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Institut
- Sonstige (47) (entfernen)
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.
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.
One goal of the assessment of the crashworthiness of passenger cars is to characterize the potential of injury outcome to occupants of cars involved in an accident. This can be achieved by the help of an index that puts the number of injured occupants of passenger cars in relation to the number of cars involved in an accident. As a consequence, this index decreases with a lower potential of injury and rises with a higher number of injuries while assuming a fixed number of accidents. Another index is introduced that uses an economical weighting of each injury level. The consequential injury costs are calculated using the average economical costs for lightly, severely and fatally injured persons. The calculation of the safety indices is based on an anonymized sample of accident data provided by the Federal Statistical Office. An index of Mercedes passenger car drivers depending on the year of registration between 1991 and 2006 is compared to the index of drivers of cars of other makes within the same range of registration years.
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.
The SafetyNet project was formulated in part to address the need for safety oriented European road accident data. One of the main tasks included within the project was the development of a methodology for better understanding of accident causation together with the development of an associated database involving data obtained from on-scene or "nearly onscene" accident investigations. Information from these investigations was complemented by data from follow-up interviews with crash participants to determine critical events and contributory factors to the accident occurrence. A method for classification of accident contributing factors, known as DREAM 3.0, was developed and tested in conjunction with the SafetyNet activities. Collection of data and case analysis for some 1 000 individual crashes have recently been completed and inserted into the database and therefore aggregation analyses of the data are now being undertaken. This paper describes the methodology development, an overview of the database and the initial aggregation analyses.
The purpose of this work is to investigate the association between the injuries in motorcycle accident and the main accident configurations. The data were provided by a multicentric case-control study MAIDS regarding the risk of crash and injuries of motorcyclists. Chi-square test was used to evaluate the relationship between the variables and a logistic regression was performed to evaluate the association of injury severity with some variables supposed to be predictive factors. Lesive patterns characterized by internal haemorrhages are mainly associated with fronto-lateral crashes, above all in urban areas. Lacerations or abrasions, mainly reported in torso and lower extremities, are mostly associated with single crashes or accidents in queue also for crashes occurred to low speed (< 50 km/h). The severity of injuries is highly associated with impact speed, regardless of the crash configuration. Fractures and haemorrhages play an important role in determining the severity of injuries. The upper extremities are the most frequently traumatised anatomic areas.
As the official German catalogue of accident causes has difficulty in matching the increasing demands for detailed psychologically relevant accident causation information, a new system, based on a "7 Steps" model, so called ACASS, for analyzing and collecting causation factors of traffic accidents, was implemented in GIDAS in the year 2008. A hierarchical system was developed, which describes the human causation factors in a chronological sequence (from the perception to concrete action errors), considering the logical sequence of basic human functions when reacting to a request for reaction. With the help of this system the human errors of accident participants can be adequately described, as the causes of each range of basic human functions may be divided into their characteristics (influence criteria) and further into specific indicators of these characteristics (e.g. distraction from inside the vehicle as a characteristic of an observation-error and the operation of devices as an indication for distraction from inside the vehicle. The causation factors accordingly classified can be recorded in an economic way as a number is assigned to each basic function, to each characteristic of that basic function and to each indicator of that characteristic. Thus each causation factor can be explicitly described by means of a code of numbers. In a similar way the causation factors based on the technology of the vehicle and the driving environment, which are also subdivided in an equally hierarchical system, can be tagged with a code. Since the causes of traffic accidents can consist of a variety of factors from different ranges and categories, it is possible to tag each accident participant with several causation factors. This also opens the possibility to not only assign causation factors to the accident causer in the sense of the law, but also to other participants involved in the accident, who may have contributed to the development of the accident. The hierarchical layout of the system and the collection of the causation factors with numerical codes allow for the possibility to code information on accident causes even if the causation factor is not known to its full extent or in full detail, given the possibility to code only those cause factors, which are known. Derived from the systematic of the analysis of human accident causes ("7 steps") and from the practical experiences of on-scene interviews of accident participants, a system was set in place, which offers the possibility to extensively record not only human causation factors in a structured form. Furthermore, the analysis of the human causation factors in such a structured way provides a tool, especially for on-scene accident investigations, to conduct the interview of accident participants effectively and in a structured way.
One of the major problems of road safety in Europe is the powered two wheelers accidents. One of the European countries with one of the highest rates is Portugal where in 2006, mopeds and motorcycles fatalities represented 27% of all road users deaths. In this work, a deep analysis and overview of the current state of mopeds and motorcycles accidents for the 2004-2006 period is presented. Within this period 830 PTW occupants die, 2958 have been severely injured and 25000 suffer slight injuries. A detailed analysis of the conditions of these accidents has been carried out, using the data of the national accident database. This analysis provides global information, about geographic environmental conditions, driver- characteristics among others. From this data detailed information is obtained allowing to know when, where and who. In order to answer the question why more a widely collection of data has been collect for 70 accidents. The data has been collected using OECD methodology. For these accidents a detailed reconstruction has been carried out, what is especially important for fatal accidents where for instance speed in an important factor. From these collection and analysis of data a wider overview of facts and measures are extracted. Among them, some are emphasized such as that the quality and non-use of helmets plays an important role in severe and fatal accidents especially for accidents involving moped vehicles, or speed is the most important factor in fatal accidents involving motorcycles. Concerning motorcycle accident reconstruction, different tools can be used depending of the accident scenario and complexity. For simple cases, with specific characteristics, analytical formulation based in vehicle crash dynamics can be use in order to determine the impact speed of the vehicles impact, analysing the skid marks, deformations, victims rest position and considering parameters (EES, vehicle deceleration, etc). Aspects such as the energy absorption capability of motorcycles are also discussed. In the general cases the accident reconstruction software Pc-Crash has been used for the reconstruction of the accident. In very complex cases, has for instance the impact between motorcyclist and barriers, Madymo software is used especially to determine speed from injuries. An example of the impact of a motorcyclist and a motorcyclist-friendly barrier is present to illustrate the benefits and limitations of such systems.
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.
The Powered Two Wheelers (PTWs) accidents constitute one of the road safety targets in Europe. PTWs users' fatalities represent 15% of EU road fatalities, having increased the last few years, which is quite opposite than other road users casualties. To reduce PTW accidents is necessary to know which the accident causations are from different points of view (human factor, vehicle characteristics, environment, type of accident, situation, etc.). In TRACE project ("Traffic Accident Causation in Europe", under the European Commission 6th Framework Program, 2006-2008,) a specific task was focused on PTW users point of view, analyzing extensive databases to locate the main accident configurations (type of accident, severity, frequency), and an in-depth database to obtain the causation factors, the risk factors for each configuration founded in the extensive databases analysis and the variables associated to each causation factor in the PTW configurations.