Forsberg Rebecca, Vázquez José Antonio Iglesias
1Department of Surgical and Perioperative Sciences,Division of Surgery - Research Center for Disaster Medicine,Umeå University,Umeå,Sweden.
2Emergency Medical Services,Galicia,Spain.
Prehosp Disaster Med. 2016 Apr;31(2):163-8. doi: 10.1017/S1049023X16000030. Epub 2016 Feb 9.
The worldwide use of rail transport has increased, and the train speeds are escalating. Concurrently, the number of train disasters has been amplified globally. Consequently, railway safety has become an important issue for the future. High-velocity crashes increase the risk for injuries and mortality; nevertheless, there are relatively few studies on high-speed train crashes and the influencing factors on travelers' injuries occurring in the crash phase. The aim of this study was to investigate the fatal and non-fatal injuries and the main interacting factors that contributed to the injury process in the crash phase of the 2013 high-velocity train crash that occurred at Angrois, outside Santiago de Compostela, Spain.
Hospital records (n=157) of all the injured who were admitted to the six hospitals in the region were reviewed and compiled by descriptive statistics. The instant fatalities (n=63) were collected on site. Influencing crash factors were observed on the crash site, by carriage inspections, and by reviewing official reports concerning the approximated train speed.
The main interacting factors that contributed in the injury process in the crash phase were, among other things, the train speed, the design of the concrete structure of the curve, the robustness of the carriage exterior, and the interior environment of the carriages. Of the 222 people on board (218 passengers and four crew), 99% (n=220) were fatally or non-fatally injured in the crash. Thirty-three percent (n=72) suffered fatal injuries, of which 88% (n=63) died at the crash site and 13% (n=9) at the hospital. Twenty-one percent (n=32) of those admitted to hospital suffered multi-trauma (ie, extensive, severe, and/or critical injuries). The head, face, and neck sustained 42% (n=123) of the injuries followed by the trunk (chest, abdomen, and pelvis; n=92; 32%). Fractures were the most frequent (n=200; 69%) injury.
A mass-casualty incident with an extensive amount of fatal, severe, and critical injuries is most probable with a high-velocity train; this presents prehospital challenges. This finding draws attention to the importance of more robust carriage exteriors and injury minimizing designs of both railway carriages and the surrounding environment to reduce injuries and fatalities in future high-speed crashes.
全球铁路运输的使用量有所增加，列车速度也在不断提高。与此同时，全球范围内列车灾难的数量也在增加。因此，铁路安全已成为未来的一个重要问题。高速碰撞会增加受伤和死亡的风险；然而，关于高速列车碰撞以及碰撞阶段旅客受伤影响因素的研究相对较少。本研究的目的是调查2013年发生在西班牙圣地亚哥-德孔波斯特拉市郊外安格罗斯的高速列车碰撞事故碰撞阶段的致命伤和非致命伤，以及导致受伤过程的主要相互作用因素。
对该地区六家医院收治的所有伤者的医院记录（n = 157）进行回顾，并通过描述性统计进行整理。现场收集了即时死亡人数（n = 63）。通过在碰撞现场观察、检查车厢以及查阅有关列车近似速度的官方报告来确定碰撞影响因素。
在碰撞阶段导致受伤过程的主要相互作用因素包括列车速度、弯道混凝土结构的设计、车厢外部的坚固性以及车厢内部环境等。列车上的222人（218名乘客和4名乘务员）中，99%（n = 220）在碰撞中受到致命或非致命伤害。33%（n = 72）的人遭受致命伤，其中88%（n = 63）在碰撞现场死亡，13%（n = 9）在医院死亡。入院治疗的患者中有21%（n = 32）遭受多发伤（即广泛、严重和/或危急伤害）。头部、面部和颈部受伤占42%（n = 123），其次是躯干（胸部、腹部和骨盆；n = 92；32%）。骨折是最常见的受伤类型（n = 200；69%）。
高速列车很可能发生大量人员伤亡事件，造成大量致命、严重和危急伤害；这给院前急救带来了挑战。这一发现凸显了更坚固的车厢外部以及使铁路车厢和周围环境的伤害最小化设计对于减少未来高速碰撞中的伤害和死亡的重要性。
