Transportation of traffic accident victims by taxis in Ho Chi Minh city Dr David TRAN Afravietmur Trung Vuong Emergency Conference November 10th 2011

  2. Particular context of HCM • Megalopolis with about 10 millions inhabitants • About 5 millions of motorbikes and a growing number of cars. • Un-adapted road corridors with trunks crossing the center city • A lack of traffic control with a lot of traffic jams • Regular traffic rule violations (red lights, priority, one way traffic etc…)

  3. Problem of traffic jam in HCM city • A lot of motorbikes • More and more cars

  4. Traffic Accidents in Vietnam & HCM city • Traffic accident are the first cause of trauma in Vietnam (11.499 people were killed in 2010 = 30/day) • Motorbike are involved in more than ½ of non-fatal accidents(734/100.000 inhabitants) • From september, traffic police punished more than 88,200 people for traffic rules violations • In HCM, about 100 serious accidents/month are officially registered (probably much more) • In HCM, 788 deaths due to traffic accidents in 2010 (more than 2 deaths/day)

  5. Organization of 115 system • Trung Vuong Emergency Hospital (tel 115) • 24h/24 call center • A fleet of about 10 ambulances (but only 4 ambulances can operate in the same time) • About 16 calls/ day (6000 per year)

  6. Trung Vuong Emergency Ambulances

  7. 115 HCM call center • A nurse from 115 alarm center waiting for a call

  8. Knowledge of prehospital service 115 by HCM inhabitants • 16% are aware of pre-hospital emergency service in HCM • 32% are aware that 115 is the emergency response number • 46% of people will transport relatives by themselves and 67% think it will be faster (than ambulance service) • The main complain is the waiting time before the arrival of the ambulance

  9. Number of ambulances in HCM • About 60 ambulances available in HCM (?) • 4 to 6 medicalized ambulance in Trung Vuong Emergency Hospital • 1 ambulance for 140.000 inhabitants (?) • 1 medicalized ambulance (SMUR) for more than 1.000.000 inhabitants

  10. Transport of victims by taxis or private cars • In 2009, a survey about pre-hospital cardiac arrest arrived in FVHospital showed that only 17% arrived by ambulances • 83% arrived at the back of a car (most of them at the back of a taxi) • The average of time to send the patient to the hospital was 35 minutes

  11. Taxi’s company in HCM • Ex. ML taxis: 2000 cars in the city (5000 drivers) • The fleet is well distributed in all districts • Time of intervention on site very short • Possibility to communicate by radio

  12. Problems of transportation of victims by non professionals • Risk of aggravation of lesions during installation in the taxi or on the way to the hospital (ex: spine injuries, obstruction of airways, inhalation etc.) • Cannot be applicable for cardiac arrest… • Responsibility in case of problem on the way to the hospital • Problem of money: who will pay the transportation?

  13. How to solve those problems? • Train the taxi drivers in first-aid (short training program) • Equip each taxi with minimum equipment (first aid kit)

  14. Train the taxi drivers in first aid • How to protect a victim • How to take care of a wound / a fracture / stop an hemorrhage • How to put a splint, a neck collar • How to carry a victim into the back of a taxi • How to open the airway of a victim and insure efficient respiration. • How to put a victim in recovery position waiting for help.

  15. Minimum equipment required • Compresses, bandages • Splint (forearm & leg) • Neck collar • Oral canula • Disposable gloves

  16. Problems: organization & cost-effective • Who will organize training courses ? (Hospitals, NGO, Training centers ?) • Who will pay the expenses for training & materiel ? • Who will replace the materiel after use? • How to train so many taxi-drivers (ML taxi: 5000 drivers) • Necessity to organize refresh courses every year, every 2 years?

  17. Advantage of this solution • Based on an existing organization (Taxi’s network) ➔ Could be effective quickly (< 1 year) • Represents an original solution waiting for an efficient professional system of pre-hospital cares (SMUR, Paramedics etc.) • Cost effective solution (training, basic equipment) • Could avoid a lot of complications and maybe a few deaths.

  18. Other aspects of the problem • Education of population (115, first aid) • Improve the pre-hospital system with generalization of ambulance services with a central decision center (intervention in less than 20 min. all over HCM) • Improve the capacity of 115 call center to be able to give a quick and adapted answer

  19. Vietnam has to invent original solutions to improve road safety • Even if this “taxi-ambulance” solution seems to be interesting, it is not the ideal solution…

  20. Thank you for your attention

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