Injury Prevention最新文献

{"title":"Home and injury location discordance patterns in paediatric trauma: trends by mechanism, age and childhood opportunity level.","authors":"Erin E Ross, MaKayla L O'Guinn, Shadassa Ourshalimian, Ryan G Spurrier, Pradip P Chaudhari","doi":"10.1136/ip-2024-045554","DOIUrl":"https://doi.org/10.1136/ip-2024-045554","url":null,"abstract":"<p><strong>Background/aims: </strong>Understanding how injury mechanisms, demographics and neighbourhood characteristics differ based on injury location can improve data-driven injury prevention efforts. Our objective was to describe the association between mechanism of injury (MOI), patient age, neighbourhood characteristics and home and injury location discordance.</p><p><strong>Methods: </strong>We performed a retrospective, multicentre study of children transported by emergency medical services to 15 trauma centres in the county trauma registry from 2010 to 2021. Home-injury discordance (discordance between home and injury zip code) and neighbourhood opportunity discordance (more than one level difference across Childhood Opportunity Index (COI) levels) were trended by age and MOI. COI discordance by home COI for each MOI was also explored.</p><p><strong>Results: </strong>Among 13 020 paediatric traumas, home-injury discordance occurred in 48% of injuries, and was highest in sports/recreation (72%) and motorised travel (69%). COI discordance (27% overall) was frequent in sports/recreation (34%) and rarer in assault (22%). Assault and assault and motorised travel injuries occurred closer to home and with less COI discordance.</p><p><strong>Conclusion: </strong>Unique patterns of injury risk and COI discordance by home COI level demonstrate that injury prevention efforts may require differential focus on factors affecting residents versus visitors of a neighbourhood depending on the MOI.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of the impact of interventions changing access to lethal means on suicide attempts and deaths.","authors":"Lisa M Shank, Derek J Smolenski, Courtney Boyd, Dawn M Bellanti, Reshmi Nair, Kiriana Cowansage, Salvatore Libretto, Kamaria Frazier, Daniel P Evatt, Marija S Kelber","doi":"10.1136/ip-2024-045611","DOIUrl":"https://doi.org/10.1136/ip-2024-045611","url":null,"abstract":"<p><strong>Objective: </strong>The study objective was to examine if interventions changing access to lethal means are associated with changes in suicide deaths and/or attempts by conducting a systematic review of controlled intervention studies.</p><p><strong>Methods: </strong>Authors searched key databases (PubMed, PsycInfo, CINAHL) from inception to March 2024 for longitudinal controlled intervention studies with at least one contemporaneous comparator group evaluating the impact of interventions changing access to lethal means on suicide attempts and/or deaths in a primarily adult population. Reviewers dually screened articles, then extracted study characteristics and assessed methodological quality.</p><p><strong>Results: </strong>Researchers screened 8522 studies and 36 articles met eligibility for inclusion. Most studies evaluated the impact of population-level firearm interventions on suicide deaths and found that stricter regulations were associated with a small reduction, if any, in total and/or firearm-specific suicide deaths. The ecological level of analysis precluded individual-level causal inference. Findings within interventions targeting methods other than firearms were limited, mixed and/or inconclusive. Notably, no high-quality randomised controlled trials (RCTs) were identified that met our eligibility criteria.</p><p><strong>Conclusion: </strong>Future studies should use an RCT design or advanced statistical causal inference techniques to further elucidate the effectiveness of these interventions on suicide deaths and/or attempts.</p><p><strong>Prospero registration number: </strong>CRD42022364775.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fentanyl-xylazine overdose deaths in the USA, 2018-2023.","authors":"David T Zhu, Manuel Cano","doi":"10.1136/ip-2024-045596","DOIUrl":"https://doi.org/10.1136/ip-2024-045596","url":null,"abstract":"<p><strong>Background: </strong>Xylazine, a veterinary sedative and analgesic, has emerged as a novel adulterant in the US illicit drug supply, frequently co-occurring with fentanyl. This study examines trends in fentanyl-xylazine overdose death rates from 2018 to 2023.</p><p><strong>Methods: </strong>This serial cross-sectional study examined death certificates from the CDC WONDER database to identify International Classification of Diseases, 10th Revision codes for overdose deaths likely coinvolving fentanyl (T40.4) and xylazine (T42.7 or T46.5). Crude mortality rates per 100 000 were calculated overall and by sex, race/ethnicity, US Census Divisions and state to examine demographic and geographical trends.</p><p><strong>Results: </strong>Fentanyl-xylazine deaths increased from 99 in 2018 to 6020 in 2023. Crude mortality rates rose from 0.03 (95% CI 0.02 to 0.04) to 1.80 (95% CI 1.75 to 1.84) per 100 000. In 2023, rates were higher among males than females (2.63 (95% CI 2.55 to 2.71) vs 0.99 (95% CI 0.93 to 1.03) per 100 000), and higher among black than white individuals (3.21 (95% CI 3.04 to 3.38) vs 1.86 (95% CI 1.80 to 1.92) per 100 000). The Middle Atlantic and New England Census Divisions had the highest regional rates at 5.72 (95% CI 5.49 to 5.95) and 4.32 (95% CI 3.99 to 4.65) per 100 000, respectively.