3rd International Conference on ESAR
A change emerges in hospital landscape due to health political measures, which in consequence also influences the pre-clinical medical care of emergencies. The main focus of this study was to gather information about emergency medical care after traffic accidents on the basis of data of Bavarian emergency medical services. In Bavaria, in 2006 it was necessary to call an emergency doctor in the case of 14.261 traffic accidents. Predominantly the patients were provided by land-based life saving appliances, air rescue services were only applied in 19.1 % of the cases. 47.6 % of patients being involved in a traffic accident were transported into a primary health care hospital. A prehospital interval of more than 60 minutes was calculated in 20 % of emergency care. 96.2 % of the patients were transported to hospitals of tertiary or maximum supply by air rescue services. The life saving appliances" readiness for action is however restricted to daylight. A further limitation appeared for routine office hours in hospitals: Only 36.7 % of accidents occurred in this time frame. An increase of hospitalizations in clinics of maximum supply appeared from 2002 until 2006 while simultaneously the prehospital period was extended. To assure a sufficient medical care of seriously injured persons further on, a fulltime and area-wide expostulation of efficient facilities is necessary. For this purpose it is necessary to establish regional trauma networks as well as emergency medical service at night time. Beyond that, a cost efficient compensation of the structural, personnel and logistic expenses has to be assured.
While many medical studies have dealt with the incidence, nature and treatment of polytrauma the injury-causing accident mechanisms are rarely discussed in detail, mostly due to the lack of documentation of the technical aspects. The present prospective study was started in late 2007 and collects data from traffic accidents with most severely injured in six south- German counties and two larger cities for the duration of one year. It is aimed at identifying and documenting all polytrauma cases (ISS ≥ 16) caused by traffic accidents and their crash circumstances. The data collection is based on an interdisciplinary concept to include both the police, emergency dispatch centers, hospitals and fire departments in the region and is completely anonymous. Potentially relevant cases where an emergency physician was called to the scene of a traffic accident are provided by the dispatch center. All three hospitals in the region suited for the treatment of polytraumatised patients record injuries, major diagnostic and surgery data. Data and images from the accident scene are provided by the police and by fire departments. The latter provide information which is usually not available from the police, like deployed airbags, vehicle extrication measures and detailed views of car interiors. The main objective of the study is to determine the structure of road users who sustain a polytrauma, their crash opponents and the injury patterns found in relation to the collision configuration and the protection by seat belts, air bags and other devices. With detailed documentation of vehicle damage and extrication measures the study is also intended to support the development of injury predictors for pre-hospital treatment and provide field data regarding further improvement of technical rescue.
A lack of representative European accident data to aid the development of safety policy, regulation and technological advancement is a major obstacle in the European Union. Data are needed to assess the performance of road and vehicle safety and is also needed to support the development of further actions by stakeholders. This short-paper describes the process of developing a data collection and analysis system designed to partly fill these gaps. A project team with members from 7 countries was set up to devise appropriate variable lists to collect fatal crash data under the following topic levels: accident, road environment, vehicle, and road user, using retrospective detailed police reports (n=1,300). The typical level of detail recorded was a minimum of 150 variables for each accident. The project will enable multidisciplinary information on the circumstances of fatal crashes to be interpreted to provide information on a range of causal factors and events surrounding the collisions.
Nowadays, traffic accidents are recorded in historical databases. Regarding the huge quantity of data, the use of data mining tools is essential to help Experts, for automatically extracting relevant information in order to establish and quantify relations between severity and potential factors of accidents. An innovative approach is here proposed for an in depth investigation of real world accidents data base. Mutual information ratio based on conditional entropies is used to quantity the association strength between an accident outcome descriptor (injury severity) and other potential association factors. Information theoretic methods help to select automatically groups of factors mostly responsible of the severity of accident.
This study aims to analyze spine injuries in motor vehicle accidents. Between 1985 and 2004 the Hannover accident research unit documented 18353 accidents. We identified 161 front passengers (0.53%) with cervical spine injuries, 84 (0.28%) with thoracic and 95 (0.31%) with lumbar injuries. Technical and medical data was reviewed. Patients" records were retrieved. X-rays were evaluated and fractures were classified according to the Magerl classification. 68% and 57% of thoracic and lumbar fractures occurred in accidents with multiple impacts. Delta-v was 50, 40 and 40 kph in passengers with cervical, thoracic and lumbar spine, resp. Passengers with spinal fractures frequently showed numerous concomitant injuries, e.g. additional vertebral fractures. The influence of seat belts and airbags is discussed. Patient work-up has to include a thorough investigation for additional injuries.
