frsc insight july 2013 edition

FRSC INSIGHT JULY , 2013

Insi htgA MONTHLY PUBLICATION OF FEDERAL ROAD SAFETY COMMISSION www.frscinsight.com

JULY, 2013

SmishingA Serious Identity Theft Scheme

TRAUMAConcepts and principles of management Vehicle

ExtricationTechniques


Insi htJULY, 2013

VehicleExtricationTechniques

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From the Editor-In-Chief

Have you ever wondered why the most enduring ideas most times are the simplest? In

fact, the most complex problems most times do actually have a simple so-lution. Just thinking simply through a challenge may reveal the solution.

In this edition, we feature the sim-ple but real stories behind some of the global brand names. FRSC de-sires to transform into a world class organisation. Do you know the sim-ple story behind the establishment of FRSC brand? We will share that simple story with you some day.

As a road safety personnel, handling of trauma itself can be traumatic. There is however a simple way of overcom-ing this challenge. Understanding the con-cept and principle of trauma management is discussed in this edition to guide person-nel on rescue patrol. Vehicle extricating techniques is also discussed in this edition.

As the FRSC continues to automate its oper-ations, and creates an e – environment, per-

sonnel would be more exposed to smishing, where fraudsters would use phony means and attempt to obtain their personal details and later use same to defraud their victims.This is in addition to the regular stories, while previous edition of the FRSC In-sight is available on www.frscinsight.com

OC Oladele(CC)Editor – In - Chief.


Insi htg

EDITORIAL Osita Chidoka OFR

Corps Marshal/Chief Executive Publisher

OC Oladele (CC) Editor–In-Chief

KD Alegieuno (ARC) Editor

Members VO Ogunnupebi (ACC) AR Obagbemiro (CRC) CB Nwokolo (DRC) DO Enakireru (ARC) 0I IKOKU (ARC)

Vehicle extrica-tion techniquesTechnology is field of

transport has comforted man, yet it has brought a

lot of grief in the form of Inci-dents, following Road Traffic Crashes or Vehicular Accident.Previously Rescuers often use fireman – Axe, circu-lar saws, Matches and other crude tools for vehicle ex-trications, but these suffered from several drawbacks, saws can generate sparks, which could start a fire, create loud noise, which could stress the

Victim or even cause shock and are often slow cutting.Alternatively rescuers could try to pry open the vehicle doors using a crowbar or Halligan bar, but this could compromise the stability of the vehicles, further injure the Victim or unintention-ally activate vehicle airbags. In comparison, Hydraulic spreader, cutter and Telescope ram jack are quieter, faster and more versatile, they can cut, open and even lift a car

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What is extrication? It can simply be defined as removing trapped Victims from the vehicle or the vehicle from the trapped Victims.

Extrication includes Victims assessment, treatment and removal of victims from vehi-cle. Some departments only carry with them minimal tools such as one set of Jaws of life and are only capable of simply “popping “ a door off and then must step away to allow a more dedicated heavy rescue team in, who has more equipment. Extrication units are sup-posed to not only have many different kinds of extrication tools, but medical equipment, oxygen, and backboards as well. Extrica-tion is the entire process from fire protection, power unit disengagement, vehicle stabiliza-tion, patient stabilization and treatment, re-moval of vehicle from patients, removal of patient and transfer by Ambulance. Extrica-tion is not just simply popping a door off.

OBJECTIVE

In any motor vehicle crash our objective as Rescu-ers is:-To remove the victim from his or her predicament without causing further injuries within the golden hour.-To prevent loss of Human life and save as many lives as possible, as fast as possible with as little resources as possible.-To facilitate fast rescue operations.

DRESSING

Dressing must conform to the International Safety standards of safe working practices. All crew work-ing directly on the road ways are to.-Wear reflective Jacket/vest.-Wear boat or a very strong shoe-Wear hand glove-Those who will actually be involved in extrac-tions should at all times wear eye protections, nose

guards and safety helmets.GUIDELINE FOR RANGE OF VEHICLE EX-TRICATION TECHNIQUES TO MEET VARY-ING SITUATION

Before extracting the Victim, officers should under-take the Following steps when appropriate.

