Risk factors in the post-accident period that may increase morbidity and mortality:
(1) delay in detecting the crash (pedestrian hit and run, driving off a cliff, etc.)
(2) presence of fire
(3) release of hazardous materials
(4) presence of alcohol or other drugs (person passed out or wanders about)
(5) difficulty in reaching the crash site
(6) difficulty in extracting the victims
(7) difficulty in evacuating passengers from buses or coaches involved in the crash
(8) lack of appropriate pre-hospital care
(9) lack of appropriate care in the Emergency Department
Lack of appropriate care before and in the Emergency Department is common in developing countries. The availability of trauma evacuation systems and trauma centers can significantly reduce morbidity and mortality.
Pre-hospital care includes care of any conditions that precipitated the crash (like acute myocardial infarction) in addition to care of the traumatic injuries.
