Abstract
The hospital course of adult pedestrians injured by automobiles and treated by a university trauma service over a 12-month period was reviewed to evaluate the prevalence, recognition, and intervention of substance use and suicidal behavior. The study showed that the pedestrian trauma patient had a dramatically high rate of substance use and a surprisingly low index of suspicion of suicide attempt by the treatment team as a cause of the accident. Appropriate intervention might greatly reduce the financial and human cost of trauma care, but awareness and identification of these risk factors must be taught first.