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Although road infrastructure is developed extensively Brazil is still one of the countries with the most dangerous roads in the world. In order to stop the increasing trend of traffic fatalities of the last few years and to improve traffic safety on Brazilian roads a pilot study on behalf of SAE Brazil started in March 2016 with the goal to lay the foundations for a long-term research activity. Piloting for an in-depth accident investigation the city of Campinas, roughly 100 km north of São Paulo was chosen. The pilot project was carried out with the local partner, the Empresa Municipal de Desenvolvimento de Campinas (EMDEC). The paper reports on the initial training of evidence based accident data collection on-spot, the implementation of the new digital database, the data collection and the first results. An outlook on the planned long-term accident investigations is given.
The increasing economics in India has an enormous growth of its road traffic. As observed from official Indian accident statistics the number of road fatalities are one of the highest worldwide. In contrast to most industrialized nations they have an rapidly increasing trend. To come along with this trend it becomes more than essential to understand the traffic accident situation. The official Indian accident statistics gives a glimpse of only basic information. Therefore more detailed data is needed. By using In-depth accident data and officially representative statistics the current accident situation can be evaluated in India, if a suitable weighting methodology is considered. Hence in 2009/2010 a pilot study with the collaboration partner JP-Research India pvt. Ldt. was gathered in Tamil Nadu in south of India. In-depth accident investigations were done around the Coimbatore area on four highways. At first, the collected data is evaluated. Due to consequent and continuous further development based on the first approach a methodology similar to NASS/CDS/GES in the US and GIDAS in Germany was developed. Of course all relevant accident related parameters including pictures and severity information were collected. As a matter of fact based on scaled sketches and reconstruction benefit analyses can be done in order to analyze the accident scenery in India. As a first outcome influence from infrastructure, missing education and vehicle safety were identified as key parameters in order to reduce the number of accidents and casualties. To compare the accident situation against international standards an accident classification for left hand traffic was developed based on the German Insurance classification system. Looking into detail additional accident types were identified and added to create an Indian accident type catalogue. The positive results encouraged several OEMs to participate in this investigation and together with BOSCH a consortium was established in 2010/11. Within one year from beginning in May 2011 about 200 highway accidents were collected, reported and reconstructed using the new standard. Hence a first good overview of the accident situation is available for the Coimbatore Tamil Nadu area. The major target for establishing accident investigations is the extension towards other states of India and urban areas to achieve a better overview of the accident scenery. Therefore local and national authorities have to be embedded in order to strengthen the awareness against traffic safety.
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.
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.
Powered Two Wheelers (PTWs) accidents constitute one of the road safety problems in Europe. PTWs fatalities represent 22% at EU level in 2006, having increased during last years, representing an opposite trend compared to other road users" figures. In order to reduce these figures it is necessary to investigate the accident causation mechanisms from different points of view (e.g.: human factor, vehicle characteristics, influence of the environment, type of accident). SAFERIDER project ("Advanced telematics for enhancing the SAFEty and comfort of motorcycle RIDERs", under the European Commission "7th Framework Program") has investigated PTW accident mechanisms through literature review and statistical analyses of National and In-depth accident databases; detecting and describing all the possible PTW's accident configurations where the implementation of ADAS (Advanced Driver Assistance Systems) and IVIS (In-Vehicle Information Systems) could contribute to avoid an accident or mitigate its severity. DIANA, the Spanish in-depth database developed by CIDAUT, has been analyzed for that purpose. DIANA comprises of accident investigation teams, in close cooperation with police forces, medical services, forensic surgeons, garages and scrap yards. An important innovation is the fact that before injured people arrive to hospitals, photographs and explanations about the possible accident injury mechanisms are sent to the respective hospitals (via 3G GPRS technology). By this, additional information to medical staff can be provided in order to predict in advance possible internal injuries and select the best medical treatment. This methodology is presented in this paper. On the other hand, the main results (corresponding to road, rider and PTW characteristics; pre and post-accident manoeuvres; road layout; rider behaviour; impact points; accident causations;...) from the analyses of the PTW accidents used for SAFERIDER are shown. Only accident types relevant to ADAS and IVIS devices have been considered.