-Check any threat to life – that may cause out break fire.-Check hazardous materials and explosives that could be dangerous to you or to the victims.-Cause & mechanism of injury or illness.-The number of victims-Under take 5-10 meter out circle check followed by 2-5 meter inner circle check.-Establish scene staging area-Size up the area (move round the scene)-mbulance equipment staging area-Rescue tool staging area-Fire protection staging area.-Rubbish dumps area.

The Rescue officer having done above, stabilize the vehicle-Disconnect the batteries, neutralize other hazards and begin to undertake only the necessary vehicle cutting expansion and Spreading to allow for ac-cessing and removal of the victims Vehicle cut-ting must be considered as part of patient care with regard to the golden hour. It should not be stopped unless it directly affects the victims care. Cutting to allow for assessment and the removal of the victims should be done simultaneously with the assess-ment and treatment of the patient to reduce scene time

PRINCIPLES OF EXTRICATIONIn determining the method of patient removal (ex-trication) from a vehicle, the two basic principles should be applied(a) Maintain spinal Alignment- To minimize spi-nal cord injury and paralysis.

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HYDRAULIC CUTTER

The cutter is hydraulic tool which is de-signed to cut through Metal. It is often called a crab –cutter, owing to the shape and configuration of its blades. These are most commonly used to cut through a ve-hicle’s structure in extrication operations.

HYDRAULIC SPREADER

This is a tool designed with 2 arms which come together in a narrow tip. The tip of the tool can be inserted into a narrow gap between two vehicles panels (such as between 2 doors or between a door and fenders) when the tool is operated, the arms are opened, drawing apart the metals in the panels. Spreaders are used to pop vehicle doors from their hinges.

HYDRAULIC TELESCOPIC RAM JACK (RESCUE CYLINDER)

The rescue cylinder is used for pushing and pulling, it is highly used in road traf-fic crash, earthquake and industrial ac-cidents. The cylinder can be turned un-der load due to rotating pushing head.

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Sugar & the human body[1] Sugar can suppress the immune system. [2] Sugar upsets the mineral relationships in the body. [3] Sugar can cause... hyperactivity, anxiety, difficulty concentrating, and crankiness in children. [4] Sugar can produce a significant rise in triglycerides. [5] Sugar contributes to the reduction in defense against bacterial infection (infectious diseases). [6] Sugar causes a loss of tissue elastic-ity and function, the more sugar you eat the more elasticity and function you lose. [7] Sugar reduces high-density lipoproteins. [8] Sugar leads to chromium deficiency. [9] Sugar leads to cancer of the ovaries. [10] Sugar can increase fasting levels of glucose. [11] Sugar causes copper deficiency. [12] Sugar interferes with absorption of cal-cium and magnesium. [13] Sugar may make eyes more vulnerable to age-related macular degeneration. [14] Sugar raises the level of a neurotrans-mitters: dopamine, serotonin, and norepi-nephrine.

[15] Sugar can cause hypoglycemia. [16] Sugar can produce an acidic digestive tract. [17] Sugar can cause a rapid rise of adrena-line levels in children. [18] Sugar malabsorption is frequent in pa-tients with functional bowel disease. [19] Sugar can cause premature aging. 20] Sugar can lead to alcoholism. 21] Sugar can cause tooth decay. [22] Sugar contributes to obesity[29] Sugar can cause heart disease. [30] Sugar can cause appendicitis. [31] Sugar can cause hemorrhoids. [32] Sugar can cause varicose veins. [33] Sugar can elevate glucose and insulin responses in oral contraceptive users. [34] Sugar can lead to periodontal disease. [35] Sugar can contribute to osteoporosis. [36] Sugar contributes to saliva acidity.

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[39] Sugar can decrease growth hormone. 40] Sugar can increase cholesterol. [41] Sugar can increase the systolic blood pressure. [42] High sugar intake increases advanced glycation end products (AGEs)(Sugar bound non-enzymatically to protein) [43] Sugar can interfere with the absorption

of protein. [44] Sugar causes food allergies. [45] Sugar can contribute to diabetes. [46] Sugar can cause toxemia during preg-nancy. [47] Sugar can contribute to eczema in chil-dren.

