Frsc insight july 2013 edition

FRSC INSIGHT JULY , 2013

Insight A MONTHLY PUBLICATION OF FEDERAL ROAD SAFETY COMMISSION

TRAUMA Concepts and principles of management

Smishing A Serious Identity Theft Scheme

www.frscinsight.com JULY, 2013

Vehicle Extrication Techniques

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From the Editor-In-Chief

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ave you ever wondered why the most enduring ideas most times are the simplest? In fact, the most complex problems most times do actually have a simple solution. Just thinking simply through a challenge may reveal the solution.

In this edition, we feature the simple but real stories behind some of the global brand names. FRSC desires to transform into a world class organisation. Do you know the simple story behind the establishment of FRSC brand? We will share that simple story with you some day.

As a road safety personnel, handling of trauma itself can be traumatic.

There is however a simple way of overcoming this challenge. Understanding the concept and principle of trauma management is discussed in this edition to guide personnel on rescue patrol. Vehicle extricating techniques is also discussed in this edition.

sonnel would be more exposed to smishing, where fraudsters would use phony means and attempt to obtain their personal details and later use same to defraud their victims.

This is in addition to the regular stories, while previous edition of the FRSC Insight is available on www.frscinsight.com

As the FRSC continues to automate its operations, and creates an e – environment, per-

OC Oladele(CC) Editor – In - Chief.

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FRSC INSIGHT JULY , 2013

g Insi ht EDITORIAL

Vehicle extrication techniques

Osita Chidoka OFR Corps Marshal/Chief Executive Publisher OC Oladele (CC) Editor–In-Chief KD Alegieuno (ARC) Editor Members VO Ogunnupebi (ACC) AR Obagbemiro (CRC) CB Nwokolo (DRC) DO Enakireru (ARC) 0I IKOKU (ARC)

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echnology is field of transport has comforted man, yet it has brought a lot of grief in the form of Incidents, following Road Traffic Crashes or Vehicular Accident.

Previously Rescuers often use fireman – Axe, circular saws, Matches and other crude tools for vehicle extrications, but these suffered from several drawbacks, saws can generate sparks, which could start a fire, create loud noise, which could stress the

Victim or even cause shock and are often slow cutting.

Alternatively rescuers could try to pry open the vehicle doors using a crowbar or Halligan bar, but this could compromise the stability of the vehicles, further injure the Victim or unintentionally activate vehicle airbags.

In comparison, Hydraulic spreader, cutter and Telescope ram jack are quieter, faster and more versatile, they can cut, open and even lift a car

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What is extrication?

It can simply be defined as removing trapped Victims from the vehicle or the vehicle from the trapped Victims.

Extrication includes Victims assessment, treatment and removal of victims from vehicle. Some departments only carry with them minimal tools such as one set of Jaws of life and are only capable of simply “popping “ a door off and then must step away to allow a more dedicated heavy rescue team in, who has more equipment. Extrication units are supposed to not only have many different kinds of extrication tools, but medical equipment, oxygen, and backboards as well. Extrication is the entire process from fire protection, power unit disengagement, vehicle stabilization, patient stabilization and treatment, removal of vehicle from patients, removal of patient and transfer by Ambulance. Extrication is not just simply popping a door off.

OBJECTIVE In any motor vehicle crash our objective as Rescuers is: -To remove the victim from his or her predicament without causing further injuries within the golden hour.

-To prevent loss of Human life and save as many lives as possible, as fast as possible with as little resources as possible.

-To facilitate fast rescue operations.

DRESSING Dressing must conform to the International Safety standards of safe working practices. All crew working directly on the road ways are to.

-Wear reflective Jacket/vest.

-Wear boat or a very strong shoe -Wear hand glove -Those who will actually be involved in extractions should at all times wear eye protections, nose

guards and safety helmets.

GUIDELINE FOR RANGE OF VEHICLE EXTRICATION TECHNIQUES TO MEET VARYING SITUATION Before extracting the Victim, officers should undertake the Following steps when appropriate.

