Head injury has generally been dramatized in the media, often giving an unreal picture to the layman. In a typical Bollywood masala movie, the hero is pushed into the operation theatre directly from the ambulance stretcher by pretty nurses and sleazy pan chewing ward boys, leaving behind inconsolable parents and a visibly shocked and tearful fiancée. After a few minutes a clean shaven doctor (you can mistake him for a model for some nice smelling after shave lotion) removes his gloves thoughtfully, and announces in final tones that the hero will open his eyes after three weeks. And lo! He opens them exactly three weeks later and gets married to his long suffering sweetheart, and lives happily ever after.

The truth is that it is never that rosy or simple for the relatives and the doctor attending on him. Head injury is a serious matter, which has not been clearly understood by the general public, or the legal system. Victims are usually in their most productive age, causing loss of manpower, permanent disability and extreme distress to near and dear, in addition to huge medical bills.

The slogan for World Health Day, which fell on the 7th of April, 2004 was 'Road safety is no accident'. Too often, road safety is treated as a concern of the transport department and legal issue not a health issue. Every day, as many as 14,0000 people are injured on the roads around the world. More than 3,000 people die and over 15,000 are disabled for life. Each of those people have a network of family, friends, neighbors, colleagues or classmates who are also affected, emotionally and economically. Families struggle with poverty when they lose a breadwinner or have the added expense of caring for disabled family members.

Section of victims:

Most of the victims are poor and marginalized, have limited access to health care and lack proper education. 20% of accident victims are pedestrians and 15% are cyclists. A two wheeler rider has 35 times greater death rate than a car occupant and 75% of cyclists suffer a road accident and eventually die due to reasons of a head injury.

What happens to the victim:

Head injury is caused by the impact of outside forces on the brain and subsequent complications due to lack of oxygen, swelling of the brain and raised pressure inside the skull. The chain of events starts with the initial injury (within seconds) and is worsened by secondary injury, which starts within a few minutes and is followed later by complications.

The role of the Government role in prevention of road accidents: 

a) Plan the roads so that heavy traffic is discouraged to pass through residential areas, schools and markets.
b) Provide safe crossings, sidewalks, paths and lanes for pedestrians and cyclists as they are the bulk of users of road and also victims.
c) Provide local buses in cities, towns and villages at cheaper rates to discourage usage of private vehicles, as this reduces number of vehicles on the road.
d) Design and improve roads.
e) Improve the visibility of roads, road signs, vehicles, and road users during both day and night.
f) Helmet & Cell phone laws.
g) Stricter laws for drunken driving and speeding.
h) Create awareness about road safety in schools.

Common causes of road traffic accidents:

a) Inappropriate and excessive speed.
b) Alcohol and other drugs abuse.
c) Fatigue and stress.
d) Using cell phone while driving.
e) Being young males become reckless drivers.
f) Travelling in darkness.
g) Poor vehicle maintenance.
h) Road design, layout and maintenance defects.
i) Inadequate visibility due to weather conditions.
j) Poor eyesight of drivers.
k) Distraction while driving - loud music, attractive advertising and hoardings.
l) Non-usage of seat-belts and child restraints by vehicle users.
m) Non use of crash helmets by two-wheelers.

Prevention:
Seat belt reduces death or serious injuries by 45% in deceleration/ acceleration injuries. In collision injuries, air bags reduce death by 11% and in frontal collisions by 30%. In Motor cycle injuries, helmet reduces death by 33%, facial injuries by 66%. Helmets in bicycle injuries reduces death by 88%. Contribution to prevent death by accidents should come from the 5 P's - professionals, policy-makers, politicians, press and public.

What should you do for a victim of head injury:

Call for the ambulance or medical help immediately if victim is:
a) Unconscious.
b) Has fits.
c) Unable to move his/her body parts.
d) Has blood or fluid coming from the nose or ears.
e) 12 years old or younger.
f) Complaining of severe or persistent headache.
g) Drowsy.
h) Persistently vomiting (three times or more).
i) Slurring of speech.
j) Experiencing difficulty in walking or has imbalance.
k) Have vision problems.

Dos and Donts:

a) Don't pour water into the mouth
b) Remove tight clothing's like belts, ties, open shirt buttons etc.
c) Remove any material (blood, vomit, foreign bodies) present in the mouth with a finger.
d) If patient has dentures, remove them.
e) Don't let the neck hang while shifting.
f) Don't move the person from the site unless it is absolutely necessary, till ambulance arrives.
g) If person is vomiting turn him to sideward so that he doesn't choke on vomit (while doing so support the neck).
h) Remove sharp objects, inflammable material (petrol, diesel est.) from the vicinity.
i) If person has to shifted away from accident site before ambulance comes do so on a wooden plank or a door or a bus / truck seat or a stretcher from a nearby hospital.
j) Don't try to shift the patient on a two or three wheeler.
k) Don't panic if he has fits, turn him sideways, support the neck and remove sharp object from vicinity during the attacks.