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Iodized saltAmericans gained up to 15 IQ points after iodized salt became mandatory in 1924

Kul Gautam, Depu-ty Executive Director, UNICEF, “IDD

is the single greatest cause of preventable mental retardation. Severe deficiencies cause cretinism, stillbirth

and miscarriage. But even mild deficiency can significantly af-fect the learning ability of populations. Scientific evidence shows

alarming effects of IDD. Even a moderate deficiency, especially in pregnant women and infants, lowers their intelligence by 10 to 15 IQ points, with incalculable damage to social and economic development of nations and communities. Today over 1 billion people in the world suffer from iodine deficiency, and 38 million babies born every year are not protected from brain damage due to IDD. These 38 millions, or nearly 30 percent of the world’s newborns, come from families that are the least educated, most isolated and economically disadvan-taged. The mark of a civilized society is how well it takes care of

its most vulnerable and deprived communities. If we continue to fail to reach these newborns, we will be consigning them

to an inter-generational cycle of poverty and injus-tice.”

Iodine is said to be found in the sea and in soil that has previously been under the sea. Salt water seafood (e.g., sea trout, lobster,

haddock, shrimp, and shark), sea vegetables (such as seaweed, including kelp, hijiki, ar-ame, nori, and laver), vegetables grown in soil containing iodine (found on any land that was previously under the sea), and animals graz-ing on plants growing in iodine rich soil all are good sources. This mineral also enters the food supply through the use of certain disin-fectants called iodophors. These are primarily used in the dairy industry, so milk and cheese, for example, contain a good amount of iodine. In addition, some red dyes contain iodine, as do some dough conditioners (look for an io-dized conditioner listed in the ingredient sec-

tion on the bread package). These sources add considerable amounts of iodine to one’s diet.

Today, salt producers are a key partner in combating Iodine Deficiency Disorders (IDD) today throughout the world. Many people er-roneously assume that because salt iodization was first implemented nearly a century ago, that the problem no longer exists. Tragically, that’s wrong. In 1990, only about 20% of the world’s households had access to iodized salt and were protected against Iodine Deficiency Disorders. After a major push, access now exceeds 70%.Scientists identified iodine as an element in the early 19th century and only 20 years later,

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French scientist J-B. Boussingault report-ed his conclusion that iodized salt would be an effective prophylaxis for goiter, stat-ing “I am convinced that goitre would dis-appear...if the authorities made available in every district town...a depot of salt con-taining iodine.” Yet it took another century for “authorities in the U.S. and Switzer-land to effectuate Boussingault’s insight.In the United States, from the outset, salt pro-ducers cooperated with public health authori-ties and made both iodized and plain salt availa-ble to consumers at the same price. Even so, the Salt Institute estimates that only about 70% of the table salt sold in the United States is iodized. Salt used in processed foods is not iodized. Given that people are cooking less at home and buying either restaurant or processed foods, iodine intakes in the U.S. have de-clined from about 250 μg/day to 157 mi-crograms/day. Public health authorities rec-

ommend 150 μg or more and the need is particularly acute for expectant mothers. Dai-ly Iodine intakes of 1,000 - 1,100 μg are safe for adults and children over 4 years of age.The technology for iodizing or iodating salt is well known, readily available, and inex-pensive. One particular problem is that some countries lack high quality salt manufacturing and packaging technologies. Another is an inadequate regulatory system depriving con-sumers of confidence that a package labeled “iodized” contains iodine and in the proper amount. Both potassium iodide and potas-sium iodate are used to add iodine to salt.

