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CHAPTER ONE: INTRODUCTION
1.1 BACKGROUND
The police currently collect statistics (
STATS19) on the number of road accidents
involving cyclists on Scottish roads. This, by its nature,
is confined to those accidents which occur on roads and to
which the police are asked to attend. It does not provide
any data on off-road accidents or on those accidents that
the police do not attend. As a result there is little data
on the full extent of cycle accidents, their severity or
their cause.
1.2 AIMS AND OBJECTIVES
This study aimed to:
- Compare hospital accident and emergency statistics
on cycle casualties with
STATS19 data to measure the extent
of any gap.
- Establish how many cycle accidents occur off road
compared to on road.
- Identify any patterns emerging on the type of
accident, the location and the nature of the injury
occurring.
1.3 METHODOLOGY
Five hospitals within the Lothian and Borders area which
offer an Accident and Emergency (A&E) service agreed to
take part in this study. They were:
- Royal Hospital for Sick Children
- Edinburgh Royal Infirmary
- Western General
- St John's Hospital
- Borders General Hospital
Data was collected over the period of September 2003 to
August 2004.
A proforma was designed to collect data relating to the
casualty and the cycle accident. This was designed after
consultation with the consultants or senior nursing
officers at each of the five participating hospital
departments and the Advisory Group established at the
Scottish Executive.
It was essential that the form was kept as simple as
possible and was easy to complete so that it could be
fitted into the busy schedule that exists within all
A&E departments. A copy of the proforma is appended to
this report. (
Appendix 1)
The form was in two parts. The top half of the form was
designed to be completed by the patients themselves and
asked for simple details relating to:
- The patient
- The timing of the accident
- The involvement of other vehicles
- The presence of any safety aids
- The location of the accident
- Any other circumstances relating to the
accident.
The bottom section of the form was designed to be
completed by clinical staff and comprised of two main
questions relating to:
- The outcome - discharged with or without follow up,
or admitted
- Extent of injury and which part of the body was
injured.
It was important that the staff at the A&E
departments co-operated fully with this study if it was to
be successful. Every effort was undertaken to maintain that
vital co-operation including personal visits to ensure that
staff had a say in how the study was designed, briefings
for staff at appropriate points in the year and personal
collection of completed data sheets throughout the year. In
addition a small goodwill incentive was provided to
participating hospitals.
All staff were briefed at the start of the study
explaining it's purpose and the data collection
requirements. An information sheet was also prepared for
patients which clinical staff were asked to distribute with
the questionnaire. A copy of the information sheet is also
appended to this report. (
Appendix 2)
In some hospitals the researcher was given access to
clinical staff to brief them herself and in others she
briefed only senior staff who then took on this role with
other staff. At no location was it possible to brief all
staff due to the shift system in operation but efforts were
made to brief as many staff as possible. There was
therefore a need to cascade information and there was a
system in place in hospitals to undertake this.
Staff at the hospitals were asked to complete a form for
ALL casualties who were riding a bicycle at the time of
their accident and who presented at a hospital Accident and
Emergency department.
Regular visits were made throughout the year to collect
forms and to ensure that there were no difficulties. Junior
doctors at the Royal Hospital for Sick Children and
Edinburgh Royal Infirmary who joined the departments in
February 2004 were provided with another briefing similar
to that given at the start of the study.
There was no practical means of auditing how well the
data was being collected by the A&E departments and
whether there was a form collected for every cycling
casualty, as requested. There were some problems in getting
the clinical staff to complete the outcome section of the
form and in 35% of the sample this was left blank.
1.4
STATS19
Lothian and Borders Police provided their
STATS19 data on pedal cycle casualities
resulting from road accidents. This was compared to the
data collected in this hospital based study.
1.5 STRUCTURE OF THIS REPORT
Across all five hospitals completed forms were received
from 806 casualties aged 5 or over who had been injured as
a result of a pedal cycle accident between 1
st September 2003 and 31
st August 2004.
Chapter 2 of this report
provides data on who was involved in those cycle accidents.
Chapter 3 explores when cycle
accidents happened.
Chapter 4 examines the extent
to which other vehicles were involved in the accident and
Chapter 5 looks at the location
of cycle accidents, in particular examining those that were
on-road compared to those off-road.
Chapter 6 examines the
incidence of safety aids at the time of the accident.
Chapter 7 looks at the factors
contributing to the accident whilst
Chapter 8 goes on to examine
the extent of the injury caused by the accident, looking at
the outcome for the casualty and the type of injury
sustained.
Chapter 9, examines the
STATS19 data, looking at the differences
between this dataset and that collected via the hospitals.
Chapter 10 concludes the report
and raises some methodological issues in relation to the
future collection of data on cycling accidents.
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