-Check any threat to life – that may cause out break fire.

-Check hazardous materials and explosives that could be dangerous to you or to the victims.

-Cause & mechanism of injury or illness.

-The number of victims -Under take 5-10 meter out circle check followed by 2-5 meter inner circle check.

-Establish scene staging area -Size up the area (move round the scene) -mbulance equipment staging area -Rescue tool staging area -Fire protection staging area.

-Rubbish dumps area.

The Rescue officer having done above, stabilize the vehicle -Disconnect the batteries, neutralize other hazards and begin to undertake only the necessary vehicle cutting expansion and Spreading to allow for accessing and removal of the victims Vehicle cutting must be considered as part of patient care with regard to the golden hour. It should not be stopped unless it directly affects the victims care.

Cutting to allow for assessment and the removal of the victims should be done simultaneously with the assessment and treatment of the patient to reduce scene time PRINCIPLES OF EXTRICATION In determining the method of patient removal (extrication) from a vehicle, the two basic principles should be applied (a) Maintain spinal Alignment- To minimize spinal cord injury and paralysis.

FRSC INSIGHT JULY , 2013 HYDRAULIC CUTTER

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HYDRAULIC TELESCOPIC RAM JACK The cutter is hydraulic tool which is de- (RESCUE CYLINDER) signed to cut through Metal. It is often called a crab –cutter, owing to the shape The rescue cylinder is used for pushing and configuration of its blades. These are and pulling, it is highly used in road trafmost commonly used to cut through a ve- fic crash, earthquake and industrial achicle’s structure in extrication operations. cidents. The cylinder can be turned under load due to rotating pushing head.

HYDRAULIC SPREADER This is a tool designed with 2 arms which come together in a narrow tip. The tip of the tool can be inserted into a narrow gap between two vehicles panels (such as between 2 doors or between a door and fenders) when the tool is operated, the arms are opened, drawing apart the metals in the panels. Spreaders are used to pop vehicle doors from their hinges.

Sugar FRSC INSIGHT JULY , 2013 5

& the

human body

[1] Sugar can suppress the immune system.

[2] Sugar upsets the mineral relationships in the body.

[3] Sugar can cause... hyperactivity, anxiety, difficulty concentrating, and crankiness in children.

[4] Sugar can produce a significant rise in triglycerides.

[5] Sugar contributes to the reduction in defense against bacterial infection (infectious diseases).

[6] Sugar causes a loss of tissue elasticity and function, the more sugar you eat the more elasticity and function you lose.

[7] Sugar reduces high-density lipoproteins.

[8] Sugar leads to chromium deficiency.

[9] Sugar leads to cancer of the ovaries.

[10] Sugar can increase fasting levels of glucose.

[11] Sugar causes copper deficiency.

[12] Sugar interferes with absorption of calcium and magnesium.

[13] Sugar may make eyes more vulnerable to age-related macular degeneration.

[14] Sugar raises the level of a neurotransmitters: dopamine, serotonin, and norepinephrine.

[15] Sugar can cause hypoglycemia.

[16] Sugar can produce an acidic digestive tract.

[17] Sugar can cause a rapid rise of adrenaline levels in children.

[18] Sugar malabsorption is frequent in patients with functional bowel disease.

[19] Sugar can cause premature aging.

20] Sugar can lead to alcoholism.

21] Sugar can cause tooth decay.

[22] Sugar contributes to obesity [29] Sugar can cause heart disease.

[30] Sugar can cause appendicitis.

[31] Sugar can cause hemorrhoids.

[32] Sugar can cause varicose veins.

[33] Sugar can elevate glucose and insulin responses in oral contraceptive users.

[34] Sugar can lead to periodontal disease.

[35] Sugar can contribute to osteoporosis.

[36] Sugar contributes to saliva acidity.

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[39] Sugar can decrease growth hormone.

40] Sugar can increase cholesterol.