According to Daily Mail reports, Iodine ap-pears to have made Americans smarter. While the addition of iodine to salt originally was intended to eliminate goiters caused by io-dine deficiencies, it appears to have had an unexpected consequence: Americans gained

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up to 15 IQ points after iodized salt be-came mandatory in 1924, a new study finds. The National Bureau of Economic Re-search recently published a report by econ-omists James Freyer, Dimitra Politi and David Weil that looked at intelligence data from roughly 2 million World War II enlistees born between 1921 and 1927. The study, which compares the IQ levels of recruits born before 1924 with those born af-ter that year, shows that those who ranked the highest were assigned to the Army Air Forc-es. Meanwhile, those recruits with lower IQ scores were sent to the Army ground forces.The economists then researched likely iodine levels in recruits’ hometowns based on the occurrence of goiters in those regions, and they discovered that recruits born in low-io-dine areas after 1924 were much more likely to be sent to the Army Air Forces than those

recruits born before 1924. In fact, the aver-age IQ of those slightly younger recruits was 15 points higher than that of older recruits.According to the report, the addition of io-dine to salt might be one cause behind the Flynn effect, a long-sustained rise in IQ from roughly 1930 to the present.Iodine is a mineral that is added to table salt and found in a variety of foods. It is important for good health and, fortunately, our bodies re-quire it in relatively small quantities. Iodine is part of a hormone, thyroxin, which is responsi-ble for maintaining a person’s metabolic rate.

Sources:1 . h t t p : / / w w w. s a l t i n s t i t u t e . o r g / U s e s - b e n e f i t s /S a l t - i n - F o o d / E s s e n t i a l - n u t r i e n t / I o d i z e d - s a l t2 . h t t p : / / n e w s . y a h o o . c o m / n e w - s t u d y - - i o d i z e d -s a l t - m a d e - a m e r i c a n s - s m a r t e r - 1 4 0 6 0 9 5 2 5 . h t m l3 . h t t p : / / g o a s k a l i c e . c o l u m b i a . e d u / w h a t s - i o -

d i z e d - s a l t - i t - b e t t e r - y o u - t h a n r e g u l a r - s a l t

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SmishingA Serious Identity Theft Scheme

Smishing is a combination of the terms “SMS” and “phishing.” It is similar to phishing, but refers to fraudulent mes-

sages sent over SMS (text messaging) rather than email. The goal of smishing is to capture people’s personal information. In order to do this, “smishers” send out mass text messages designed to capture the recipients’ attention. It is an identity theft scheme that involves send-ing consumers text messages containing a link to a fraudulent website or a phone number in an attempt to collect personal information.Some messages may be threatening, e.g., “Visit this URL to avoid being charged $5.00

per day,” while others may provide a fake incentive, such as “You have won a free gift card, visit this website to claim your prize.” If you click on a link in the text message, you will be directed to a fraudulent web-site that will ask you to enter your personal information, such as your name, address, phone number, and email address. In some cases, a smishing website will ask you to en-ter your bank account information or social security number. Smishing has become in-creasingly common now that smartphones are widely used, considering that criminals go where their opportunities are greatest.

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According to Network World, there are more than 6 billion cellphone subscrib-ers in the world, nearly two-thirds of all adults with a cellphone use text messag-ing and more than 90% of text messages are opened within 15 minutes of being received Many smartphones allow you to simply click on a link in a text message to view the web-site in your phone’s browser. This makes text messages an effective “bait” for luring unsuspecting users to fraudulent websites. Therefore, just like when you receive email spam, is best to not visit websites mentioned in text messages from unknown sources. Peo-ple should know how to determine if they are being targeted by these criminals and how to ensure that their mobile devices are secure.SMiShing attempts should be growing so rapidly, considering that criminals go where their opportunities are greatest. They’ve got to be salivating over these statistics: • There are more than 6 bil-lion cellphone subscribers in the world.• Nearly two-thirds of all adults

with a cellphone use text messaging.• More than 90% of text messages are opened within 15 minutes of being received

Many mobile phone users keep their per-sonal data, like bank account information, stored on their smartphones, this informa-tion can be accessed by criminals through phishing and other scams. One example of a phishing scam is a criminal sending an alert from a bank asking the cellphone user to fol-low a link to verify account information as reactivate your ATM card by entering a PIN.Consumers should also send these scam text messages to 7726 (SPAM) to cellphone carri-ers to have the number blocked, the BBB said. If the smishing scam included the name of a bank, contact the bank to notify them of the text.Phone users should be wary of any mes-sage that is not a cell number, A mes-sage that is asking a phone user to respond quickly can be a scam, and people should stop and think it over before taking action.