</p><p><strong>Discussion and conclusions: </strong>The sharp increase in fentanyl-xylazine deaths, particularly among black individuals, highlights both the growing infiltration of xylazine into the illicit drug supply and persistent structural disparities in addiction treatment. Addressing this escalating epidemic requires routine toxicological testing for xylazine and expanded access to trauma-informed care, harm reduction services and interventions such as naloxone, opioid agonist therapies and wound care.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute work-related injuries among older adults in the USA on Medicare, 2016-2019: a national longitudinal study.","authors":"Matthew McFalls, Beth Virnig, Andrew D Ryan, Hyun Kim, Bruce H Alexander, Marizen Ramirez","doi":"10.1136/ip-2024-045363","DOIUrl":"https://doi.org/10.1136/ip-2024-045363","url":null,"abstract":"<p><strong>Objectives: </strong>Work-related injuries are only partially captured for older workers in the USA, likely due to low sensitivity of traditional data sources, such as workers' compensation, to capture non-fatal incidents. Using claims from Medicare, the primary health insurance of most US adults after age 65, we identified and described work-related injuries among Medicare enrollees aged 65 years and older.</p><p><strong>Methods: </strong>We identified injury claims from 2016 to 2019 Medicare inpatient and outpatient claims for aged 65+ Medicare fee-for-service enrollees. We then identified work-related injury claims using ICD-10-CM external cause codes and employment-related and workers' compensation codes used in Medicare claims processing. We calculated annual rates of work-related injuries among aged 65+ Medicare fee-for-service enrollees. We described demographics, injuries and their mechanisms, and healthcare encounter characteristics of Medicare enrollees with work-related injuries.</p><p><strong>Results: </strong>From 2016 to 2019, the average annual rate of work-related injuries was 27.6 per 100 000 Medicare fee-for-service enrollees aged 65+. Injury claims were most often for outpatient emergency department (ED) visits (58%), followed by non-ED outpatient visits (20%) and hospitalisations (19%). Falls, transportation and machinery-related mechanisms of injury each accounted for approximately 20% of injuries.</p><p><strong>Conclusions: </strong>Using the mechanism of injury, employment-related and workers' compensation codes, Medicare claims can be used to identify work-related injuries. Most work-related injuries appear in outpatient settings, although hospitalisations involve the most extensive care. Future research should validate and expand these methods, drawing on the depth of information in Medicare claims data to explore costs and health outcomes of work-related injuries in older populations.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do socioeconomic status, race and ethnicity modify the relationship between alcohol use and unintentional injury mortality?","authors":"Laura Llamosas-Falcón, Yachen Zhu, William C Kerr, Jürgen Rehm, Charlotte Probst","doi":"10.1136/ip-2024-045505","DOIUrl":"https://doi.org/10.1136/ip-2024-045505","url":null,"abstract":"<p><strong>Background: </strong>There is a knowledge gap regarding the potential roles that socioeconomic status (SES), race and ethnicity may play in the associations between alcohol use and injury risk. This study aimed to examine these factors as potential effect modifiers in the relationship between heavy episodic drinking (HED) and unintentional injury mortality.</p><p><strong>Methods: </strong>We used mortality-linked data from the 1997-2018 US National Health Interview Survey. We performed survey-weighted Cox proportional hazards models to evaluate the effect modification of education, income, race and ethnicity on the relationship between the frequency of HED and motor vehicle and other unintentional injuries mortality.</p><p><strong>Results: </strong>559 442 participants were included, with 772 motor vehicle fatalities and 2003 other unintentional injury deaths. Our cohort study found no significant interaction effect between SES, race and ethnicity, and HED on motor vehicle fatalities. For other unintentional injury mortality, we identified a significant interaction effect between low education and HED once or more per month (HR 2.75, 95% CI 1.38 to 5.49). Similarly, we found a significant interaction effect between low income and HED once or more per month (HR 1.84, 95% CI 1.02 to 3.34). Finally, both Black and Hispanic participants exhibited a higher risk of other fatal unintentional injuries at varying frequencies of HED compared with White participants.</p><p><strong>Conclusions: </strong>Our results emphasise the importance of considering SES, race and ethnicity in understanding the complex interplay between alcohol consumption and unintentional injury mortality. Understanding subgroup-specific dynamics is crucial for formulating targeted interventions to address disparities and enhance public health outcomes.