Introduction: The management of blunt and penetrating liver trauma continues to pose a tremendous challenge to surgeons. This study reviews the pattern of liver trauma and its management, both operative and non-operative, in RIPAS Hospital, the only tertiary referral center in Brunei Darussalam. Material and Methods: A retrospective study of patients admitted with liver trauma, with and without other associated injuries between January 2002 and December 2006 to RIPAS Hospital was undertaken. The patients' case records were retrieved. Details on age, sex, mode of injury, pre-operative imaging, severity of liver injury based on the Liver Injury Scale (LIS, grades I to VI), presence of other associated injuries, overall management, complications and outcome were collected and analysed. Results: Twenty patients (male, n = 12) with a mean age of 36 years old (range 20 to 75) were treated for liver trauma (median LIS grade of III, range I to V) during the study period. Road traffic accidents accounted for 75% of the injuries. Thirteen (65%) had high grade injuries (≥ LIS grade III). Seventeen (85%) patients underwent surgical procedures for liver and other associated injuries. Four patients (20%) had non-operative management with one failure (5%). This patient subsequently required surgery. There were six post-operative deaths (mortality 30%). There were three major morbidities (15%): right hepatic artery aneurysm, a right hepatic duct bile leak and left hemiplegia secondary to cerebrovascular accident. Conclusions: In our local setting, blunt liver trauma is often due to road traffic accidents and is associated with a high mortality rate. A majority was of high grades and required urgent surgical interventions. Non-operative management is an option for those with low grade injuries and who are stable.
Abdominal Injuries ; Accident, Traffic ; Treatment Outcome

OBJECTIVEThere is no safer way to transport a child than a school bus. Fatal crashes involving occupants are extremely rare events in the US. In recent years, school bus transportation began to develop in China. We want to bring advanced experience on school bus safety in Western countries such as the US to developing countries.

METHODSWe searched the papers related to school bus safety from Medline, Chinese Scientific Journals Database and the Web of the National Highway Traffic Safety Administration (NHTSA).

RESULTSThere were only 9 papers related to school bus safety, which showed that higher levels of safety standards on school buses, school bus-related transportation and environmental laws and injury prevention were the primary reasons for the desired outcome. Few school bus is related to deaths and injuries in the developed countries.

CONCLUSIONSThe developing countries should make strict environmental laws and standards on school bus safety to prevent children's injury and death.

Accident Prevention ; Accidents, Traffic ; Child ; China ; Humans ; Motor Vehicles ; Safety Management ; legislation & jurisprudence ; methods ; Schools

PURPOSE: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. METHODS: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (< 0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). RESULTS: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. CONCLUSION: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.
Accident Prevention ; Accidents, Traffic ; Child ; Emergency Service, Hospital ; Family Characteristics ; Humans ; Infant ; Mortality ; Retrospective Studies

Child restraint system (CRS) can protect children in the event of crash and reduce the severity of injuries. As such, it is crucial to understand the prevalence of CRS usage and knowledge attributes on CRS usage among drivers. This study aims to assessdrivers’ knowledge on CRS usage.A semi-structured questionnaire was developed and pilot tested to verify its validity and reliability. The questionnaireaddressesdrivers’ knowledge about CRS currently available in the Malaysian market, the types of restraints used and views on fitting restraints to passenger vehicles. Seventy four percentfrom 500 respondents cited that they are usingor theyhave used CRS,64% knowabout CRS and its function, and 43% areawareof ISOFIX. In short, majority of the respondents are aware of CRS use and functions. Awareness and education program should berigorously introduced to public towards the implementation of the CRS law.
Child restraint system ; children passenger safety ; road traffic accident ; child injury

Established in 1997, the European New Car Assessment Programme (Euro NCAP) provides consumers with a safety performance assessment for the majority of the most popular cars in Europe. Thanks to its rigorous crash tests, Euro NCAP has rapidly become an important driver safety improvement to new cars. After ten years of rating vehicles, Euro NCAP felt that a change was necessary to stay in tune with rapidly emerging driver assistance and crash avoidance systems and to respond to shifting priorities in road safety. A new overall rating system was introduced that combines the most important aspects of vehicle safety under a single star rating. The overall rating system has allowed Euro NCAP to continue to push for better fitment and higher performance for vehicles sold on the European market. In the coming years, the safety rating is expected to play an important role in the support of the roll-out of highly automated vehicles.
Accident Prevention ; methods ; Accidents, Traffic ; prevention & control ; Automobiles ; standards ; Europe ; Female ; Humans ; Male ; Program Evaluation ; Safety ; standards ; Safety Management ; organization & administration

OBJECTIVETo study the epidemiological characteristics and preventive methods of road traffic crashes in a mountain city in western China through sampling investigation of traffic crashes in different regions of Chongqing city in recent years.