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Tips to avoid falling for a SMiShing attackHere are some general tips to share with your end users to help them from falling vic-tim to SMiShing.• Avoid clicking links within text mes-sages, especially if they are sent from some-one you don’t know. But, be aware that attack messages can appear to come from someone you do know, so think before you click. • Don’t respond to text messages that request private or financial information from you.• If you get a message that appears to be from your bank, financial institution, or other entity that you do business with, contact that business directly to determine if they sent you a legitimate request. Review this entity’s policy on sending text messages to custom-ers. • Beware of messages that have a num-

ber that is not a cell number. Scammers often mask their identity by using email-to-text services to avoid revealing their actual phone number. • If a text message is urging you to act or respond quickly, stop and think about it. Remember that criminals use this as a tactic to get you to do what they want. • Never reply to a suspicious text mes-sage without doing your research and verify-ing the source. If your bank is really going to cancel your credit card, you should be able to call the number on the back of your card to discuss this matter with them. • Never call a phone number from an unknown texter.

Sources:1. www.networkworld.com/newsletters

2. www.techterms.com/definition/smishing

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Adobe This came from name of the river Adobe Creek that ran behind the house of founder John Warnock

Apple Computers It was the favorite fruit of founder Steve Jobs. He was three months late in filing a name for the business, and he threatened to call his company Apple Computers if the other colleagues didn’t suggest a better name by 5 O’clock that evening

CISCO It is not an acronym as popularly believed. It is short for San Francisco

Compaq This name was formed by using COMp, for computer, and PAQ to denote a small integral object

Corel The name was derived from the founder’s name Dr. Michael Cowpland. It stands for COwpland REsearchLaboratory

The Real Storiesbehind leading BRAND NAMESThere are many companies, brands, products whose names were derived from strange circumstances, things or happenings.

Mercedes: This was actually the financier’s daughter’s name.

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Many years ago in a small Zezuru village, a farmer had the mis-fortune of owing a large sum of

money to a village moneylender. The moneylender, who was old and ugly, fancied the farmer’s young beauti-ful daughter. So the moneylender pro-posed a bargain. He said he would for-go the farmer’s debt if he could marry his daughter. Both the farmer and his daughter were horrified by the proposal.So the cunning money-lender suggested that they let providence decide the matter. He told them that he would put a black pebble and a white pebble into An empty money bag. Then the girl would have to pick one peb-ble from the bag. 1. If she picked the black pebble, she would be-come his wife and her father’s debt would be forgiven. 2. If she picked the white peb-ble she need not marry him and her father’s debt would still be for-given. 3. But if she refused to pick a peb-ble, her father would be thrown into jail.

They were standing on a pebble strewn path in the farmer’s field.As they talked, the moneylender bent over to pick up two pebbles. As he picked them up, the sharp-eyed dam-sel/girl noticed that he had picked up two black pebbles and put them into the bag. He then asked the girl to pick a pebble from the bag. Now, im-agine that you were standing in the field. What would you have done if you were the girl? If you had to advise her, what would you have told her? Careful analysis would produce three

possibilities: 1. The girl should refuse to take a pebble. 2. The girl should show that there were two black peb-bles in the bag and expose the money-lender as a cheat. 3. The girl should pick a black pebble and sacrifice herself in order to save her father from his debt and im-prisonment. Take a moment to pon-der over the story.

