The SceneScore is a simple mechanism of injury scoring system designed to facilitate the appropriate triage of crash victims. It comprises 7 variables including age, collision type, impact location, airbag deployment, steering wheel deformity, intrusion, and restraint use. A cutoff value of 7 or 8 provides the maximum balance between sensitivity and specificity, with sensitivities of 75% to 83% and specificities of 29% to 46%. For cases triaged to the trauma center based only on high suspicion of injury, the SceneScore reduces the overtriage rate by almost half. Proper application of the SceneScore may lead to improved triage and enhanced communication of mechanism of injury criteria.

This study applies NASS/CDS, GES and FARS data to examine occupant exposure plus injury and fatality rates for belted occupants in frontal crashes by seating position, age and gender. The NASS data was used to examine the distributions by crash severity. The GES data showed that when two elderly occupants (age 65+) were present, the female occupied the right front passenger position 73% of the time. A paired comparison analysis using FARS data showed that, for elderly occupants (age 65+), the fatality risk for elderly right front passengers is 42% higher than for elderly drivers. The NASS/CDS analysis found 74% of the seriously injured vulnerable passengers with MAIS 3+ injuries were in crashes less severe than 26 mph. This group of injured occupants was made up of 43% aged 50 and older and 42% younger females. The injury rates for the older (age 50+) right front passengers were 1.8 times the rates for the elderly drivers. These results suggest the need for more benign safety systems for the right front passenger that are appropriate for the lower injury tolerance of the predominant occupants of that seating position.

This study examines the residual injuries reported in NASS/CDS 1997-2004 by crash mode, crash severity, body region and occupant age. It examines how serious injuries are distributed in present day crashes and identifies opportunities for further injury reduction. In planar crashes, approximately 66% of the MAIS 3+ injuries occur in crashes less severe than 25 mph delta-V. Chest injuries predominate in these crashes, particularly among elderly occupants. A reduction in chest injuries to belted elderly occupants during low severity frontal crashes offers a prime opportunity for further improvement of safety systems. Younger occupants could also benefit from improved chest protection.

Individual non-minor injuries (Abbreviated Injury Scale (AIS)≥ 2) to the head that occurred to belted and unbelted drivers and front seat passengers on the struck side of impacted vehicles were examined. Injury type, injury combination, collision severity in relation to type of injury as well as contact sources were assessed. Forty-eight percent of injuries were moderate in severity (AIS 2). The most common type of injury was the diffuse brain injury, typically marked by a short period of unconsciousness, which occurred in collisions of lower severity than focal brain and skull fracture injuries. One-hundred and five out of 216 (48.6%) of contact sources for all injury types originated from outside the vehicle and such exterior sources were more likely to result in high severity injuries. Thirty percent of injuries resulted from head contacts with other vehicles. The most frequent vehicle interior contact source was the side window glass. Diffuse injuries tended to occur independently of other injury types and were more likely to originate from an interior rather than exterior contact. Preventative measures for head injury reduction in lateral collisions are discussed. Overall, the data show that proposed and present European and U.S. lateral impact test methods do not address many head injury problems such as those included in this study.

This study investigates injury occurrence for belted occupants as a function of age. An analysis of NASS/CDS 1997-2003 data was conducted to determine crash involvement rates and injury rates for front seat occupants versus mean occupant age. In frontal and near-side crashes, the average age of MAIS 3+ belted front seat occupants injured in crashes less severe than 15 mph is of the order of 50 years. The average age of the population exposed to crashes less severe than 15 mph is under 40 years old. The crash exposure and frequency if injuries to the elderly were both found to be the highest in low severity crashes. The chest is the most frequent body region injured for the elderly. These findings suggest the need for more benign safety systems to protect the elderly in low severity crashes. Design of safety systems for the elderly should give priority to reducing the chest loading in low severity frontal and near-side crashes.

Although seat belts significantly reduce the extent and severity of injuries sustained by motor vehicle occupants, seat belts are known to be associated with chest and abdominal trauma. Less commonly understood are severe neck injuries caused by the use of two-point automatic shoulder harnesses without concurrent use of a manual lap belt. Such injuries may include cervical spine fractures, craniocervical dislocations and rarely decapitation. Recognizing patterned injuries caused by seat belts and the ability to correlate autopsy findings with the circumstances surrounding the death will allow for correct interpretation of seat-belt related trauma. The four cases described detail fatal neck injuries as a result of improper seat belt use in which an automatic two-point shoulder harness was used without a manual lap restraint. In two of the cases, the victims were decapitated.