[41] Sugar can increase the systolic blood pressure.

[42] High sugar intake increases advanced glycation end products (AGEs)(Sugar bound non-enzymatically to protein) [43] Sugar can interfere with the absorption

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of protein.

[44] Sugar causes food allergies.

[45] Sugar can contribute to diabetes.

[46] Sugar can cause toxemia during pregnancy.

[47] Sugar can contribute to eczema in children.

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Iodized salt

Americans gained up to 15 IQ points after iodized salt became mandatory in 1924 Kul Gautam, Deputy Executive Director, UNICEF, “IDD is the single greatest cause of preventable mental retardation. Severe deficiencies cause cretinism, stillbirth and miscarriage. But even mild deficiency can significantly affect the learning ability of populations. Scientific evidence shows alarming effects of IDD. Even a moderate deficiency, especially in pregnant women and infants, lowers their intelligence by 10 to 15 IQ points, with incalculable damage to social and economic development of nations and communities. Today over 1 billion people in the world suffer from iodine deficiency, and 38 million babies born every year are not protected from brain damage due to IDD. These 38 millions, or nearly 30 percent of the world’s newborns, come from families that are the least educated, most isolated and economically disadvantaged. The mark of a civilized society is how well it takes care of its most vulnerable and deprived communities. If we continue to fail to reach these newborns, we will be consigning them to an inter-generational cycle of poverty and injustice.”

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odine is said to be found in the sea and in soil that has previously been under the sea.

Salt water seafood (e.g., sea trout, lobster, haddock, shrimp, and shark), sea vegetables (such as seaweed, including kelp, hijiki, arame, nori, and laver), vegetables grown in soil containing iodine (found on any land that was previously under the sea), and animals grazing on plants growing in iodine rich soil all are good sources. This mineral also enters the food supply through the use of certain disinfectants called iodophors. These are primarily used in the dairy industry, so milk and cheese, for example, contain a good amount of iodine.

In addition, some red dyes contain iodine, as do some dough conditioners (look for an iodized conditioner listed in the ingredient sec-

tion on the bread package). These sources add considerable amounts of iodine to one’s diet.

Today, salt producers are a key partner in combating Iodine Deficiency Disorders (IDD) today throughout the world. Many people erroneously assume that because salt iodization was first implemented nearly a century ago, that the problem no longer exists. Tragically, that’s wrong. In 1990, only about 20% of the world’s households had access to iodized salt and were protected against Iodine Deficiency Disorders.

After a major push, access now exceeds 70%.

Scientists identified iodine as an element in the early 19th century and only 20 years later,

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French scientist J-B. Boussingault reported his conclusion that iodized salt would be an effective prophylaxis for goiter, stating “I am convinced that goitre would disappear...if the authorities made available in every district town...a depot of salt containing iodine.” Yet it took another century for “authorities in the U.S. and Switzerland to effectuate Boussingault’s insight.

In the United States, from the outset, salt producers cooperated with public health authorities and made both iodized and plain salt available to consumers at the same price. Even so, the Salt Institute estimates that only about 70% of the table salt sold in the United States is iodized.

Salt used in processed foods is not iodized.

Given that people are cooking less at home and buying either restaurant or processed foods, iodine intakes in the U.S. have declined from about 250 μg/day to 157 micrograms/day. Public health authorities rec-

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ommend 150 μg or more and the need is particularly acute for expectant mothers. Daily Iodine intakes of 1,000 - 1,100 μg are safe for adults and children over 4 years of age.

The technology for iodizing or iodating salt is well known, readily available, and inexpensive. One particular problem is that some countries lack high quality salt manufacturing and packaging technologies. Another is an inadequate regulatory system depriving consumers of confidence that a package labeled “iodized” contains iodine and in the proper amount. Both potassium iodide and potassium iodate are used to add iodine to salt.

