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Montreal has the highest volume of pedestrian injuries in Canada. Each day five pedestrians are hospitalized in Montreal because of motor vehicle collisions. With schoolchildren getting ready for summer vacation and more pedestrians out and about, the MUHC Traumatic Brain Injury Program and the Montreal Children's Hospital of the MUHC want to protect citizens from fatal or serious life-changing injuries by encouraging a partnership in safety between motorists and pedestrians.

"Safety is a joint responsibility of both pedestrians and motorists," says Mitra Feyz, director of the Traumatic Brain Injury (TBI) Program at the MUHC adult sites. "Both groups are responsible for observing traffic rules and regulations. Adults especially have an obligation to children and must set the examples for them to follow. Children are less knowledgeable about the hidden risks and dangers of traffic and will do as they see adults do. Special patience and understanding should also be accorded to teenagers, elderly people and physically challenged populations," adds Feyz.

Each year, the Children's Emergency Department treats close to 400 children and adolescents who have been injured after being hit by a car. At least 100 are pedestrians; the other 300 are cyclists, skateboarders, ATVs, motorists and passengers. Debbie Friedman, Administrative Director of the Child and Adolescent Trauma Program, emphasizes that "most of these injuries are completely preventable and the responsibility must be shared by drivers, pedestrians and police. It all boils down to a combination of being aware of the risks, following the rules, looking at environmental factors that can assist in road safety, and using common sense."

AQTC (Association québécoise des traumatisés crâniens) is a resource for victims of traumatic brain injuries, helping victims and their families to cope with the aftermath of the injuries and maintain their ability to function in society. "Collisions between vehicles and pedestrians can result in traumatic brain injuries that can change a person's life forever, making daily living and routine activities extremely challenging," says Pascal Brodeur, Administrative Assistant of the AQTC. "As well as facing physical consequences that range from partial to complete paralysis, there are also problems with speech, concentration, memory, attention and fatigue."

Below are some simple suggestions by the MUHC and the AQTC to help improve pedestrian and motorist safety.

Pedestrians: can take charge of their own safety by doing the following:

• Make yourself visible at night; whether walking, riding a bike, rollerblading, wear colours that are easy to see, such as visible or reflective clothing.
• Always use crosswalks – Don't cross in the middle of the street – especially at night.
• Don't assume the coast is clear; look both ways before crossing the street.
• Cross and walk in well-lit areas.
• Don't jaywalk – respect the traffic lights and rules of the road regardless of what time of day it is.
• Assist the very young, elderly and anyone needing help crossing the street and please be patient with them.
• Avoid talking on cell phones or listening to loud music on portable musical devices; these are distracting and prevent you from hearing sirens of emergency vehicles or even car horns.
• Avoid walking under the influence of alcohol (alcohol impairs judgment and leads to walking irresponsibly, jaywalking and not respecting the rules of the road). Among the TBI pedestrians tested for alcohol upon admission to MUHC Montreal General Hospital, 25% were found to be under the influence of alcohol.

Motorists, cyclists, anyone on rollerblades, scooters or skateboards: can protect themselves and pedestrians by doing the following:

• Adhere to traffic lights and speed limits at all times.
• Slow down in school zones, near parks and residential areas.
• Exercise more caution when driving in dangerous weather conditions.
• Stop for school buses as they let children on and off.
• Be patient with the elderly, physically challenged people and children who are crossing the street.
• Do not drink and drive (again, alcohol impairs judgment and leads to driving irresponsibly and not respecting the rules of the road). Among the TBI patients involved in a motor vehicle crash who were tested for alcohol upon admission to the Montreal General Hospital, 27% were found to be under the influence of alcohol.
• Exercise more vigilance when driving down a street where there are parked vehicles as children can emerge suddenly from between them.
• ATVs and other large vehicles have height-related blind spots that often prevent the drivers from seeing small children; therefore drivers must make doubly sure when manoeuvring in school zones, near parks and residential areas.

"It's not just motor vehicles we have to worry about, it is anything that has wheels," emphasizes Dr. S. Tinawi, "skateboards, rollerblades, bicycles – if it has wheels, it is like a vehicle, it has speed which increases the damage it can do upon impact, and add alcohol to this, you have a formula for disaster."

Tertiary care trauma centres such as the Montreal General Hospital of the MUHC and the Child and Adolescent Trauma Centre at the Montreal Children's Hospital have helped to increase the survival rates of TBI victims; however, the long-term physical, mental and emotional damage can change the lives of these patients and their families forever.

If pedestrians and motorists can use their common sense, they can not only prevent life-changing injuries, but make it unnecessary for the city to establish jaywalking fines, speed bumps, speed traps and such.

About the UUÖ±²¥ Health Centre (MUHC)
The UUÖ±²¥ Health Centre (MUHC) is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at UUÖ±²¥ — the Montreal Children's, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge.

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