The significant demographic changes are predicted for the European future. The age group over 65 years is permanently increasing and over next 30 years every fourth person will belong to this group. This development will continue so far that by 2050 in many countries will double the percentage of the population aged 65 and more. Many studies analyze the new phenomena of the ageing (graying) society during the last decade. Mobility is integrated part of the life of every citizen, even more it means for the elderly people. The adequate mobility is the precondition for their active life and for their social communication that contribute to their health and functional capacity and their autonomy and independency. The active seniors demand less public support. The mobility of the older citizens is closely linked with health and societal problems and creates an important public challenge. On the other side the participation of seniors in transport due to their limited physical and mental possibilities means for them an increased risk to be injured or killed. The main mobility spaces are roads that can be used not only as a traveler in a vehicle (driver or passenger) but also as a pedestrian or cyclist or even as a motorcyclist. The road traffic is then an opportunity and danger in the same time. The accident analyzes show specific risk features of seniors that are different compared with other age groups. First of all the older road users (65 and more) are facing to the higher risk (number of killed divided by the population size) to be killed in a road accident compared with the group of younger road users (0 - 64). More significant difference can be observed when comparing the road user groups. The fatality percentage of the older pedestrians is 2,5 times higher compared with the group 25 " 64. Similar frequency show the cyclist fatalities. On the other side the vehicle passengers in the younger group have more or less two time higher percentage compared to seniors and in the group of motorcyclists even achieved in 2008 almost five times higher compared with the older group. The share of the old road users fatalities (around 19%) didn"t practically change during the last 10 years in the European average. But comparing the gender involvement (2006) there is an interesting difference " female fatalities make 30, 2%, male fatalities 15, 3% of all fatalities in their groups. The risk of the senior users is more connected with their physical and mental limits than with their risk behavior. According to the Czech statistics (2007) the vehicle drivers over 65 years cause only 3, 6% of all accidents. The solution of the problem is to minimize the risk and to create a safe environment for the elderly people using the roads. In order to achieve this goal a deep knowledge of risk and of accident circumstances, full understanding of the behavior of the seniors and their limitations and accommodating approach of the whole society is necessary. Road risk of the ageing society has to be considered as a part of the health and social policy. These can build a creditable basis for the implementation of the measures that secure safe moving of seniors on the roads.
Die Unfallzahlen für das Jahr 2008 zeigen, dass die intensiven Anstrengungen für die Verkehrssicherheit weiterhin Früchte tragen. Nachdem im Jahr 2007 mit 220 Toten auch in Rheinland-Pfalz der geringste Stand seit Einführung der Unfallstatistik registriert wurde, konnte dieser Trend auch im Jahr 2008 bestätigt werden. Die Verkehrssicherheitsarbeit in Rheinland-Pfalz sieht sich dabei zunächst im Kontext des anspruchsvollen Ziels der EU, die Zahl der Verkehrstoten bis 2010 zu halbieren. Im Mittelpunkt steht dabei die Frage, wie die Risiken im Verkehrsverhalten der Menschen minimiert werden können. Vorhandene Sicherheitspotenziale sollen genutzt werden, Maßnahmen sind gezielt auf die Brennpunkte im Verkehrsgeschehen auszurichten. Neben Sicherheitsaktionen und Trainings für die Verkehrsteilnehmer sowie der Polizeiarbeit ist einer der wichtigsten Ansätze die Verbesserung der Infrastruktur. Zu den Maßnahmen auf diesem Gebiet zählen neue Ansätze beispielsweise bei der Überprüfung sicherheitsrelevanter Aspekte schon in der Planung, beim Bau moderner Verkehrsbeeinflussungsanlagen oder bei der Sicherheit an Bahnübergängen und in Tunnels. Ein Fokus liegt jedoch auf der Unfallkommissionsarbeit. Sie ist ein wesentlicher Bestandteil der Gesamtkonzeption zur Verbesserung der Verkehrssicherheit. Das Land Rheinland-Pfalz verfügt seit nunmehr über 35 Jahren über institutionalisierte Erfahrungen auf diesem Gebiet, die auch als Beispiel für die bundesweite Entwicklung dienten. In einem weiteren Schritt werden seit kurzem in einer landesweiten Unfallkonferenz nunmehr Programmschwerpunkte wie beispielsweise die Bekämpfung von Motorradunfällen oder Baumunfällen definiert. Zudem wurden mit einem aufwändigen Programm allen der etwa 400 Unfallkommissionsmitglieder in Rheinland-Pfalz Schulungen angeboten. Eine permanente Nachschulung garantiert dabei einen gleichbleibend hohen Wissensstand. Beispielgebend ist allerdings auch die zentrale Unfallauswertestelle beim Landesbetrieb Mobilität in Koblenz, die es in dieser Form so nur noch in Bayern gibt. Mit ihr steht seit vielen Jahren ein Instrument zur Verfügung, das nicht nur die Grundlagen für gezielte und effektive Verkehrssicherheitsmaßnahmen schafft, sondern auch landesweite Controllings durchführt. Ohne eine finanzielle Ausstattung ist jedoch eine effektive Unfallkommissionsarbeit nicht möglich. Aus diesem Grund wurde als Novum ein spezieller Haushaltsansatz geschaffen, der gezielt ausschließlich im Sinne der Verkehrssicherheit - derzeit mit dem Schwerpunkt Baumunfälle und Motorradsicherheit - eingesetzt wird. Dabei wurde auch in einem Bewertungsverfahren zum Ausbauplan für Landesstraßen die Verkehrssicherheit so gewichtet, dass speziell Unfallhäufungsstellen in die Prioritätenreihung gelangen. Diese Ansätze mit Strategien aus einer Landesunfallkonferenz, gezielter Schulung, finanzieller Ausstattung sowie Unterstützung und Controlling durch eine zentrale Unfallauswertestelle sind zugleich Chance und Herausforderung für eine künftige Verkehrssicherheitsarbeit.