According to Daily Mail reports, Iodine appears to have made Americans smarter. While the addition of iodine to salt originally was intended to eliminate goiters caused by iodine deficiencies, it appears to have had an unexpected consequence: Americans gained

FRSC INSIGHT JULY , 2013 9 up to 15 IQ points after iodized salt became mandatory in 1924, a new study finds.

The National Bureau of Economic Research recently published a report by economists James Freyer, Dimitra Politi and David Weil that looked at intelligence data from roughly 2 million World War II enlistees born between 1921 and 1927.

The study, which compares the IQ levels of recruits born before 1924 with those born after that year, shows that those who ranked the highest were assigned to the Army Air Forces. Meanwhile, those recruits with lower IQ scores were sent to the Army ground forces.

The economists then researched likely iodine levels in recruits’ hometowns based on the occurrence of goiters in those regions, and they discovered that recruits born in low-iodine areas after 1924 were much more likely to be sent to the Army Air Forces than those

recruits born before 1924. In fact, the average IQ of those slightly younger recruits was 15 points higher than that of older recruits.

According to the report, the addition of iodine to salt might be one cause behind the Flynn effect, a long-sustained rise in IQ from roughly 1930 to the present.

Iodine is a mineral that is added to table salt and found in a variety of foods. It is important for good health and, fortunately, our bodies require it in relatively small quantities. Iodine is part of a hormone, thyroxin, which is responsible for maintaining a person’s metabolic rate.

Sources: 1 . h t t p : / / w w w. s a l t i n s t i t u t e . o r g / U s e s - b e n e f i t s / Salt-in-Food/Essential-nutrient/Iodized-salt 2.http://news.yahoo.com/new-study--iodizedsalt-made-americans-smarter-140609525.html 3.http://goaskalice.columbia.edu/whats-iodized-salt-it-better-you-thanregular-salt

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Smishing A Serious Identity Theft Scheme

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mishing is a combination of the terms “SMS” and “phishing.” It is similar to phishing, but refers to fraudulent messages sent over SMS (text messaging) rather than email. The goal of smishing is to capture people’s personal information. In order to do this, “smishers” send out mass text messages designed to capture the recipients’ attention. It is an identity theft scheme that involves sending consumers text messages containing a link to a fraudulent website or a phone number in an attempt to collect personal information.

Some messages may be threatening, e.g., “Visit this URL to avoid being charged $5.00

per day,” while others may provide a fake incentive, such as “You have won a free gift card, visit this website to claim your prize.”

If you click on a link in the text message, you will be directed to a fraudulent website that will ask you to enter your personal information, such as your name, address, phone number, and email address. In some cases, a smishing website will ask you to enter your bank account information or social security number. Smishing has become increasingly common now that smartphones are widely used, considering that criminals go where their opportunities are greatest.

FRSC INSIGHT JULY , 2013 11 According to Network World, there are more than 6 billion cellphone subscribers in the world, nearly two-thirds of all adults with a cellphone use text messaging and more than 90% of text messages are opened within 15 minutes of being received Many smartphones allow you to simply click on a link in a text message to view the website in your phone’s browser. This makes text messages an effective “bait” for luring unsuspecting users to fraudulent websites.

Therefore, just like when you receive email spam, is best to not visit websites mentioned in text messages from unknown sources. People should know how to determine if they are being targeted by these criminals and how to ensure that their mobile devices are secure.

SMiShing attempts should be growing so rapidly, considering that criminals go where their opportunities are greatest. They’ve got to be salivating over these statistics: • There are more than 6 billion cellphone subscribers in the world.

• Nearly two-thirds of all adults

with a cellphone use text messaging.

• More than 90% of text messages are opened within 15 minutes of being received Many mobile phone users keep their personal data, like bank account information, stored on their smartphones, this information can be accessed by criminals through phishing and other scams. One example of a phishing scam is a criminal sending an alert from a bank asking the cellphone user to follow a link to verify account information as reactivate your ATM card by entering a PIN. Consumers should also send these scam text messages to 7726 (SPAM) to cellphone carriers to have the number blocked, the BBB said.