A lot of factors are related to a road traffic accident; particularly human factors such as road use characteristic, driving maneuver characteristic and safety attitude are the major ones. As a random factor is also included, so it is necessary to minimize the contribution of a random factor to identify human factors related to a road traffic accident. There are several standpoints for traffic accident analysis, such as vehicle-based, location-based and driver-based. And it is effective to analyze driver-based traffic accident data for discussion on the relation between human factors and accidents. An integrated traffic accident database system was developed for analysis considering driver- accident and violation records by ITARD, and several studies were carried out for the evaluation. Useful data for discussion on the relation between types of collision and traffic violations, and the effect of accident experience to the following accident were obtained.
In the context of the COST357 research project, the climatic conditions and requirements for protective helmets for motorcyclists have been examined. The extent to which these factors would influence motorbike handling and accidents in which motorcyclists are involved have also been examined. This project addresses how cognitive abilities of motorcyclists relate to helmet construction factors. In particular, the aspects of motorcycle driver helmets are to be parameterized in order that they may be used subsequently as a basis for future requirement profiles. The task of one working group of the COST357 project has been to analyse accident events and to identify helmet design issues which affect motorcycle drivers while wearing a helmet. This has been achieved by collating accident data across different countries recorded in the course of in-depth investigations at the site of accidents and by combining this with field studies of motorcyclists participating in traffic, but not involved in accidents. This paper presents the study methodology, database and first results of this international survey. The basis of the study has been a total of 424 interviews of motorcyclists and 134 motorcycle accidents, which were collected across Germany, Greece, Italy, Ireland, Portugal and Turkey and combined in a single database.
Pedestrian accidents are one of the major concerns related with road accidents around the world. Portugal has one of the highest rates of pedestrian fatalities in Europe. In this paper an overview conditions were the pedestrian accidents occurred in Portugal is presented. In the last years, a project related with the pedestrian accidents has run in Portugal for the period 2004-2006 where 603 people died, 2097 have been severely injured and about 17000 slightly injured. Within this project all the pedestrian accidents in this period have been analysed providing global information about a wide range of aspects, since location, driver and pedestrian characteristics, weather and road conditions, among others. In addition, 50 in-depth accidents have been investigated and the data collected according the Pendant methodology. For this in-depth methodology detailed information about the accident has been collected, including injuries, vehicle damage, road conditions and road user- behaviour and actions. An accident reconstruction has been carried for each case including the determination of the speeds and driver actions, and the analysis of the contributing factors for the accident. Depending of the accident complexity, different methodologies have been used to analyse these accident, from the classical analytical equations such as Simms and Woods, to the use of detailed computational pedestrian models as those included in the commercial software- PC-Crash-® or Madymo-®. Also one of the goals of our investigation is the development of multibody models and methodologies for the reconstruction of pedestrian accidents. Some of these tools integrated in the commercial software Cosmos Motion-® are presented. The advantages of the different approaches are compared and discussed for some of the accidents investigated. With these tools the impact speed can be determined from the projection distance with analytical tools or PC-Crash-®, but more complex tools should be used to determine speed from the injuries, what is especially important for fatal accidents. The influence of the vehicle geometry and stiffness characteristics is another aspect analysed, where the influence of the vehicle stiffness has been determined using a combined multibody-finite elements approach within the software Madymo-®.
Who doesn't wear seat belts?
(2009)
Using real world accident data, seat belts were estimated to be 61% effective at preventing fatalities, and 32% effective at preventing serious injuries. They were most effective for drivers with an airbag. Seat belts were estimated as having prevented 57,000 fatalities and 213,000 seriously injured casualties in the UK since 1983. Seat belt legislation was estimated to have prevented 31,000 fatalities and 118,000 seriously injured casualties. A future increase in effective seat belt wearing rate (which takes into account seating position) in the UK from 92.5% to 93% may prevent casualties valued at a societal cost of over -£18 million per year. To target a seat belt campaign, the question "who doesn"t wear seat belts?" must be answered. Seat belt wearing rates and the number of unbelted casualties were analysed. It was primarily young adult males who didn"t wear seat belts, and they made up the majority of unbelted fatalities and seriously injured casualties.
In an on-going project since 2005, ADAC has been analyzing accidents documented by the ADAC air rescue service. The knowledge derived from real-life accidents serves as a basis for new test configurations and assessment criteria. In 2007, ADAC began looking into the feasibility of international data collection. The idea of Global Accident Prevention was born. Three European partner clubs have begun pioneering the project (ÖAMTC, ANWB, and RACC). The aim is to set up an international accident research network to provide a steady stream of information on road accidents. The FIA Foundation supports ADAC in developing and coordinating this initiative.