Motorcycle riders are one of the most vulnerable road users. Annually, on estimate 6000 people are killed in motorcycle accidents in the former 15 EU countries. The objective of this research was to investigate and analyze the main aspects and causes of this vulnerability and the accidents in general. For this aim around 70 accidents in The Netherlands were investigated in the framework of an international research program (MAIDS). Also a control group of motorcycles with riders was investigated so that exposure could be taken into account. An important result is that human failure is in 82% of the cases the main cause of the accident, in 52% this is due the other vehicle driver. Perception and decision failures are the most common failures. The most injuries are caused by the environment but they are typically only less severe (AIS1). Injuries caused by the car (front and side) are typically severe injuries (AIS4+). Previous convictions of the MC rider seem to be related to the chance to get involved in an accident. It was shown that the Dutch and the total MAIDS accident sample are comparable.
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 total survey of road traffic accidents involving most severely injured, defined as sustaining a polytrauma or severe monotrauma (ISS > 15) or being killed, was conducted over 14 months in a large study region in Germany. Data on injuries, pre-clinical and clinical care, crash circumstances and vehicle damage were obtained both prospectively and retrospectively from trauma centers, dispatch centers, police and fire departments. 149 patients with a polytrauma and eight with a severe monotrauma were recorded altogether. 22 patients died in hospital. Another 76 victims had deceased at the accident scene. In 2008, 49 % of patients treated with life-threatening injuries were car or van occupants, 21 % motorcyclists, 18 % cyclists and 10 % pedestrians. Among fatalities at the scene, vehicle occupants constituted an even larger portion. The number of road users with life-threatening trauma in the region was extrapolated to the German situation. It suggests that 10 % among the "seriously injured" as defined in national accident statistics are surviving accident victims with a polytrauma or severe monotrauma.
This paper reviews briefly the evolution of the investigation of transport accidents from the early beginnings when individual events were studied but systematic data was not collected. In the transport modes other than on the roads, accident investigation early on, even of single events, was important in introducing safety improvements. Road accidents, however, evolved enormously with the growth of car ownership without any comparable political response to the consequent deaths and injuries, equivalent to what happened with the other modes. From the 1950s data bases started to contribute to our knowledge of the epidemiology of road traffic injuries, and in-depth sample studies have contributed much to the body of knowledge in the last 30 years. However, even the basic input and output variables of a crash, its severity and the seriousness of the outcomes in terms of injuries and their consequences are not complete or agreed upon. Issues of experimental design and sampling are discussed. It is proposed that the most important area for current research to address is the effect of population variations on injury outcomes. The need for the establishment of good data bases for active safety issues is emphasised with the consequent need for better links between the research community and the police.
