INJURY SURVEILLANCE IN TRINIDAD - The San Fernando General Hospital Experience Roanna Bynoe September 7, 2006

History of Surveillance System  Surveillance System initiated in December 2001 with grant from IDRC  Joint initiative of the CAREC, SWRHA and the Rotary Club, San Fernando South  Data collection commenced in February 2002  Collaboration with Mc Laughlin Centre, Ottawa in 2005

ANALYSIS  February December 2005  Catchment population: 500, 000  23.5% of all A&E Department Visits

Total Injuries by year

Age Group

Intent

Intentional Interpersonal Injuries  Quarrel - predominant context of injury Leading context in the 25 – 44 age category with men twice likely to be at risk than female counterpart.  The predominant object used during a Quarrel was Bodily force and predominant location is home, 2 nd leading location is street/highway.

Intentional Interpersonal Injuries  The predominant Victim/Perpetrator Relationship was a friend/ acquaintance and leading age group is 25 – 44 years, 2 nd leading age group is 15 – 24 years  Predominant Object Used is bodily force especially with 25 – 44 and 15 – 24 age groups.

Mechanism of Injury

Mechanism of Injury  Falls accounted for 32.5% of the Level IV injuries whilst Other Blunt Force accounted for 26.8% of the Level IV injuries  The predominant mode of transportation is the private car, 2 nd leading mode of transport is the pedestrian  The leading type of road user is the passenger, next predominant road user is the driver.

Clinical Outcome

 <1% of persons sustaining an unintentional injury died in the A&E Department  72.1% of persons discharged sustained an intentional interpersonal injury  <20% of persons sustaining a fall were admitted to hospital  17.9% of traffic injuries admitted to hospital

System Limitations  Injury surveillance system exists only in South West Region  Profile of injuries may differ substantially across different Health Regions  System does not capture injuries presenting at: Private Facilities Private Facilities Health Centers Health Centers  Under-representation of fatal injuries

Next Steps  Develop and implement intervention strategies with key stakeholders  Training and sensitisation of staff  Expansion of the system to other A&E Departments within the SWRHA  National expansion of the system

Acknowledgements  Caribbean Epidemiology Centre  South West Regional Health Authority (data collection and entry, nursing staff, medical staff, hospital administration)  Ministry of Health  Rotary Club, San Fernando South  PAHO (biennial funds)  Health Canada