Accidents and Suicide Flashcards
Deaths of England and Wales in one year - accidents.
10,000
Deaths of England and Wales in one year - suicide.
5000
Deaths of England and Wales in one year - homicide.
300
Accidents, suicide and homicide - % of all deaths in men? In women?
4% of all deaths in men, 2% in women
Accidents, suicide and homicide - % of all deaths in 15-34 year olds?
58% of all deaths in men, 33% in women
How many adults report suicidal thoughts in UK in one year?
How many report symptoms of depression?
1 million+ adults
6 million
How can suicide be prevented?
By removing the means - suicide is impulsive and the impulse may only last a minute
Explain how the “means” of suicide by carbon monoxide poisoning were removed?
E.g. putting head in gas oven. They reduced the % of CO in domestic gas gradually, until 0% in 1975. When gas ovens were no longer a means of suicide, the rate of suicide fell accordingly. People did not simply find another way because suicide is impulsive.
Drugs most commonly used in fatal overdose (1998)?
Paracetamol (11%) Dothiepin (10%) Coproxamol (10%) Amitryptilline (6%) Other antidepressants (5%) Aspirin (1%) All others (57%)
What analgesic legislation was brought in in 1998 to prevent overdoses?
Limit size of the pack
Blister pack format
3 years after –> reduction in overdoses in total and especially paracetamol and aspirin
What is co-proxamol?
Paracetamol plus dextropropoxyphene
Why is death following overdose 10x more common with co-proxamol than with comparable analgesics?
As dextropropoxyphene –> ventricular arrhythmias &
respiratory depression
When was co-proxamol withdrawn from the market? What effect did this have on overdoses?
2005
Obviously cut down overdoses using co-proxamol to almost 0, and it didn’t increase fatal overdoses using other analgesics. People still took overdoses but far fewer were fatal.
The approach is not to attempt to stop people racing to their bathroom cabinet, but to make the contents of the bathroom cabinet less lethal.
Use sedatives and anti-depressants as examples.
Sedatives: benzodiazepines instead of barbiturates
Anti-depressants: SSRIs instead of tricyclics
How can suicide by train by prevented?
- Pits under the track in London Underground
stations. 32% reduction in death rates in those who jump in front of the train in stations with a pit. - Doors barring access to the track in tube/metro stations.
How can suicide by jumping from a height be prevented?
Patrolling cliffs etc. regularly
Suicide barriers on bridges
How do methods of suicide differ between the sexes?
Men - hanging by far the most common (60%)
Women - hanging + drug overdoses about equal
Most common types of fatal accidents?
Falls
Drugs
Road traffic accidents
The annual number of deaths from RTAs has more than halved in the last 40 years. What interventions have taken place to reduce fatalities?
Seat belts Breathalysers and police vigilance Social disapproval of drink driving More dual carriageways Speed cameras and road humps Safer cars (air bags, better brakes) Ban on mobile phone use while driving Cycle helmets More pedestrian crossings
Road traffic accident deaths - what population are they more common in?
Men (3:1 ratio) in the age group 15-44 (51%)
How many % of fatal RTAs was the driver over the alcohol limit?
12%
What % of drivers killed in accidents tested positive for recreational drugs?
33%
How do accidents commonly occur on A roads?
Speed, or alcohol, with:
Failure to take a bend
Dangerous right turn
Head on collision
Deaths from falls most commonly affect which age group?
65+ (85%)
Average lifetime risk of hip fracture in women compared to men?
Women 1 in 7 (same as stroke)
Men 1 in 28
Incidence of hip fracture in women over the age of 90?
26%
Why are hip fractures more common in women?
Rapid bone loss for ten years after the menopause, reducing bone density by about a third. This combined with a lower bone density than men to begin with, puts women at a higher risk of all long bone fractures.
Status one year after fractured hip - how many % are dead? How many % walk unaided? How many % walk with a frame or stick?
34%
15%
47%
Consequences of hip fracture? (4)
- precipitation of confusional states, dementia
- pressure sores, pneumonia
- a third die in first year after
- half have impaired mobility after
How can hip fracture be prevented?
Regular exercise (halves risk)
Avoid immobility (doubles risk if >3 weeks)
Stopping smoking (smoking doubles risk)
HRT (if taken continuously for 30 years or more)
Thiazides (almost halves risk)
What increases the risk of falling?
Mental impairment Gait/balance disorder Impaired mobility Neuro diseases Visual impairment
How can falls be prevented by modifying living accommodation?
- Carpeted floors
- No slippery mats
- No electricity cords crossing floors where people walk
- No steps
- Handrails in bathroom and toilet
Homicide according to relationship to culprit - how does this differ for males and females?
Almost 50% of female homicides are by the woman’s spouse/partner, and another 20% by other family members.
In males, “known, not family” and “stranger” makes up almost 70%.
