The compulsory wearing of seat belts, first introduced in the world in Victoria in 1970, has effectively reduced the number of deaths and injuries by approximately one‐third for car occupants involved in motor vehicle crashes. Initially, the legislation did not apply to children under the age of eight years, but in 1975 a further law was introduced banning children from the front seat of any vehicle unless properly harnessed. Seat belts offer the best protection for front seat drivers and passengers involved in frontal impacts, but offer less protection to the recipient of a side impact. Ten per cent of car. occupants admitted to hospital after a frontal impact show injuries, mostly minor, directly attributable to the wearing of seat belts.
This presentation is an account of the involvement of the Royal Australasian College of Surgeons in trauma care over the past 25 years. In October 1969 a 3 day seminar was held at the College entitled ‘The Management of Road Traffic Casualties’. This was in response to an increasing demand for the College to combat the devastating effects resulting from road traftic accidents. By the mid‐60s road trauma in Australia and New Zealand, as seen in other fully motorized countries, had reached epidemic proportions. Those directly involved in the care of surgical emergencies were aware of the frequency and severity of road trauma which was striking all sections of the community. Unlike the USA. Australia was not troubled by a high incidence of penetrating injuries due to guns and knives.
Road trauma is a major public health problem in all motorized societies. Doctors who treat casualties must commit themselves not only to providing optimum care but to becoming equally involved in the epidemiological and sociological aspects of road trauma prevention. The prevention of trauma requires a threefold approach: prevent the crash, prevent injury in the crash, and prevent injury aggravation after the crash. Strategies and program options to implement them have been formulated to reduce traffic injury. These strategies are exposure control, crash prevention, injury control, behavior modification, and post-crash trauma management. The combined experience of war injuries and road trauma has lead to major advances in investigation technology and management procedures and far less costly efforts directed at road trauma prevention. The balance between prevention on the one hand and investigation and procedure on the other needs to be addressed. Productive research adequately funded is essential if prevention initiatives are to succeed in reducing the incidence of highway death and injury.
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