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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.
It is well known that motorcycle riding is fascinating but quite more dangerous than for example car driving. In 2006, 5,091 persons were killed as victims of crashes occurring on public roads in Germany. 52% (2,683) were car occupants, 16% (793) motorcycle riders, 14% (711) pedestrians, 10% (486) bicycle riders, 5% (235) commercial vehicle occupants, 2% (107) riders of smaller powered two-wheelers, called "Mofa, Moped and Mokick". This shows that motorcycle riders recently are the second largest group of killed traffic participants in Germany. Latest information coming from the Federal Statistics predict for the year 2007 the figure of 4,958 killed road victims in total. This would be again a successful reduction (-133 killed persons or "2.6% compared to the year 2006). But the news coming from the Federal Statistics during the year 2007 and at the begin of 2008 did not always tell the same positive story. It is questioned whether the positive trend of substantially reduced figures of killed road user year by year will longer continue for Germany. That means it could be impossible to reach the ambitious target, set by the European Commission, to cut in half the figure of killed road users until the year 2010 " compared to the figure for the year 2001. It was reported that the group of 45 to 49 years old traffic participants (all traffic modes) is conspicuous with an increase of 30% up to 297 killed road users in total from January to August 2007. This increase can be ascribed in particular by an increase of killed motorcycle riders within this age group. Due to mild weather conditions in Germany in 2007 the season for motorcycle riding began relatively early and this may be a main reason for the increase of the figure of killed motorcycle riders by 16% from January to August 2007. With this background the accident occurrence of motorcycles became more and more essential. As part of the actual discussion about historical trends, recent emphases, causes and relevant structures of the events of motorcycle crashes it is evident, to have latest and carefully updated figures coming from both the Federal Statistics and In-depth studies. The paper will give a contribution to this using the German Federal Statistics and in-depth studies, for example GIDAS. Additional data coming from the DEKRA Motorcycle Accident Database as well as from literature are considered, too. The paper will help to describe the current situation of the accident involvement of motorcycles in Germany.
Since its beginning in 1999, the German In-Depth Accident Study (GIDAS) evolved into the presumably leading representative road traffic accident investigation in Europe, based on the work started in Hanover in 1973. The detailed and comprehensive description of traffic accidents forms an essential basis for vehicle safety research. Due to the ongoing extension of demands of researchers, there is a continuous progress in the techniques and systematic of accident investigation within GIDAS. This paper presents some of the most important developments over the last years. Primary vehicle safety systems are expected to have a significant and increasing influence on reducing accidents. GIDAS therefore began to include and collect active safety parameters as new variables from the year 2005 onwards. This will facilitate to assess the impact of present and future active safety measures. A new system to analyse causation factors of traffic accidents, called ACASS, was implemented in GIDAS in the year 2008. The whole process of data handling was optimised. Since 2005 the on-scene data acquisition is completely conducted with mobile tablet PCs. Comprehensive plausibility checks assure a high data quality. Multi-language codebooks are automatically generated from the database structure itself and interfaces ensure the connection to various database management systems. Members of the consortium can download database and codebook, and synchronize half a terabyte of photographic documentation through a secured online access. With the introduction of the AIS 2005 in the year 2006, some medical categorizations have been revised. To ensure the correct assignment of AIS codes to specific injuries an application based on a diagnostic dictionary was developed. Furthermore a coding tool for the AO classification was introduced. All these enhancements enable GIDAS to be up to date for future research questions.
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.
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.
In the course of the EUROPEAN PROJECT TRACE all fatally injured pedestrians autopsied at the Institute for Legal Medicine in Munich in 2004 had been analysed by using the "Human Functional Failure (HFF) analysis" method. It was possible to apply this method although some restrictions have to be taken into account. The results derived from this analysis comprise first the failures the pedestrians (most often "impairment of sensorimotor and cognitive abilities") and the opponents (most often " Non-detection in visibility constraints conditions") faced in the accident, second the conflicts and tasks (pedestrian crossing the street conflicting with a vehicle from the side (which was going ahead on a straight road), the degree of accident involvement (pedestrians often the primary active part), and further the contributing factors to the accident (pedestrians most often "alcohol (> 0.05% BAC)", opponents most often "visibility constraints").
Side impacts, both nearside and farside, have been indicated by research to be responsible for a large proportion of serious injuries from road crashes. This study aimed to compare and contrast the characteristics of nearside and farside crashes in Australia, Germany and the U.S., using the ANCIS, GIDAS and NASS/CDS in-depth-databases, in order to establish the impact and injury severity associated with these crashes, and the types of injuries sustained. The analyses revealed some interesting similarities, as well as differences, between both nearside and farside crashes, and the emergent trends between the three investigated countries. More specifically, it was indicated that whilst the severity of injury sustained in nearside crashes was slightly greater overall than that found for farside crashes, careful consideration of struck and nonstruck side occupants must be made when considering aspects such as vehicle design and occupant protection.
The bicyclist accidents were analyzed to get better understanding of the occurrences and frequency of the accidents, injury distributions, as well as correlation of injury severity/outcomes with engineering and human factors in two different countries of China and Germany. The accident cases that occurred from 2001 to 2006 were collected from IVAC database in Changsha and GIDAS database in Hannover. Based on specified sampling criteria, 1,570 bicyclist cases were selected from IVAC database in Changsha, and 1806 cases were collected from Hannover, documented in GIDAS database. Statistical analyses were carried out by using these selected data. The results from the statistical analysis are presented and discussed in this study.