METHODSTwo police teams of traffic management in downtown, two teams in suburb, one team in county and one freeway team were randomly selected, and road traffic crashes between 1988 and 1997 were investigated and analyzed.

RESULTSA total of 13121 road traffic crashes with 6201 crashes with casualties were analyzed. The incidence of crashes was higher in May, June and July, and on Friday and Wednesday and at 8:00-12:00 and 14:00-18:00 within a day. Casualties were 44.0% in pedestrians and 42.5% in passengers of total casualties. The deaths and severe injuries in pedestrians were 59.1% of total deaths and 56.4% of total severe injuries. The age of drivers and passengers were mainly at 18-30 years, followed by 31-40 years. People over 60 years old accounted for 24.1% of total pedestrian casualty. Head injury was the most common reason for deaths. The main reasons for these crashes were improper driving and violating traffic laws. Violating traffic laws by pedestrian was one of the main reasons for pedestrian casualty.

CONCLUSIONSThe crashes are related to the characteristics of geography, climate, society activity of people, and the sense of traffic safety, the basic traffic construction and management in Chongqing. The traffic casualty of pedestrian is a big problem in Chongqing. To prevent and decrease road traffic injuries effective methods should be worked out and propaganda on traffic safety and traffic management should be strengthened according to different characteristics of different regions. To strengthen the first aid and treatment of cranium-brain injury and chest-back injury is also helpful in decreasing traffic deaths.

Accident Prevention ; Accidents, Traffic ; mortality ; statistics & numerical data ; Adolescent ; Adult ; Age Distribution ; Cause of Death ; Child ; China ; epidemiology ; Female ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Sex Distribution ; Survival Analysis ; Urban Population ; Wounds and Injuries ; epidemiology ; etiology

OBJECTIVETo describe the epidemiological characteristics of nonfatal child pedestrian injuries and provide information to help understand an important public-health problem.

METHODSThis was a school-based, cross-sectional questionnaire survey. The sample (42 750 children) was obtained from two urban cities of Guangdong Province, China, using multi-stage randomized sampling. Information was collected by the respondents self-reporting in the classroom.

RESULTSThe incidence rate of nonfatal child pedestrian injuries in the cities was 2.0%. Boys had a higher incidence rate (2.6%) than girls (1.4%). Compared to other children, those aged 10 years are at the highest risk. The primary places of occurrence were sidewalks, residential roads, and crosswalks. High-risk behavior of the children immediately prior to injury included mid-block crossings, playing on roads, and crossing on red lights. The major vehicles that caused pedestrian injuries were bicycles, car or vans, and motorcycles. Bruises, fractures, and injuries to the internal organs were the top three types of injuries. Almost 40% of victims were hospitalized, and nearly 30% of the victims suffered long-term disabilities.

CONCLUSIONThis study shows that nonfatal child pedestrian injuries are a very serious public-health problem in the urban cities of Guangdong. Based on the epidemiological characteristics, prevention strategies and further research should be carried out to reduce the occurrence of injuries.

Accident Prevention ; methods ; Accidents, Traffic ; prevention & control ; statistics & numerical data ; Animals ; Child ; China ; epidemiology ; Cross-Sectional Studies ; Data Collection ; Female ; Humans ; Incidence ; Male ; Motor Vehicles ; Surveys and Questionnaires ; Urban Population ; statistics & numerical data ; Wounds and Injuries ; epidemiology

OBJECTIVES: Recently injury has become a major world-wide health problem. But studies in Korea about injuries were very few. Thus, this study was conducted to analyze the trend of major injuries from 1991 to 2006 and to provide basic data for preventing injuries. METHODS: This study was based on the National Statistical Office data from 1991 to 2006 and calculated to estimate the burden of major injuries by using the standard expected years of life lost (SEYLL) and total lost earnings equation. RESULTS: For transport accidents, mortality, SEYLL and total lost earnings were increased from 1991 to 1996 and decreased from 2000 to 2006. On the other hand, for suicides, these were increased gradually. Since 2003, falls were included in ten leading causes of death. This study showed that injury causes major social and economical losses. CONCLUSIONS: We could reduce injury related premature death through active interest in injury prevention program.
Accident Prevention ; Accidental Falls/mortality/statistics & numerical data ; Accidents/*mortality/*statistics & numerical data ; Accidents, Traffic/mortality/statistics & numerical data ; Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cause of Death/trends ; Child ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Mortality/*trends ; Sex Distribution ; Suicide/trends ; Wounds and Injuries/*epidemiology ; Young Adult