A storyon problem solving

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The story is used with the hope that it will make us appreciate the difference between lateral and logi-cal thinking. The girl’s dilemma can-not be solved with traditional logical thinking.Think of the consequences if she chooses the above logical answers. What would you recommend to the girl do?There is a huge potential for creativ-ity and new ideas. Yet our compla-cency with existing ideas makes them difficult to achieve

Please see the solution after you come up with your own solutionWhat the girl really did:Well, here is what she did…The girl put her hand into the moneybag and

drew out a pebble. Without look-ing at it, she fumbled and let it fall onto the pebble-strewn path where it immediately became lost among all the other pebbles. “Oh, how clumsy of me,” she said. “But never mind, if you look into the bag for the one that is left, you will be able to tell which pebble I picked.” Since the remaining pebble is black, it must be assumed that she had picked the white one. And since the money-lender dared not admit his dishon-esty, the girl changed what seemed an impossible situation into an ex-tremely advantageous one.Most complex problems may have a simple solution; just change the way you think about them.

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The Nigerian Road Users: a socio-psychological perspective of the Federal Road Safety Corps’ ideal

The Nigerian road is one of the most unsafe in the world today. This seems an established fact going by the

amount of loss both human and economic re-sources on our roads every year. In this pa-per we shall be dwelling on who Nigerian road users are what are their psychological and sociological makes ups that could pre-dispose him to total neglect of road use eth-ics to the detriment of his life and others.

It is only when these matters are resolved that solution could be found to the problem of carnage on our roads. Such answers would have varied but positive implications for the FRSC and other road traffic enforcers in a bid to make our roads safe for all users. These is-sues form the basis of this paper which if tak-en seriously the commission may be heading towards success in combating road accidents.

THE NIGERIAN ROAD USERWho constitute the road user in Nigeria to-day? These are pedestrians, hawkers, beg-gars, cyclist (bicycle, motorcycle and tricy-cle), vehicle drivers, private, commercial, and trailer and lorry drivers. Commercial bus, tractors, cranes and other articulat-ed vehicles, road construction equipment.This List is by no means conclusive.

PSYCHOLOGICAL MAKE-UP OF THE NIGERIAN ROAD USERA typical Nigerian is an average road user, in the sense that everyone born either en-ters on his own or is carried into the road.The Microsoft Encarta word English dic-tionary (1999) defines psycho-social as

that which relate to both the psychological and the social aspect of something, or re-lating to a thing that has both the psycho-logical and social aspect. In other words to further explain this word we take it apart.Psychology defined as the systematic study of human behavior psychology deals with men-tal experience of individuals while sociology deals with systematic study of social behavior and human groups/grouping. The difference between the two lies in the unit of reference , i.e either the individual or the group for the psychologist and sociologist respectively. For a psychologist, the focus is on the way individual behavior is organized to form his personality, while the sociology focuses on the group i.e society and culture of which the individual constitute a part. Experts, however agree that human psychology is a product of social con-dition. This meeting point /ground be-tween the two discipline called social psychology shared by both discipline.

BASIC PSYCHOLOGY INGREDI-ENT REQUIRED FOR CHANGEThe greatest ingredient required for change in behavior is the appropriate motivation.MOTIVATION: this is anything which pro-pels action and leads people to persist in their goal directed behavior. It’s the drive that makes people to prefer disciplined be-havior e.g driving to discipline one, to pur-sue nationalistic and patriotic acts, to join special road marshal squads etc Basic mo-tives are guarded by basic needs such as se-curity, food, shelter, and sexual gratifica-tion. There are hierarchies of human needs .

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i. Social need - opportunity to participate, be involved, help oth-ers and to develop close friendships.ii. Esteem needs - people have need for raised esteem as well as prestige.iii. Autonomy – involves giving people authority/ opportunity to be independent in thought and action achieved through involv-ing programme, planning and execution.iv. Self actualization – opportu-nity for personal growth and develop-ment for feeling of self fulfillment, feel-ing of worthwhile accomplished etc.