If the smishing scam included the name of a bank, contact the bank to notify them of the text.

Phone users should be wary of any message that is not a cell number, A message that is asking a phone user to respond quickly can be a scam, and people should stop and think it over before taking action.

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FRSC INSIGHT JULY , 2013 Tips to avoid falling for a SMiShing attack Here are some general tips to share with your end users to help them from falling victim to SMiShing.

• Avoid clicking links within text messages, especially if they are sent from someone you don’t know. But, be aware that attack messages can appear to come from someone you do know, so think before you click.

• Don’t respond to text messages that request private or financial information from you.

• If you get a message that appears to be from your bank, financial institution, or other entity that you do business with, contact that business directly to determine if they sent you a legitimate request. Review this entity’s policy on sending text messages to customers.

• Beware of messages that have a num-

ber that is not a cell number. Scammers often mask their identity by using email-to-text services to avoid revealing their actual phone number.

• If a text message is urging you to act or respond quickly, stop and think about it.

Remember that criminals use this as a tactic to get you to do what they want.

• Never reply to a suspicious text message without doing your research and verifying the source. If your bank is really going to cancel your credit card, you should be able to call the number on the back of your card to discuss this matter with them.

• Never call a phone number from an unknown texter.

Sources: 1. www.networkworld.com/newsletters 2. www.techterms.com/definition/smishing

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The Real Stories behind leading BRAND NAMES There are many companies, brands, products whose names were derived from strange circumstances, things or happenings.

Mercedes: This was actually the financier’s daughter’s name.

Adobe This came from name of the river Adobe Creek that ran behind the house of founder John Warnock

Apple Computers It was the favorite fruit of founder Steve Jobs. He was three months late in filing a name for the business, and he threatened to call his company Apple Computers if the other colleagues didn’t suggest a better name by 5 O’clock that evening

CISCO It is not an acronym as popularly believed. It is short for San Francisco

Compaq This name was formed by using COMp, for computer, and PAQ to denote a small integral object

Corel The name was derived from the founder’s name Dr. Michael Cowpland. It stands for COwpland REsearchLaboratory

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A story on problem solving

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any years ago in a small Zezuru village, a farmer had the misfortune of owing a large sum of money to a village moneylender. The moneylender, who was old and ugly, fancied the farmer’s young beautiful daughter. So the moneylender proposed a bargain. He said he would forgo the farmer’s debt if he could marry his daughter. Both the farmer and his daughter were horrified by the proposal.

So the cunning money-lender suggested that they let providence decide the matter. He told them that he would put a black pebble and a white pebble into An empty money bag.

Then the girl would have to pick one pebble from the bag. 1.

If she picked the black pebble, she would become his wife and her father’s debt would be forgiven. 2. If she picked the white pebble she need not marry him and her father’s debt would still be forgiven. 3. But if she refused to pick a pebble, her father would be thrown into jail.

They were standing on a peb ble strewn path in the farmer’s field.

As they talked, the moneylender bent over to pick up two pebbles. As he picked them up, the sharp-eyed damsel/girl noticed that he had picked up two black pebbles and put them into the bag. He then asked the girl to pick a pebble from the bag. Now, imagine that you were standing in the field. What would you have done if you were the girl? If you had to advise her, what would you have told her?

Careful analysis would produce three possibilities: 1. The girl should refuse to take a pebble.

2. The girl should show that there were two black pebbles in the bag and expose the moneylender as a cheat.

3. The girl should pick a black pebble and sacrifice herself in order to save her father from his debt and imprisonment. Take a moment to ponder over the story.

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The story is used with the hope that it will make us appreciate the difference between lateral and logical thinking. The girl’s dilemma cannot be solved with traditional logical thinking.

Think of the consequences if she chooses the above logical answers.

What would you recommend to the girl do?

