Article Text

Download PDFPDF
Look right! A retrospective study of pedestrian accidents involving overseas visitors to London
  1. A Baldwin1,
  2. T Harris2,
  3. G Davies2
  1. 1
    Brighton and Sussex Medical School, Royal Sussex County Hospital, Brighton, UK
  2. 2
    A&E and HEMS, Royal London Hospital, Whitechapel, London, UK
  1. Mr A Baldwin, Brighton and Sussex Medical School, Audrey Emerton Building, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK; a.baldwin{at}


Introduction: Research within the European Union has shown international visitors to have a higher injury mortality than residents. Traffic accidents are the leading cause of injury-related death among overseas visitors and evidence suggests overseas visitors are at a greater risk of being involved in road traffic accidents than the resident population. Little information looks specifically at pedestrian injuries to overseas visitors. Pedestrian deaths account for 21% of all UK road deaths.

Methods: A retrospective database review of London helicopter emergency medical service (HEMS) missions was undertaken to examine the number and type of missions to overseas visitors, specifically examining pedestrian incidents.

Results: Of 121 missions to overseas visitors, 74 (61%) involved the visitor as a pedestrian struck by a vehicle. Thirty-five pedestrians (47%) were struck by a bus and 20 by a car (27%). Fourteen patients (19%) had an initial Glasgow coma scale score of 3–8, suggesting severe head injury and half of all patients required prehospital intubation (38/74, 51%). Mortality was 16% (12/74%) and 62 patients (84%) survived to hospital discharge. Of 39 patients admitted to the Royal London Hospital, the average injury severity score (ISS%) was 23.0 (ISS >15 denotes severe trauma) with a mean inpatient stay of 17.9 days.

Conclusion: During the 7-year period studied, 61% of HEMS missions to overseas visitors involved a pedestrian being struck by a vehicle, compared with 16% of missions to UK residents. For HEMS missions, serious trauma to pedestrians is disproportionally more common among the visitor population to London.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None.

Linked Articles

  • Primary survey
    Geoff Hughes