The road traffic injury treatment network in mainland China
Authors: Wang Zheng-guo , Zhang Lianyang , Zhang Liang , Zhao Wenjun 
Published: November 2015

The issue of road traffic safety in mainland China is particularly serious. The total number of vehicles is growing rapidly (e.g. 60 million in 2000 vs. 240 million in 2012); meanwhile the number of road traffic accidents and associated casualties still remains high and shows no signs of meaningful decline. It is reported road traffic causalities in China ranks highest in the world, with an annual death toll exceeding 100,000 and an average daily death toll of 300 [Yue, Liu & Cai, 2004]. Therefore, it is urgent to build up a China-specific road traffic injury treatment network in order to reduce the fatality and disability rate. This article intends to review China’s road traffic injury treatment system from pre- and in-hospital aspects, meanwhile discuss how to improve traffic safety in the future.
1. Pre-hospital rescue system for traffic injury
To improve the efficiency of pre-hospital treatment, the key lies in shortening the reaction time, which calls to establish a multi-level treatment system in each region. In China, trauma treatment system is built upon regional emergency centers and 120 emergency calls. The city level rescue systems are generally well-established, comprising of independent emergency centers or emergency departments affiliated with large hospitals. Most of county-level trauma treatment systems rely on county hospitals, while rural areas on first-aid stations [Wang, 2000]. There are three main types of pre-hospital rescue control center in China (Table 1). In addition, standardization of pre-hospital treatment unit, quick on-site rescue and real-time connect with the corresponding medical treatment organization are essential.
China’s road injury pre-hospital treatment system varies greatly across regions, mainly resulted from differences in regional cultures, economic development, and status of local infrastructure. These differences have led to issues such as non-standardized pre-hospital treatment system, deficient emergency treatment network, prolonged accident response time; shortage of emergency rescue staff, etc.
2. In-hospital traffic injury treatment
There is no universal in-hospital trauma treatment protocol in China. Majority of the general hospitals use specialist consultation to treat trauma patients. The two dominant mechanisms are cross-department consultation coupled with serial treatment process and integrated process. In our hospital, trauma treatment center consists of specialists and technicians from many departments such as general surgery, orthopedics, neurosurgery, etc.
Conclusion
Improving traffic injury treatment requires a systematic approach and coordinated efforts from the whole society. After all, the medical emergency treatment is the last link of the 5E strategy (education, environment, enforcement, engineering, and emergency). To conduct definitive treatment in the golden window and to enhance the pre-hospital as well as in-hospital treatment capabilities are critical. It is also recommended to unify various pre-hospital and in-hospital treatment protocols in China based on field experience [Wang 2007]. Other critical areas include to establish a national level treatment system closely linked to the 120 emergency call system, to use helicopters as the main aerial transport vehicles, to set up state-level training centers for trauma treatment, to build national and regional traffic injury database, and to formulate standards to qualify trauma treatment hospitals and doctors
References
Yue MX, Liu ZG, Cai XQ, et al (2004). The characteristics of road traffic injuries and a new concept for on-site emergency rescue. Chinese General Practice, 7, 1803-1805.
Wang YT (2000). Current status and future prospects for China’s pre-hospital rescue of traffic injury. Journal of Traumatic Surgery, 2, 5-6.
Wang ZG (2007). Research and reflections on road traffic injury. Acta Academiae Medicinae Sinicae, 29, 455-458.