There is a huge potential for creativity and new ideas. Yet our complacency with existing ideas makes them difficult to achieve Please see the solution after you come up with your own solution What the girl really did: Well, here is what she did…The girl put her hand into the moneybag and

drew out a pebble. Without looking at it, she fumbled and let it fall onto the pebble-strewn path where it immediately became lost among all the other pebbles. “Oh, how clumsy of me,” she said. “But never mind, if you look into the bag for the one that is left, you will be able to tell which pebble I picked.” Since the remaining pebble is black, it must be assumed that she had picked the white one. And since the moneylender dared not admit his dishonesty, the girl changed what seemed an impossible situation into an extremely advantageous one.

Most complex problems may have a simple solution; just change the way you think about them.

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The Nigerian Road Users: a socio-psychological perspective of the Federal Road Safety Corps’ ideal

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he Nigerian road is one of the most unsafe in the world today. This seems an established fact going by the amount of loss both human and economic resources on our roads every year. In this paper we shall be dwelling on who Nigerian road users are what are their psychological and sociological makes ups that could predispose him to total neglect of road use ethics to the detriment of his life and others.

It is only when these matters are resolved that solution could be found to the problem of carnage on our roads. Such answers would have varied but positive implications for the FRSC and other road traffic enforcers in a bid to make our roads safe for all users. These issues form the basis of this paper which if taken seriously the commission may be heading towards success in combating road accidents.

THE NIGERIAN ROAD USER Who constitute the road user in Nigeria today? These are pedestrians, hawkers, beggars, cyclist (bicycle, motorcycle and tricycle), vehicle drivers, private, commercial, and trailer and lorry drivers. Commercial bus, tractors, cranes and other articulated vehicles, road construction equipment.

This List is by no means conclusive.

PSYCHOLOGICAL MAKE-UP OF THE NIGERIAN ROAD USER A typical Nigerian is an average road user, in the sense that everyone born either enters on his own or is carried into the road.

The Microsoft Encarta word English dictionary (1999) defines psycho-social as

that which relate to both the psychological and the social aspect of something, or relating to a thing that has both the psychological and social aspect. In other words to further explain this word we take it apart.

Psychology defined as the systematic study of human behavior psychology deals with mental experience of individuals while sociology deals with systematic study of social behavior and human groups/grouping. The difference between the two lies in the unit of reference , i.e either the individual or the group for the psychologist and sociologist respectively.

For a psychologist, the focus is on the way individual behavior is organized to form his personality, while the sociology focuses on the group i.e society and culture of which the individual constitute a part.

Experts, however agree that human psychology is a product of social condition. This meeting point /ground between the two discipline called social psychology shared by both discipline.

BASIC PSYCHOLOGY INGREDIENT REQUIRED FOR CHANGE The greatest ingredient required for change in behavior is the appropriate motivation.

MOTIVATION: this is anything which propels action and leads people to persist in their goal directed behavior. It’s the drive that makes people to prefer disciplined behavior e.g driving to discipline one, to pursue nationalistic and patriotic acts, to join special road marshal squads etc Basic motives are guarded by basic needs such as security, food, shelter, and sexual gratification. There are hierarchies of human needs .

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i. Social need opportunity to participate, be involved, help others and to develop close friendships. ii. Esteem needs - people have need for raised esteem as well as prestige. iii. Autonomy – involves giving people authority/ opportunity to be independent in thought and action achieved through involving programme, planning and execution. iv. Self actualization – opportunity for personal growth and development for feeling of self fulfillment, feeling of worthwhile accomplished etc.

IMPLICATION TO FRSC Motives according to experts are ordered to hierarchy ranging from the basic (biological) needs e.g. security to the most advanced or complex ones e.g. needs for self actualization. It is also said that people are preoccupied with lower lever needs are not likely to accomplish higher level ones and vice versa (Lindgren, 1973).