Causation patterns and data collection blind spots for fatal intersection accidents in Norway
(2010)
Norwegian fatal intersection accidents from the years 2005-2007 were analysed to identify any causation patterns among their underlying contributing factors, and also to evaluate whether the data collection and documentation procedures used by the Norwegian in-depth investigation teams produces the information necessary to perform causation pattern analysis. A total of 28 fatal accidents were analysed. Details on crash contributing factors for each driver in each crash were first coded using the Driving Reliability and Error Analysis Method (DREAM), and then aggregated based on whether the driver was going straight or turning. Analysis results indicate that turning drivers to a large extent are faced with perception difficulties and unexpected behaviour from the primary conflict vehicle, while at the same time trying to negotiate a demanding traffic situation. Drivers going straight on the other hand have less perception difficulties. Instead, their main problem is that they largely expect turning drivers to yield. When this assumption is violated, they are either slow to react or do not react at all. Contributing factors often pointed to in literature, e.g. high speed, drugs and/or alcohol and inadequate driver training, played a role in 12 of 28 accidents. While this confirms their prevalence, it also indicates that most drivers end up in these situations due to combinations of less auspicious contributing factors. In terms of data collection and documentation, information on blunt end factors (those more distant in time/space, yet important for the development of events) was more limited than information on sharp end factors (those close in time/space to the crash). A possible explanation is that analysts may view some blunt end factors as event circumstances rather than contributing factors in themselves, and therefore do not report them. There was also an asymmetry in terms of reported obstructions to view due to signposts and vegetation. While frequently reported as contributing for turning drivers, they were rarely reported as contributing for their counterparts in the same accidents. This probably reflects an involuntary focus of the analyst on identifying contributing factors for the driver legally held liable, while less attention is paid to the driver judged not at fault. Since who to blame often is irrelevant from a countermeasure development point of view, this underlying investigator mindset needs addressing to avoid future bias in crash investigation reports.
Accident data shows that the vast majority of pedestrian accidents involve a passenger car. A refined method for estimating the potential effectiveness of a technology designed to support the car driver in mitigating or avoiding pedestrian accidents is presented. The basis of the benefit prediction method consists of accident scenario information for pedestrian-passenger car accidents from GIDAS, including vehicle and pedestrian velocities. These real world pedestrian accidents were first reconstructed and the system effectiveness was determined by comparing injury outcome with and without the functionality enabled for each accident. The predictions from Volvo Cars" general Benefit Estimation Model are refined by including the actual system algorithm and sensing models for a relevant car in the simulation environment. The feasibility of the method is proven by a case study on a authentic technology; the Auto Brake functionality in Collision Warning with Full Auto Brake and Pedestrian Detection (CWAB-PD). Assuming the system is adopted by all vehicles, the Case Study indicates a 24% reduction in pedestrian fatalities for crashes where the pedestrians were struck by the front of a passenger car.
The evaluation of the expected benefit of active safety systems or even ideas of future systems is challenging because this has to be done prospectively. Beside acceptance, the predicted real-world benefit of active safety systems is one of the most important and interesting measures. Therefore, appropriate methods should be used that meet the requirements concerning representativeness, robustness and accuracy. The paper presents the development of a methodology for the assessment of current and future vehicle safety systems. The variety of systems requires several tools and methods and thus, a common tool box was created. This toolbox consists of different levels, regarding different aspects like data sources, scenarios, representativeness, measures like pre-crash-simulations, automated crash computation, single-case-analyses or driving simulator studies. Finally, the benefit of the system(s) is calculated, e.g. by using injury risk functions; giving the number of avoided/mitigated accidents, the reduction of injured or killed persons or the decrease of economic costs.
Analysis of the accident scenario of powered two-wheelers on the basis of real-world accidents
(2013)
For the first time since 20 years the German national statistics of traffic accidents revealed an increasing number of fatalities and seriously injured persons in 2011. This negative development was especially caused by increasing numbers in all groups of vulnerable road users (VRU). Furthermore, the comparison of fatality reduction rates between several categories of road users shows that persons on motorcycles show the worst performance over years. Although every second fatality in German traffic accidents is still a car occupant, users of PTW make up more than 20% in the meantime. Assuming further improvements in the field of occupant protection this trend will continue. For that reason, a study on the basis of real-world accidents was conducted to describe the accident scenario involving motorcycles and to identify the reasons of the above-described fact. Approximately 1.800 motorcycle accidents out of GIDAS database were used for the analyses. The first part of the study deals with the question how representative the GIDAS database is for the German motorcycle accident scenario. Afterwards, detailed descriptive statistics on motorcycle accidents were presented considering numerous parameters about the accident scene, environmental influences, vehicle information, individual characteristics, interview data, injury severity and injury causation. One important point is the identification of the most frequent critical situations that are typical for motorcycle accidents. Furthermore, a special focus was on accident causation. Finally, conspicuous facts out of the analysis are emphasized. All in all, the study gives a comprehensive overview about the German motorcycle accident scenario. One the one hand, the use of weighted GIDAS data allows representative and robust statements on the basis of large case numbers; on the other hand highly detailed conclusions can be drawn. The results of the study help to understand the particularities of motorcycle accidents and provide approaches for further improvements in the field of PTW safety.