IMPLICATION TO FRSCMotives according to experts are ordered to hierarchy ranging from the basic (biological) needs e.g. security to the most advanced or com-plex ones e.g. needs for self actualization. It is also said that people are preoccupied with lower lever needs are not likely to accomplish high-er level ones and vice versa (Lindgren, 1973).This has implication for the type of persua-sion or communication that FRSC should design for Nigerians. Persuasive message or road safety education programmes should be designed with specific population in mind. For rural population, the message should exploit

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the most elementary motives and needs such as food, shelter, and security. On the other hand, for urban, professional and middle class people, emphasis should be placed on the need for self regard, self esteem, feel-ing of fulfillment and worthwhile accom-plishment. Communication experts know the importance of matching one’s persua-sive communication to the level of audience.Suggestibility -critical situations such as we have been experiencing in the coun-try e.g. economic uncertainties, unem-ployment, in-security, etc can force peo-ple to become vulnerable to suggestions according Cantrill (1976) in two ways:i. When a person lacks ad-equate mental context.ii. When his mental context is rigidly fixed.The FRSC campaign must take into ac-count these obvious realities of our soci-

ety in dealing with an average road users.Use of slogan and symbols- these are short-cut rationalizations which fire imagination. They spread fast because they express dis-satisfaction from which the people have been suffering and at the same time suggest a new direction and purpose. The social con-text of a slogan is what sells it. e.g why hurry to make your children orphans fatherless.Make your message/campaign programmes simple for easy understanding by all. This gives meaning to people and shows how their immediate needs and desires are met. Make full use of our social setting homes, school, workshop, church, mosque, highways, mar-ket places, shopping malls community, etc.

A PAPER DELIVERED AT BATCH ‘’D’’ OF INTERMEDATE LEADERSHIP COURSE, AT FRSC ACADEMY, JOS BYAR OBAGBEMIRO9CRC)

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TRAUMA: Concepts and principles of management(II)ASSESSMENTIt may not be possible to wait for overt clini-cal signs if time is critical.Response to a problem needs to be initiated before we are sure of its existence.Diagnoses should be positively sought and in some cases screened.This allows us to move forward rapidlyUnderstanding the relationship between the:-Patient-Mechanism of injury-Injury produced at time zero, is the key to understanding the problem to be solved. Mechanism + Patient = InjuryThe initial nature of this relationship quite obvious (overt – most cases) or hidden (cov-ert – rarely).As clinicians we need to convert everything to the overt so that appropriate clinical re-sponses can be carried out.When the mechanism is not known reliably while other variables are known, the equa-tion can be rewritten: Injury – Patient = MechanismIf an injury is obvious and the patient previ-ously fit, we may be able to work out the likely mechanism of injury.Approach useful in assessing unconscious patients to guide the search for the covert or hidden injuries.On some occasions the equation appears not to apply at first sight: Mechanism + Patient ≠ InjuryThis failure is not real but apparent; some-thing has probably been misjudged and the factor must be sought.

Some aspect of the injury has not been dis-covered.Mechanism suggested may not be genuine.Some aspect of the patient before the injury the Clinician is unaware.

Mechanism suggested may not be genuine

These are situations where there is deliberate at-tempt to mislead.When the patient is a victim of abuse in a relation-ship.Common when patient is unable to give their own history e.g. very young child or elderly.The mechanism of injury are criminal (NAI)Factors that suggest NAI has occurred are:History inconsistent with the injuries sustained.Changing history.Aggressive behavior of carers at interview.Injuries of different ages.Posterior rib fractures.Long bone fractures in a pre-ambulatory child.The simple early response is to admit the at-risk per-son on clinical ground that allows time for consider-able clinical response.Accurate assessment and documentation of find-ings is required as the victim of an assault may need good forensic evidence at some later date to convict their assailant.Some aspect of the patient before injury not knownWhen the mechanism and the injury are obvious but inconsistent, there is something previously unknown about the patient to discover.Commonly there is a pre-existing pathology e.g. pathological fracture in the elderly or medical fall and mechanical fall caused by transient ischaemic attack, abnormal cardiac rhythm.

TO BE CONTINUED IN THE NEXT EDITION

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Planning Adisory UnitConverting data into intelligence for making evidence based decision

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Phone:+234 8077201236+234 7036136152

frsc insight july 2013 edition

Documents

establishment of frsc

vehicle doors

vehicle airbags

trapped victims

frsc desires

removal of victims

victims assessment

vehicle extrications