title: Injuries associated with cycle rickshaws accidents.
abstract: BACKGROUND
  Cycle rickshaw is an important means of transportation in Urban India. Pedestrians, rickshaw users, rickshaw pullers, two wheeled vehicle users and cyclists are among the most vulnerable road user groups in terms of injuries and fatalities resulting from road traffic accidents in India. Our objectives were to study characteristics of crashes and nature of injuries associated with cycle rickshaw.
  
  
  METHODS
  Between August 2008 to July 2009, a hospital based observational study was done of patients who presented to King George medical college trauma center with injury sustained due to cycle rickshaw in emergency department. Age, time of trauma, mode of trauma, contributing factors and type of injury were recorded.
  
  
  RESULTS
  The mean age of the patient was 32.1. Seventeen patients were rickshaw pullers and the rest were occupants of the rickshaw. Overloading with more than two passengers was found in 24 cases (28.5%). Most common cause of injury was collision with a moving vehicle (56 patients, %) followed by fall from rickshaw. The most common contributing factor was the overloading of rickshaw. On arrival to the hospital, the mean Injury severity score (ISS) was 3.5 ± 2.2 and the mean Glasgow coma scale (GCS) was 13.4 ± 4.3. Nine patients were admitted to ICU (Intensive care unit). The median ICU stay was 4 (1-24 days). Six of the ICU admitted patients had head injury.
  
  
  CONCLUSIONS
  Rickshaw pullers and occupants are vulnerable to road traffic accidents. Urgent preventive measures targeted towards this group are needed to reduce the morbidity and mortality resulting from injuries involving rickshaws. The need for improved understanding of the risk characteristics of cycle rickshaw is emphasized.
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi - 110 029, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Meena
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi - 110 029, India.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Barwar
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, New Delhi - 110 029, India.
authors.forename: Devarshi
authors.initials: D
authors.lastname: Rastogi
authors.affiliation: Department of Orthopedic Surgery, C S M Medical University Hospital, Lucknow, Uttar Pradesh, India.
authors.forename: Vineet
authors.initials: V
authors.lastname: Sharma
keywords: Bicycle; crashes; injury; rickshaw; trauma