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderating role of drowning risk perceptions in the relationship between adolescent and peer risk-taking behaviours: implications for drowning prevention.","authors":"Shi Luo, Zhengyang Mei","doi":"10.1136/ip-2024-045419","DOIUrl":"https://doi.org/10.1136/ip-2024-045419","url":null,"abstract":"<p><strong>Background: </strong>While previous studies have investigated the risk factors contributing to drowning risk-taking behaviours in adolescents, whether peer risk-taking behaviours influence this relationship remains uncertain. This study explored the potential relationship between peer risk-taking behaviours and adolescent drowning risk-taking behaviours while examining whether drowning risk perceptions play a moderating role in this relationship.</p><p><strong>Methods: </strong>A national survey of 7485 adolescents in China was conducted using three scales: the Drowning Risk-Taking Behaviours scale, the Peer Risk-Taking Behaviours scale and the Drowning Risk Perceptions scale. Pearson's analysis was employed to identify the correlations and hierarchical regression to examine the moderating role of drowning risk perceptions.</p><p><strong>Results: </strong>Peer risk-taking behaviours promoted adolescent drowning risk-taking behaviours (β=0.428, t=45.384, p<0.001). The interaction between peer risk-taking behaviours and susceptibility to drowning and seriousness of drowning reduced adolescent drowning risk-taking behaviours (β=-0.175, t=-18.576, p<0.001; β=-0.189, t=-20.802, p<0.001, respectively). The interaction between peer risk-taking behaviours and benefits of swimming skills also reduced adolescent drowning risk-taking behaviours (β=-0.227, t=-24.858, p<0.001), whereas the interaction between peer risk-taking behaviours and perceived barriers did not (β=0.012, t=1.242, p>0.05).</p><p><strong>Conclusions: </strong>Peer risk-taking behaviours are an important risk factor for adolescent drowning risk-taking behaviours, whereas an individual's drowning risk perceptions serve as a protective factor that negatively moderates the relationship between the two.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-wise economic burden of road traffic injuries in India.","authors":"Sajith Kumar S, Bhavani Shankara Bagepally, Akhil Sasidharan, Kayala Venkata Jagadeesh, Manickam Ponnaiah","doi":"10.1136/ip-2024-045429","DOIUrl":"https://doi.org/10.1136/ip-2024-045429","url":null,"abstract":"<p><strong>Background: </strong>Road traffic injuries (RTI) cause multifarious detrimental consequences, including fatality and serious injuries. RTIs cause considerable financial strain on healthcare systems with high costs of medical care, long-term care for the injured and lost productivity. To assess this economic burden, we estimated the state-wise economic costs of RTI in India.</p><p><strong>Methods: </strong>We followed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Checklist 2022 to present the methods and outcomes. Data were obtained from the Global Burden of Diseases, Injuries and Risk Factors Study, Government of India's budget documents, annual reports of the National Health Authority, Controller General of Accounts and Economic Surveys. Cost per disability-adjusted life years (DALY), direct costs, indirect costs and total costs associated with RTI burden were estimated for India and by its states.</p><p><strong>Results: </strong>The RTI burden declined in all Indian states except Jammu and Kashmir (with a minor increase from 1458 to 1564 DALYs per 100 000) and Rajasthan (from 1275 to 1394 DALYs per 100 000) during the 2010-2019 period. The estimated mean cost per DALY in India due to RTI was ₹1821 (95% CI 1606 to 2036) (US$22 (95% CI 19 to 24)), with a median (IQR) of ₹1609 (551) (US$19 (7)). As of 2019, the estimated mean total cost of RTI burden in India was ₹1017 billion (US$12 billion), with a median (IQR) of ₹731 billion (1220 billion) (US$9 billion (15 billion)).</p><p><strong>Conclusion: </strong>The burden of RTIs declined across the Indian states during 2010-2019, and the same was not observed with fiscal implications. The study reiterates the need for strategic road safety interventions to ameliorate the socioeconomic and health impacts of RTIs in India.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of question wording for self-reported traumatic brain injuries among adults: findings from the 2023 SummerStyles survey.","authors":"Dana Waltzman, Rashad Kuku, Alexis Peterson, Matthew Breiding, Jill Daugherty","doi":"10.1136/ip-2024-045282","DOIUrl":"https://doi.org/10.1136/ip-2024-045282","url":null,"abstract":"<p><strong>Background: </strong>Surveillance of traumatic brain injury (TBI) in the USA has historically relied on healthcare administrative datasets, but these methods likely undercount the true burden of TBI. Self-report measures may help obtain more comprehensive estimates. A fundamental question is whether TBI prevalence estimated through self-report varies by whether and how TBI signs and symptoms are ascertained in the survey question(s).</p><p><strong>Methods: </strong>Self-report data were collected from 4303 adults in the summer wave of Porter Novelli's 2023 ConsumerStyles survey. Respondents were randomised to receive a question about their 12-month experience of head injury and a grouped list of TBI signs/symptoms or a question about their 12-month experience of head injury and an option to select individual TBI signs and symptoms that resulted from the head injury. All respondents who indicated they experienced a head injury received a set of follow-up questions.