Injury Investigation of a Bus that Plunged into Ravine in Lampang Province, Thailand, 25 – 27 October 2013

Abstract

Introduction: On 25 October 2013, the Surveillance and Rapid Response Team of Bureau of Epidemiology with local authorities conducted the injury investigation of bus that plunged into ravine on highway No.120, Lampang province in order 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 in the event. The event description data were analyzed using the Haddon matrix framework.
Results: The bus transported 39 passengers, median age = 59 years, male to female ratio = 1:5.5, survivors = 17, deaths = 22. The main cause of death was a severe head injury (63.6%). The mean of Injury Severity Score (ISS) among 22 deaths = 62.1 (SD=18.6) and 17 survivors = 8.6 (SD=6.4). Important factors influencing in this accident were: (1) lack of driving skill of the bus driver despite receiving a driving license, (2) insufficient vehicle crash protection and safety equipment, (3) environmental factors as a barrier of post-crash care, and (4) practice of rescuer teams and pre-hospital care as a determinant of post-crash severity.
Conclusion and Recommendation: The standard of bus driving license and bus safety equipment should be improved. The mass casualty response plan and preparedness are important factors for post-crash outcome.