The advent of Automatic Crash Notification Systems (ACN) offers the possibility of immediately locating crashes and of determining the crash characteristics by analyzing the data transmitted from the vehicle. A challenge to EMS decision makers is to identify those crashes with serious injuries and deploy the appropriate rescue and treatment capabilities. The objective of this paper is to determine the crash characteristics that increase the risk of serious injury.Within this paper, regression models are presented which relate occupant, vehicle and impact characteristics to the probability of serious injury using the Maximum Abbreviated Injury Scale Level (MAIS). The accuracy of proposed models were evaluated using National Automotive Sampling System/Crashworthiness Data System (NASS/CDS) and Crash Injury Research and Engineering Network (CIREN) case data. Cumulatively, the positive prediction rate of models identifying the likelihood of MAIS3 and higher injuries was 74.2%.Crash mode has a significant influence of injury risk. For crashes with 30 mph deltaV, the risk of MAIS3+ injury for each mode is 38.9%, 83.8%, 47.8% and 19.9% for frontal, near side, far side and rear impact crashes, respectively. In addition to deltaV, a number of crash variables were identified that assist in the accurate prediction of the probability of MAIS 3+ injury. These variables include occupant age, partial ejection, safety belt usage, intrusion near the occupant, and crashes with a narrow object. For frontal crashes, added crash variables include air bag deployment, steering wheel deformation, and multiple impact crashes. The quantitative relationship between each of these crash variables and injury risk has been determined and validated by regression analysis based on NASS/CDS and CIREN data.

Die Entwicklung von Automatischen Unfallbenachrichtigungssystemen (ACN) bietet die Moeglichkeit, Unfaelle sofort zu lokalisieren und die Unfallmerkmale durch Analyse der vom Fahrzeug uebertragenen Daten sofort festzulegen. Dies stellt eine Herausforderung fuer EMS-Entscheidungstraeger dar, die Unfaelle mit schweren Verletzungen feststellen und die entsprechenden Rettungs- und Behandlungseinrichtungen aktivieren. Ziel dieser Untersuchung ist die Festlegung der Aufprallmerkmale, die das Risiko schwerer Verletzungen erhoehen. In dieser Studie werden Regressionsmodelle vorgestellt, die Fahrzeuginsassen, Fahrzeug und Aufprallmerkmale mit der Wahrscheinlichkeit schwerer Verletzungen abgleichen und dabei den Maximum Abbreviated Injury Scale Level (MAIS) heranziehen. Die Genauigkeit der vorgeschlagenen Modelle wurde anhand des National Automotive Sampling System/Crashworthiness Data System (NASS/CDS) und mit Hilfe der Falldaten der Crash Injury Research and Engineering Network (CIREN) bewertet. Kumulativ lag die positive Prognoserate von Modellen, die die Wahrscheinlichkeit von MAIS3 und schwereren Verletzungen feststellte, bei 74,2 Prozent. Die Art des Aufpralls hat einen deutlichen Einfluss auf das Verletzungsrisiko. Bei Aufprall mit 30 mph DeltaV liegt das Risiko fuer eine MAIS3+ Verletzung fuer jede Art bei 38,9 Prozent, 83,8 Prozent, 47,8 Prozent und 19,9 Prozent bei Unfaellen mit Frontal-, Frontseiten, Heckseiten und Heckaufprall respektive. Zusaetzlich wurden zu Delta V eine Reihe von Aufprallvariablen ermittelt, die bei der genauen Vorhersage der Wahrscheinlichkeit einer MAIS3+-Verletzung helfen. Diese Variablen beinhalteten das Alter des Fahrzeuginsassen, teilweises Herausschleudern, Verwendung des Sicherheitsgurtes, Intrusion in der Naehe des Fahrzeuginsassen und Aufprall auf ein schmales Objekt. Bei Frontalaufprall beinhalteten die zusaetzlichen Variablen das Ansprechen des Airbags, Lenkradverformung und Unfaelle mit Mehrfachaufprall. Das quantitative Verhaeltnis zwischen jeder dieser Crash-Variablen und dem Verletzungsrisiko wurde ermittelt und durch Regressionsanalyse auf der Basis von NASS/CDS- und CIREN-Daten validiert. ABSTRACT IN ENGLISH: The advent of Automatic Crash Notification Systems (ACN) offers the possibility of immediately locating crashes and of determining the crash characteristics by analyzing the data transmitted from the vehicle. A challenge to EMS decision makers is to identify those crashes with serious injuries and deploy the appropriate rescue and treatment capabilities. The objective of this paper is to determine the crash characteristics that increase the risk of serious injury. Within this paper, regression models are presented which relate occupant, vehicle and impact characteristics to the probability of serious injury using the Maximum Abbreviated Injury Scale Level (MAIS). The accuracy of proposed models were evaluated using National Automotive Sampling System/ Crashworthiness Data System (NASS/CDS) and Crash Injury Research and Engineering Network (CIREN) case data. Cumulatively, the positive prediction rate of models identifying the likelihood of MAIS3 and higher injuries was 74.2 percent. Crash mode has a significant influence of injury risk. For crashes with 30 mph deltaV, the risk of MAIS3+ injury for each mode is 38.9 percent, 83.8 percent, 47.8 percent and 19.9 percent for frontal, near side, far side and rear impact crashes, respectively. In addition to deltaV, a number of crash variables were identified that assist in the accurate prediction of the probability of MAIS 3+ injury. These variables include occupant age, partial ejection, safety belt usage, intrusion near the occupant, and crashes with a narrow object. For frontal crashes, added crash variables include air bag deployment, steering wheel deformation, and multiple impact crashes. The quantitative relationship between each of these crash variables and injury risk has been determined and validated by regression analysis based on NASS/CDS and CIREN data. (A) Beitrag zum Themenbereich Pre-/Post Crash II der Tagung Innovativer Kfz-Insassen- und Partnerschutz Fahrzeugsicherheit 2010 - der VDI-Gesellschaft Fahrzeug- und Verkehrstechnik, Berlin, 20. und 21. November 2003. Siehe auch Gesamtaufnahme der Tagung, ITRD-Nummer D352586.