The paper presents a methodology for the benefit estimation of several secondary safety systems for pedestrians, using the exceptional data depth of GIDAS. A total of 667 frontal pedestrian accidents up to 40kph and more than 500 AIS2+ injuries have been considered. In addition to the severity, affected body region, exact impact point on the vehicle, and the causing part of every injury, the related Euro NCAP test zone was determined. One results of the study is a detailed impact distribution for AIS2+ injuries across the vehicle front. It can be stated, how often a test zone or vehicle part is hit by pedestrians in frontal accidents and which role the ground impact plays. Basing on that, different secondary safety measures can be evaluated by an injury shift method concerning their real world effectiveness. As an example, measures concerning the Euro NCAP pedestrian rating tests have been evaluated. It was analysed which Euro NCAP test zones are the most effective ones. In addition, real test results have been evaluated. Using the presented methodology, other secondary safety like the active bonnet (pop-up bonnet) or a pedestrian airbag measures can be evaluated.
The declining trend since 1991 in the number of killed people was broken in 2011 when overall 4 009 people died in traffic accidents in Germany. The question arises if there is a stagnating trend of fatalities in Germany in future? By breaking down the accidents with casualties towards a monthly view one can see a decreasing trend of fatalities in the warmer months especially since 2009. When comparing against winter months higher deviations are observed. In December 2011 an increase of 191 traffic deaths were registered (181 in 2010 compared to 372 in 2011). Further analyses of different accident influences were evaluated and their possibility of drastic change from one year to the other was determined. As seen weather- and environmental conditions are one of the major contributing factors and are one of the causes for the increased number of fatalities. To support the underlying assumption a model had been created to calculate the number of traffic deaths on a daily basis approach. As an input, road conditions projected through weather parameters and also different driving behaviors on weekdays or holidays were used. As a result, estimates of daily fatality with up to 75% precision can be achieved out of the 2009, 2010 and 2011 data. Further on it shows that weather and street conditions have a high influence on the overall resulting number of traffic accidents with casualties, and especially to the number of fatalities. Hence it is estimated that approximately 3 300 people were killed in traffic accidents in Germany in 2013 which would be again a reduction of another 13% compared to 2012. Therefore an answer to the question will be that the decreasing trend in traffic fatalities in Germany somehow is not broken when environmental conditions are included in national statistics. Their effects will become more visible in future accident statistics and it is estimated variances of 5% to 8% of the annual number of traffic fatalities in Germany will be seen.
Annually within the European Union, there are over 50,000 road accident fatalities and 2 million other casualties, of which the majority are either the occupants of cars or other road users in collision with a car. The European Commission now has competency for vehicle-based injury countermeasures through the Whole Vehicle Type Approval system. As a result, the Commission has recognised that casualty reduction strategies must be based on a full understanding of the real-world need under European conditions and that the effectiveness of vehicle countermeasures must be properly evaluated. The PENDANT study commenced in January 2003 in order to explore the possibility of developing a co-ordinated set of targeted, in-depth crash data resources to support European Union vehicle and road safety policy. Three main work activity areas (Work Packages) commenced to provide these resources. This paper describes some of the outcomes of Work Package 2 (WP2, In-depth Crash Investigations and Data Analysis). In WP2, some 1,100 investigations of crashes involving injured car occupants were conducted in eight EU countries to a common protocol based on that developed in the STAIRS programme. This paper describes the purposes, methodology and results of WP2. It is expected that the results will be used as a co-ordinated system to inform European vehicle safety policy in a systematic, integrated manner. Furthermore, the results of the data analyses will be exploited further to provide new directions to develop injury countermeasures and regulations.
Interaction of road environment, vehicle and human factors in the causation of pedestrian accidents
(2005)
The UK On-the-Spot project (OTS) completed over 1500 in-depth investigations of road accidents during 2000-2003 and is continuing for a further 3 years. Cases were sampled from two regions of England using rotating shifts to cover all days of the week and all hours of the day and night. Research teams were dispatched to accidents notified to police during the shifts; arrival time to the scene of the accident was generally less than 20 minutes. The methodology of OTS includes sophisticated systems for describing accident causation and the interaction of road, vehicle and human factors. The purpose of this paper is to describe and illustrate these systems by reference to pedestrian accidents. This type of analysis is intended to provide an insight into how and why pedestrian accidents occur in order to assist the development of effective road, vehicle and behavioural countermeasures.
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.