</p><p><strong>Results: </strong>A significantly higher percentage of people who received the 'individual signs/symptoms' question self-reported a TBI (8.3%) than those who received the 'grouped signs/symptoms' question (4.3%) χ²=19.6, p<0.0001. Among TBI cases identified, there were no statistical differences between question type in relation to whether the respondent reported being evaluated for or diagnosed with a TBI, nor any demographic differences.</p><p><strong>Conclusions: </strong>These results demonstrate that how TBI is ascertained in a survey can meaningfully impact reporting of TBI prevalence and provides evidence that question wording and structure affect estimates on national surveys.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Oregon's extreme risk protection order law to address risk of firearm suicide.","authors":"Rebecca Valek, Rebecca Teichman, Shauna Rakshe, Susan DeFrancesco, Kathleen F Carlson","doi":"10.1136/ip-2024-045581","DOIUrl":"https://doi.org/10.1136/ip-2024-045581","url":null,"abstract":"<p><strong>Background: </strong>Extreme risk protection order (ERPO) laws may be effective tools for preventing firearm suicide. Oregon's ERPO law allows family/household members or law enforcement officers (LEOs) to petition a civil court for an order to temporarily restrict a person's access to firearms when at imminent risk of harming themselves or others. We analysed Oregon's ERPO petitions to describe the law's utilisation for the potential prevention of suicide.</p><p><strong>Methods: </strong>ERPO petitions were obtained from the Oregon Judicial Department. Data were abstracted for the 6-year period after the law took effect (2018-2023). A 20% random sample of records was double-coded. Inter-rater agreement was >80% for key variables. Descriptive analyses were conducted to examine petitions citing suicide risk; cross-tabulations compared suicide-related petitions to those unrelated to suicide.</p><p><strong>Results: </strong>There were 835 petitions filed and 650 (78%) initially granted. Suicide risk was identified in 516 petitions (62%), 421 of which were initially granted (82%). Suicide-related petitions were more likely to be granted than non-suicide-related petitions (72%; p=0.001). Threats to others were also cited in 80% of suicide-related petitions. LEOs filed 60% and family/household members filed 29% of suicide-related petitions. Concerns cited in suicide-related petitions included substance use (56%) and mental health diagnoses (27%). Respondents were hospitalised or referred for services in 41% of suicide-related petitions.</p><p><strong>Conclusions: </strong>Oregon's ERPO law is being used to address firearm suicide risk, but implementation gaps may exist, including missed opportunities for healthcare or other services. Further research examining barriers and facilitators to ERPO use for suicide prevention is needed.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulance services for road traffic injury (RTI) victims in Bangladesh: a cross-sectional study on the ground realities and the way forward.","authors":"Zarin Tasnim, Samiun Nazrin Bente Kamal Tune, Bushra Zarin Islam, Nahitun Naher, Syed Masud Ahmed","doi":"10.1136/ip-2024-045302","DOIUrl":"https://doi.org/10.1136/ip-2024-045302","url":null,"abstract":"<p><strong>Introduction: </strong>Swift and safe transport of road traffic injury patients for life-saving interventions requires a functioning ambulance system which is largely lacking in the low- and middle-income countries. This study explored the current situation of ambulance-based prehospital care services in Bangladesh to inform the development of an evidence-based national ambulance system.</p><p><strong>Methods: </strong>A cross-sectional study conducted in five selected districts of Bangladesh, employing qualitative and quantitative approaches, elicited data on the 29 ambulances and the knowledge and skills of their operators. Findings were validated through 32 key informant interviews with relevant stakeholders on their experiences and insights towards developing a national ambulance system in the country.</p><p><strong>Results: </strong>Most of the ambulances were 'makeshift ambulances' (converted microbus) and commonly lacked the necessary supplies and equipment, including a Global Positioning System tracker or location identifier system. Around 20 drivers had 10+years of work experience, but none were trained in first-aid. Some drivers developed a few life-saving skills like removing foreign bodies from the airway or immobilising fractured limbs, etc from work experiences. The public sector ambulances were mostly used for transporting referral patients and, quite frequently, for transporting staff. Public ambulances had government-determined fixed rates, whereas private ambulances did not. The responsible authority/operator for the public sector ambulances was ambiguous and not coordinated by any local/central authority.</p><p><strong>Conclusion: </strong>The 'ambulance' service in the country is rudimentary, fragmented and poorly resourced, lacking any central/regional level coordination. A recommendation is made to develop a national ambulance service, integrating public and private sectors and operating under a central/regional authority.</p>","PeriodicalId":13682,"journal":{"name":"Injury Prevention","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}