The URGENCY algorithm uses vehicle crash sensor data in Automatic Crash Notification (ACN) systems to assist in instantly identifying crashes that are most likely to have time critical injuries. The algorithm also provides the capability of improving injury identification, using data obtained from the scene. The prime purpose of the algorithm is to automatically provide emergency medical responders with objective information on crash severity to assist in detecting the approximately 1% of crashes with serious injuries needing the most urgent medical care. The algorithm calculates the risk of a MAIS 3+ injury being present in the crashed vehicle, instantly at the time of the crash. The prediction can be subsequently updated as more information becomes available. The algorithm was based on a multiple regression analysis using data from the National Accident Sampling System/Crashworthiness Data System, (NASS/CDS) years 1988-95. In this paper, the accuracy of the algorithm was evaluated for near side crashes by applying it retrospectively to the population of injured occupants in NASS 1997-2000. URGENCY was applied to the population of injured occupants in near side crashes. Using an injury risk criterion of 50%, URGENCY identified 69% of the crashes with MAIS 3+ injuries. By lowering injury risk criterion to 40%, URGENCY identified 78% of the crashes with MAIS 3+ injuries. Vehicle side intrusion was found to be a highly influential variable. By changing side intrusion from a binary to a continuous variable, the correctly identified crashes increased from 69% to 81%. Examination of the consequence of missing variables found that unknown values of occupant height and weight had a negligible effect on the ability to capture the MAIS 3+ injured. However, lack of knowledge of these variables did increase the magnitude of the false positives.

Occupants exposed to far-side crashes are those seated on the side of the vehicle opposite the struck side. This study uses the NASS/CDS 1988-98 to determine distributions of AIS 3+ injuries among occupants exposed to far-side crashes and the sources of the injuries. The William Lehman Injury Research Center (WLIRC) data from 1994-98 is used to assess injury mechanisms among seriously injured crash exposed far-side occupants. The NASS/CDS indicated that injury patterns for far-side restrained drivers were different from far-side restrained front passengers. For the driver, the head accounted for 40% of the AIS 3+ injuries in far-side collisions and the chest/abdomen accounted for 45.5%. For the right front passengers, head injuries contributed 27.2%, while chest and abdominal injuries accounted for 64.5%. The opposite-side interior was the most frequent contact associated with driver AIS 3+ injuries (30.5%). The seat belt was second, accounting for 22.6%. Among thirteen WLIRC cases of far-side belted occupants with MAIS 3+ injuries, five of the most serious injuries were attributed to the seat belt. The liver or the spleen was the most seriously injured body organ in all five cases. The seat was the most frequent source of passenger AIS 3+ injuries for the NASS/CDS weighted cases. However, non-contacts, contacts with other occupants, and the seat belt contacts were more frequent sources when considering the raw number of injuries. Overall, contacts with the opposite side of the car interior and with safety belts were the most frequent causes of AIS 3+ injuries in far-side crashes. The presence of an occupant on the near-side changed the injury pattern of the far-side occupant, mitigating injuries from contacts with the opposite side interior of the vehicle.

