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Trauma management (TM) covers two types of medical treatment: the initial one provided by Emergency Medical Services (EMS) and a further one provided by permanent medical facilities. There is a consensus in the professional literature that to reduce the severity and the number of road crash victims, the TM system should provide rapid and adequate initial care of injury, combined with sufficient further treatment at a hospital or trauma centre. Recognizing the important role of TM for reducing road crash injury outcome, it was decided, within the EU funded SafetyNet project, to develop road safety performance indicators (SPIs) which would characterize the level of TM systems" performance in European countries and enable country comparisons. The concept of TM SPIs was developed based on a literature study of performance indicators in TM, a survey of available practices in Europe and data availability examinations. A set of TM SPIs was introduced including 14 indicators which characterize five issues such as: availability of EMS stations; availability and composition of EMS medical staff; availability and composition of EMS transportation units; characteristics of the EMS response time, and availability of trauma beds in permanent medical facilities. Basic information on the TM systems was collected in close cooperation with the national expert group. A dataset with TM SPIs for 21 countries was created. It was demonstrated that the countries can be compared using selected TM SPIs. Moreover, a more general comparison of the TM systems' performance in the countries is possible, using multiple ranking and statistical weighting techniques. By both methods, final estimates were received enabling the recognition of groups of countries with similar levels of the TM system's performance. The results of various trials were consistent as to the recognition of countries with high or low level of the TM systems" performance, where in grouping countries with intermediate levels of the TM system's performance some differences were observed. The SafetyNet project's practice demonstrated that data collection for estimating TM SPIs is not an easy task but is realizable for the majority of countries. The TM SPIs" message is currently limited to the availability of trauma care services. Further development of the TM SPIs should focus on characteristics of actual treatment supplied, based on combined police and medical road crash related databases.
The United Nations Economic Commission for Europe Informal Group on GTR No. 7 Phase 2 are working to define a build level for the BioRID II rear impact (whiplash) crash test dummy that ensures repeatable and reproducible performance in a test procedure that has been proposed for future legislation. This includes the specification of dummy hardware, as well as the development of comprehensive certification procedures for the dummy. This study evaluated whether the dummy build level and certification procedures deliver the desired level of repeatability and reproducibility. A custom-designed laboratory seat was made using the seat base, back, and head restraint from a production car seat to ensure a representative interface with the dummy. The seat back was reinforced for use in multiple tests and the recliner mechanism was replaced by an external spring-damper mechanism. A total of 65 tests were performed with 6 BioRID IIg dummies using the draft GTR No.7 sled pulse and seating procedure. All dummies were subject to the build, maintenance, and certification procedures defined by the Informal Group. The test condition was highly repeatable, with a very repeatable pulse, a well-controlled seat back response, and minimal observed degradation of seat foams. The results showed qualitatively reasonable repeatability and reproducibility for the upper torso and head accelerations, as well as for T1 Fx and upper neck Fx. However, reproducibility was not acceptable for T1 and upper neck Fz or for T1 and upper neck My. The Informal Group has not selected injury or seat assessment criteria for use with BioRID II, so it is not known whether these channels would be used in the regulation. However, the ramping-up behavior of the dummy showed poor reproducibility, which would be expected to affect the reproducibility of dummy measurements in general. Pelvis and spine characteristics were found to significantly influence the dummy measurements for which poor reproducibility was observed. It was also observed that the primary neck response in these tests was flexion, not extension. This correlates well with recent findings from Japan and the United States showing a correlation between neck flexion and injury in accident replication simulations and postmortem human subjects (PMHS) studies, respectively. The present certification tests may not adequately control front cervical spine bumper characteristics, which are important for neck flexion response. The certification sled test also does not include the pelvis and so cannot be used to control pelvis response and does not substantially load the lumbar bumpers and so does not control these parts of the dummy. The stiffness of all spine bumpers and of the pelvis flesh should be much more tightly controlled. It is recommended that a method for certifying the front cervical bumpers should be developed. Recommendations are also made for tighter tolerance on the input parameters for the existing certification tests.
In general the passive safety capability is much greater in newer versus older cars due to the stiff compartment preventing intrusion in severe collisions. However, the stiffer structure which increases the deceleration can lead to a change in injury patterns. In order to analyse possible injury mechanisms for thoracic and lumbar spine injuries, data from the German Inâ€Depth Accident Study (GIDAS) were used in this study. A twoâ€step approach of statistical and caseâ€byâ€case analysis was applied for this investigation. In total 4,289 collisions were selected involving 8,844 vehicles, 5,765 injured persons and 9,468 coded injuries. Thoracic and lumbar spine injuries such as burst, compression or dislocation fractures as well as soft tissue injuries were found to occur in frontal impacts even without intrusion to the passenger compartment. If a MAIS 2+ injury occurred, in 15% of the cases a thoracic and/or lumbar spine injury is included. Considering AIS 2+ thoracic and lumbar spine, most injuries were fractures and occurred in the lumbar spine area. From the case by case analyses it can be concluded that lumbar spine fractures occur in accidents without the engagement of longitudinals, lateral loading to the occupant and/or very severe accidents with MAIS being much higher than the spine AIS.