This has implication for the type of persuasion or communication that FRSC should design for Nigerians. Persuasive message or road safety education programmes should be designed with specific population in mind. For rural population, the message should exploit

FRSC INSIGHT JULY , 2013 the most elementary motives and needs such as food, shelter, and security. On the other hand, for urban, professional and middle class people, emphasis should be placed on the need for self regard, self esteem, feeling of fulfillment and worthwhile accomplishment. Communication experts know the importance of matching one’s persuasive communication to the level of audience.

Suggestibility -critical situations such as we have been experiencing in the country e.g. economic uncertainties, unemployment, in-security, etc can force people to become vulnerable to suggestions according Cantrill (1976) in two ways: i. When a person lacks adequate mental context. ii.

When his mental context is rigidly fixed.

The FRSC campaign must take into account these obvious realities of our soci-

18 ety in dealing with an average road users.

Use of slogan and symbols- these are shortcut rationalizations which fire imagination.

They spread fast because they express dissatisfaction from which the people have been suffering and at the same time suggest a new direction and purpose. The social context of a slogan is what sells it. e.g why hurry to make your children orphans fatherless.

Make your message/campaign programmes simple for easy understanding by all. This gives meaning to people and shows how their immediate needs and desires are met. Make full use of our social setting homes, school, workshop, church, mosque, highways, market places, shopping malls community, etc.

A PAPER DELIVERED AT BATCH ‘’D’’ OF INTERMEDATE LEADERSHIP COURSE, AT FRSC ACADEMY, JOS BY AR OBAGBEMIRO9CRC)

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TRAUMA:

Concepts and principles of management(II) ASSESSMENT It may not be possible to wait for overt clinical signs if time is critical.

Response to a problem needs to be initiated before we are sure of its existence.

Diagnoses should be positively sought and in some cases screened.

This allows us to move forward rapidly Understanding the relationship between the: -Patient -Mechanism of injury -Injury produced at time zero, is the key to understanding the problem to be solved.

Mechanism + Patient = Injury The initial nature of this relationship quite obvious (overt – most cases) or hidden (covert – rarely).

As clinicians we need to convert everything to the overt so that appropriate clinical responses can be carried out.

When the mechanism is not known reliably while other variables are known, the equation can be rewritten:

Injury – Patient = Mechanism If an injury is obvious and the patient previously fit, we may be able to work out the likely mechanism of injury.

Approach useful in assessing unconscious patients to guide the search for the covert or hidden injuries.

On some occasions the equation appears not to apply at first sight:

Mechanism + Patient ≠ Injury This failure is not real but apparent; something has probably been misjudged and the factor must be sought.

Some aspect of the injury has not been discovered.

Mechanism suggested may not be genuine.

Some aspect of the patient before the injury the Clinician is unaware.

Mechanism suggested may not be genuine These are situations where there is deliberate attempt to mislead.

When the patient is a victim of abuse in a relationship.

Common when patient is unable to give their own history e.g. very young child or elderly.

The mechanism of injury are criminal (NAI) Factors that suggest NAI has occurred are: History inconsistent with the injuries sustained.

Changing history.

Aggressive behavior of carers at interview.

Injuries of different ages.

Posterior rib fractures.

Long bone fractures in a pre-ambulatory child.

The simple early response is to admit the at-risk person on clinical ground that allows time for considerable clinical response.

Accurate assessment and documentation of findings is required as the victim of an assault may need good forensic evidence at some later date to convict their assailant.

Some aspect of the patient before injury not known When the mechanism and the injury are obvious but inconsistent, there is something previously unknown about the patient to discover.

Commonly there is a pre-existing pathology e.g. pathological fracture in the elderly or medical fall and mechanical fall caused by transient ischaemic attack, abnormal cardiac rhythm.

TO BE CONTINUED IN THE NEXT EDITION

FRSC INSIGHT JULY , 2013 EMERGENCY CALL LINE: 0700- CALL-FRSC (0700-2255-3772) EMERGENCY TEXT MESSAGE LINE: 0807 -769- 0362 FRSC EMERGENCY TOLL FREE LINE ON ALL NETWORKS: 122

frsc emergency

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