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Injury Prevention and Control Peter L. Lane, MD, FRCPC

Injury Prevention and Control Peter L. Lane, MD, FRCPC. Introduction. Prevention and Control Accident? An injury story Taxonomy of Injury Control Case studies. Prevention and Control. Unlike smallpox

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Injury Prevention and Control Peter L. Lane, MD, FRCPC

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  1. Injury Prevention and ControlPeter L. Lane, MD, FRCPC Peter L. Lane, MD, FRCPC

  2. Introduction • Prevention and Control • Accident? • An injury story • Taxonomy of Injury Control • Case studies

  3. Prevention and Control • Unlike smallpox • Reduction of harm = reduction of incidence and severity of injuries, in order to reduce deaths and to reduce disabilities

  4. Accident? • Event without apparent cause – inevitable • Prevent – to come before; to hinder • Inevitable – unavoidable; sure to happen; tiresomely familiar

  5. An injury story • 22 y.o. male • Recent college graduate • Dove off a dock into lake • Struck head on bottom • Floated to the top face down

  6. An injury story (cont’d) • Friends turned him over • Taped and tied him to a door • Drove him to the highway • Ambulance to hospital • Airlifted to trauma center

  7. An injury story (cont’d) • C 6-7 fracture dislocation with bilateral jumped facets • Insensate below nipples • Complete quadriplegia • Halo, surgical decompression, MPSS protocol • 10 days trauma center • 6 months rehab center

  8. An injury story (cont’d) • Long term requirements include • daily attendant services, am and pm • Modified vehicle • Wheelchair, adaptive devices • Modified housing • Career choice change

  9. Acute care Rehab care Ongoing care p.a. 10 yr Foregone income p.a. 10 yr 10 yr Total $65,000 $90,000 $45,000 $450,000 $71,000 $710,000 $1.315M An injury story - costs

  10. Taxonomy of Injury Control • Primary prevention • Secondary prevention • Tertiary prevention

  11. Phase Strategy Before disease present Before the event or behavior Reduce or remove risk factors Primary prevention

  12. Phase Strategy Asymptomatic disease Reduce or remove risk factors Secondary prevention

  13. Phase Strategy Disease present Clinical course after the injury Reduce fatalities and complications Trauma care, rehabilitation and reintegration Tertiary prevention

  14. Persuade Inform and educate Require Laws and regulations Automatic Engineering Most common Least expensive Least effective Cumbersome Enforcement issues Freedom/civil rights issues By far the most cost effective measures Prevention strategies

  15. Risk Factor Identification • Instrument/agent • Environment • Physical • Social • Human/individual

  16. HADDON MATRIX OF INJURY CAUSATION

  17. Case studies • Bicycle injuries • ATV driver injuries • Youth violence • Elderly pedestrian injuries

  18. Instrument/agent Environment Physical Social Human/individual ____________________________________________________________________________________________________________________________________________________________ Risk Factor Identification

  19. HADDON MATRIX OF INJURY CAUSATION

  20. Persuade Inform and educate Require Laws and regulations Automatic Engineering ____________________________________________________________________________________________________________________________________________________________ Prevention strategies

  21. Summary • Prevention and Control • Accident? • An injury story • Taxonomy of Injury Control • Case studies

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