The European Enhanced Vehicle-safety Committee (EEVC) Working Group 13 for Side Impact Protection has been developing an Interior Headform Test Procedure to complement the full-scale Side Impact Test Procedure for Europe and for the proposed IHRA test procedures. In real world accidents interior head contacts with severe head injuries still occur, which are not always observed in standard side impact tests with dummies. Thus a means is needed to encourage further progress in head protection. At the 2003 ESV-Conference EEVC Working Group 13 reported the results on Interior Headform Testing. Further research has been performed since and the test procedure has been improved. This paper gives an overview of its latest status. The paper presents new aspects which are included in the latest test procedure and the research work leading to these enhancements. One topic of improvement is the definition of the Free Motion Headform (FMH) impactor alignment procedure to provide guidelines to minimize excessive headform chin contact and to minimize potential variability. Research activities have also been carried out on the definition of reasonable approach head angles to avoid unrealistic test conditions. Further considerations have been given to the evaluation of head airbags, their potential benefits and a means of ensuring protection for occupants regardless of seating position and sitting height. The paper presents the research activities that have been made since the last ESV Conference in 2003 and the final proposal of the EEVC Headform Test Procedure.
The European Enhanced Vehicle-safety Committee wants to promote the use of more biofidelic child dummies and biomechanical based tolerance limits in regulatory and consumer testing. This study has investigated the feasibility and potential impact of Q-dummies and new injury criteria for child restraint system assessment in frontal impact. European accident statistics have been reviewed for all ECE-R44 CRS groups. For frontal impact, injury measures are recommended for the head, neck, chest and abdomen. Priority of body segment protection depends on the ECE-R44 group. The Q-dummy family is able to reflect these injuries, because of its biofidelity performance and measurement capabilities for these body segments. Currently, the Q0, Q1, Q1.5, Q3 and Q6 are available representing children of 0, 1, 1.5, 3 and 6 years old. These Q-dummies cover almost all dummy weight groups as defined in ECE-R44. Q10, representing a 10 year-old child, is under development. New child dummy injury criteria are under discussion in EEVC WG12. Therefore, the ECE-R44 criteria are assessed by comparing the existing P-dummies and new Q-dummies in ECE-R44 frontal impact sled tests. In total 300 tests covering 30 CRSs of almost all existing child seat categories are performed by 11 European organizations. From this benchmark study, it is concluded that the performance of the Q-dummy family is good with respect to repeatability of the measurement signals and the durability of the dummies. Applying ECE-R44 criteria, the first impression is that results for P- and Q-dummy are similar. For child seat evaluation the potential merits of the Q-dummy family lie in the extra measurement possibilities of these dummies and in the more biofidelic response.
The frontal crash is still an important contributor to deaths and serious injured resulting from road accidents in Europe. As the Hybrid-III dummy used in crash tests is over two decades old, the European Enhanced Vehicle-safety Committee is studying the potential for a new test device. Key is the availability of a well-defined set of requirements that identifies the minimum level of biofidelity required for an advanced frontal dummy. In this paper, a complete set of frontal impact biofidelity requirements, consisting of references , description of test conditions and corridors, is presented.
The purpose of this paper is to review injuries found in real world lateral collisions and determine the mechanisms responsible for certain kinds of biomechanical failure. During the last years the distribution of deaths among the different types of accidents has changed. Lateral collisions now are the most frequent cause of fatal and other serious injuries. Every third accident is an impact from the side, while every second fatality is the result of a lateral accident. Just a few years ago this value was no higher than 30%. This is probably the result of increasing safety standards for frontal collisions (airbags, seatbelt usage, structural improvements of cars, etc.). Although the number of registered vehicles increased, the total amount of fatalities decreased during the same period. Thus it is now necessary to pay greater attention to the lateral accident situation in order to improve road safety and decrease the number of traffic injuries. Several European organisations had decided to launch the project SID2000, which was funded by the European Commission, with the intention of gathering more knowledge on injuries occurring in lateral accidents and the mechanisms that lead to such injuries. This should enable the group to define the requirements for a new side impact dummy (SID) to be designed. Within the same project the existing TNO-EUROSID 1 was enhanced by another group and the experience gained has now enabled allowed to design a better measuring device for side impacts. The data used for this contribution came from sources from all over Europe and had to be gathered in such a manner that as many accident parameters as possible were taken into account.