An Injury Investigation of a Bus that Plunged into Ruak Abyss in Maetho, Muang District, Tak Province, Thailand, 28 - 29 March 2014

Abstract

Background: On 28-29 March 2014, the Surveillance and Rapid Response Team of The Office of Disease Prevention and Control Region 9 Phitsanulok, Bureau of Epidemiology, Bureau of Non-Communicable Disease and local authorities joint conducted injury investigation of a bus that plunged into abyss on highway No. 69, at Doi Ruak. Maetho, Muang, Tak province on 24 March 2014 which aimed to describe the event and factors affecting injury and death for implementing specific interventions to prevent road traffic injuries.
Methods: A descriptive study was conducted by gathering data from medical documents and interviewing those involved people in the event. The event description data were analyzed using the Haddon matrix framework.
Results: The bus transported 52 passengers, median age was 41 years, male to female ratio was 1:2. There were 21 survivors and 31 deaths. The main cause of death was a severe head injury. The three most common injuries among 31 deaths belong to head and neck (80.2%), chest and thorax (25.8%) and face equals to extremity (22.6%), respectively. Important factors influencing in this accident were: (1) Bus driver drove on unfamiliar route and used high speed on S-shaped curve, lack of proper performance brake system and careless driving downhill, (2) Insufficient vehicle crash protection and safety equipment (3) Environmental factors as night, 30-meter-depth abyss, 5-kilometer-S-shaped curves and downhill slope, a barrier of post-crash care, and (4) a lot of Inadequate necessary equipment for rescuers, such as headlamps and rescue cutters/spreaders.
Conclusion: The standard of bus driving license, driver training, bus structure and safety equipment should be improved as well as visibility of warning signs and lights at emergency stopping lanes. Also note promotion of emergency stopping lane’s advantages for motorists. The mass casualty response plan and preparedness are important factors for post-crash outcome.