The objective of this paper is to examine injuries and injury mechanisms in side impact crashes being addressed by the United States standard, FMVSS 214. In this side impact protection standard, a moving deformable barrier impacts the occupant compartment of a vehicle being tested. The moving barrier is crabbed at an angle of 23 degrees measured relative to the side of the struck vehicle. The standard assesses the crash protection provided in a vehicle-to-vehicle crash to an occupant seated on the struck side, in the vicinity of the maximum intrusion. The National Automobile Sampling System /Crashworthiness Database System (NASS/CDS) data indicates that 75% AIS 3+ injuries occur in vehicle-to-vehicle crashes, 66% occur to the struck side occupants and 94% occur in crashes with damage to the occupant compartment. Crash directions of 10 and 2 o''clock are the most common injury producing crashes. In vehicle-to-vehicle side crashes examined in this study, the most frequent seriously injured (AIS 3+) body regions in the NASS/CDS 1988/1996 database were: chest/abdomen - 49%; head/face - 24%, pelvic/lower extremity - 14%; and neck/spine - 4%. The University of Miami School of Medicine - William Lehman Injury Research Center (WLIRC) data was representative of more severe crashes than the NASS/CDS database, and it contained a higher percentage of chest/abdominal injuries and a lower percentage of pelvic/lower extremity injuries. In the WLIRC data, the most frequent severely injured (AIS 4+) organs were the brain (21%) and the thoracic aorta (21%). In-depth analysis of brain induced injuries showed that the most frequent injury causing contacts for head injuries were: other vehicle 37.5%; pillar, 25%, and side interior, 25%. Light trucks were most frequently the source of the injuring head strikes. For aortic injuries, 100% were from contact with the side interior. Other factors that were observed in the WLIRC cases with aortic injuries were: older occupants, female gender, the presence of a far side occupant, oblique angles of impact, and damage to the front fender and door of the struck vehicle.

The University of Miami's William Lehman Injury Research Center at the Jackson Memorial Medical Center conducts interdisciplinary investigations to study seriously injured restrained occupants in frontal automobile collisions. Engineering analysis of these crashes is conducted in conjunction with the National Crash Analysis Center at the George Washington University. The multidisciplinary research team includes expertise in crash investigation, crash reconstruction, computer graphics, biomechanics of injuries, crash data analysis, trauma care, and all of the medical specialties associated with the Ryder Trauma Center at Jackson Memorial Hospital. More than 350 injured occupants and their crashes have been studied in depth. The purpose of this paper is to report on an observed pattern of liver lacerations suffered by drivers wearing shoulder belts, without the lap belt fastened and to assess the ability of existing crash test dummies to measure the potential for these injuries. During the initial years of the study, 48 cases of drivers protected by shoulder belts but without the lap belt fastened met the criteria for the study. Fifty percent of these drivers suffered liver lacerations. Further study showed that 22 of the crashes involved damage to the right front of the vehicle. Among the drivers in vehicles with right front damage, 92% sustained injuries to the liver. This observation indicated that 2-point belts were most likely to produce liver injuries in low severity frontal collisions when the crash direction is 1 to 2 o'clock. An analysis of the National Accident Sampling System for the years 1988-95 indicated that liver injuries constitute about 0.5% of the injuries suffered by drivers who are in tow-away crashes. NASS data showed that the risk of chest injury is more likely among drivers with automatic shoulder belts than drivers with 3-point manual belts. The crash test dummies showed no difference in chest injury measures. Finite element computer modeling demonstrated that the high deflection of the right lower rib on the Hybrid III dummy predicts the liver injuries in the 1 o'clock crashes. These higher deflections were less apparent at the location of the center chest deflection measurement device on the Hybrid III.

One issue associated with second generation air bags is the concern that the performance in higher severity crashes may be reduced. The purpose of this study is to examine the kinds of injuries sustained by belted drivers in the higher severity crashes, based on cases from the Lehman Injury Research Center at the University of Miami, which conducts interdisciplinary investigations of seriously injured restrained occupants in frontal automobile collisions. The crash severity range examined is the upper limit anticipated by the tests required by the federal standard for air bags and for consumer information: 30 mph (48 kph) and 35 mph (56 kph), respectively. Among 30-mph (48-kph) cases, impacts with narrow objects were overrepresented. The common injury mode for the narrow object impact was liver laceration. These injuries were attributed to the safety belt rather than the air bag. In the higher severity crashes, there were no head injuries. The chest injuries were the most life threatening and included rib fractures and injuries to the liver, spleen, heart, and lungs. Injuries to lower and upper limbs were also present in the higher severity crashes. All cases had liver lacerations. Two different crash conditions may contribute to liver injury: a shoulder belt only, without the lap belt fastened, and a centerline crash with a narrow object at a crash speed around 30 mph (48 kph). In the centerline pole crashes, the belt loading appears to be the initial source of injuries to the liver. It is concluded that the air bag and three-point belt system is providing high levels of protection to belted drivers in car-to-car crashes for the 30-35 mph (48-56 kph) severity range. However, the combined belt and air bag loading may be excessive in some centerline crashes with narrow objects.