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Adopted by the 42nd World Medical Assembly
Rancho Mirage, CA., USA, October 1990 and
Revised by the WMA General Assembly, Pilanesberg, South Africa,
October 2006
- Injuries are the leading cause of death and disability in
children and young adults. Injuries destroy the health, lives
and livelihoods of millions of people each year. Yet many injuries
are preventable. Injury control should be recognized as a public
health priority requiring coordination among health, transportation
and social service agencies in each country. Physician participation
and leadership is necessary to assure the success of such injury
control programmes.
- The World Medical Association urges National Medical Associations
to work with appropriate public and private agencies to develop
and implement programmes to prevent and treat injuries. Included
in the programmes must be efforts to improve medical treatment
and rehabilitation of injured patients. Research and education
on injury control must be increased, and international cooperation
is a vital and necessary component of successful programmes.
- National Medical Associations should recommend that the following
basic elements be incorporated in their countries' programmes:
Epidemiology
- The initial activity of such programmes must be the acquisition
of more adequate data on which to base priorities, interventions
and research. An effective injury surveillance system should
be implemented in each country to gather and integrate information.
A consistent and accurate system for coding injuries must be
implemented by hospitals and health agencies. There should also
be uniform coding of injury severity.
Prevention
- Injury prevention requires education and training to teach
and persuade people to alter their behaviour and thereby control
their risk of injury. Laws and regulations based on scientifically
sound methods of preventing injuries may be appropriate for
effecting changes in behaviour (for example, the use of seatbelts
and protective helmets). These laws must be strictly enforced
in order to effectively influence behaviour changes. Improvements
in product and environmental design of various products to provide
automatic protection against injuries must be encouraged, as
they will be the most effective means of preventing injuries.
Implementing a reporting system to encourage learning from mistakes
could also be beneficial in preventing future injuries.
Biomechanics
- Biomedical research on injury causation and prevention should
be given priority. A better understanding of the biomechanics
of injury and disability could enable the development of improved
protection for humans. Regulations pertaining to product design
must incorporate product safety standards developed from an
improved understanding of the biomechanics of injury.
Treatment
- Injury management at the scene of the occurrence must be
enhanced by an effective system of communication with medical
practitioners, to facilitate decision-making. Rapid and safe
transportation to the hospital should be provided. An experienced
team of trauma practitioners should be available at the hospital.
There should also be adequate equipment and supplies available
for the care of the injured patient, including immediate access
to a blood bank. Education and training of medical practitioners
in trauma care must be encouraged to assure optimal technique
by an adequate number of physicians at all times.
Rehabilitation
- Trauma victims need continuity of care emphasizing not only
survival but also the identification and preservation of residual
functions. Rehabilitation to restore biological, psychological
and social functions must be undertaken in an effort to allow
the injured person to achieve maximal personal autonomy and
an independent lifestyle. Where feasible, community integration
is a desirable goal for people chronically disabled by injury.
Rehabilitation may also require changes in the patient's physical
and social environment.
14.10.2006
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