Luck of the Irish

“Luck of the Irish” – the Australian program saving Irish lives on the road

It turns out teenagers don’t care about violent death; but being stripped naked in a roomful of strangers is mortifying

The Just One Life road safety awareness program has been running in the Omniplex since 9am. Several busloads of secondary students sit in relative silence as images of devastating car crashes flash up on the giant screen. I’m doing my emergency department elective on the southeast coast of the Republic of Ireland, and have been invited to watch one of the sessions.

The campaign is an Australian import that began its life in 2001 as the Rotary Youth Driver Awareness scheme in St Ives, New South Wales (1). It brings together guest speakers from the fire department, police, and medical services. Each lecturer provides a different perspective on road trauma and its impact on individuals and communities. There is shock factor, humour, and practical advice. There is also some welcome praise, not often given to this demographic – the youth of Wexford County have played a role in drastically reducing the Irish road death toll over the preceding 20 years, from 458 in 1998 to 150 in 2018 (2).

Mr Paul Kelly, emergency consultant in Wexford General Hospital, is a familiar face. He sets out for the assembled 15-to-17-year-olds, in painstaking detail, emergency management of motor vehicle accident injury.

First, we cut your clothes off. We insert a cannula into a vein in your arm to give you medication and fluids. Depending on the severity of injury, and your level of consciousness, we may insert a drain into your chest, a breathing tube down your trachea, and a catheter into your bladder.

This last comment is accompanied by a diagram, which generates a gasp, and bouts of nervous laughter throughout the auditorium. The attendees are on the cusp of independent driving, a period fraught with inexperience and impulsivity (3).

An effective road safety approach rests on three pillars: engineering, enforcement, and education. Enforcement measures employed by the Department of Transport, Tourism and Sport over the last two decades include a penalty points system in 2002, mandatory roadside alcohol testing in 2006, a speed camera network in 2010, and continuous revision of speed limits from 2015 (2, 4, 5). Just One Life is an attempt to add an evidence-based educational component. It uses a four-step workshop-based system of identifying crash factors, appreciating risk, developing management strategies, and recognising the social responsibility of driving (6). After the lectures, students will be passengers in carefully controlled emergency stop procedures conducted by police. Usual engineering interventions include safer road and infrastructure design, managing roadside hazards, and creating solutions for high-risk areas (7).

Just One Life has now been implemented by several other counties throughout Ireland. As to benefit, an Australian social impact study completed in 2016 showed a significant effect of the program on both understanding of risk, and on intention to implement positive and safe driving behaviours, by students. Follow-up studies conducted up to a year later seem to demonstrate that prosocial decision-making persists for many program participants, resulting in a reduced overall economic burden (3). While the program is younger in Ireland, some informal surveys suggest similar results, at least in the short term (8). It’s a concerted approach to road safety, and a contribution to public health of which Australia can be proud. In the meantime, Ireland continues striving for fewer road deaths (9).

Getting a lift back to the hospital, I’m quietly pleased that I’m not the one behind the wheel.

Guest post: Will Pridmore, Year 4, MChD. ANU Medical School


References:

  1. Rotary Youth Driver Awareness scheme (Australia)
  2. Road Safety in Ireland
  3. RYDA Social Impact Study 2016
  4. Hosford P. Speed limits are changing – here’s how. The Journal. 2015
  5. Garda Mobile Safety Cameras
  6. RYDA Program
  7. Road safety workshops & technical training. Vic Roads
  8. Just One Life (Ireland)
  9. Road Safety Strategy 2013-2020

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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