Limits...
Crash injury prediction and vehicle damage reporting by paramedics.

Vaca FE, Anderson CL, Herrera H, Patel C, Silman EF, Deguzman R, Lahham S, Kohl V - West J Emerg Med (2009)

Bottom Line: Paramedic prediction of injury profile was sensitive, and prediction of disability outcome at discharge was accurate when compared to discharge diagnosis.Their reporting of vehicle specific crash variables was less accurate.Further study should be undertaken to assess the benefits of crash biomechanics education for paramedics and other pre-hospital care providers.

View Article: PubMed Central - PubMed

Affiliation: University of California, Irvine Medical Center, Department of Emergency Medicine Center for Trauma and Injury Prevention Research, Orange, CA.

ABSTRACT

Objective: The accuracy of pre-hospital crash scene details and crash victim assessment has important implications for initial trauma care assessment and management. Similarly, it is known to influence physician perception of crash victim injury severity. The goal of this feasibility study was to examine paramedic accuracy in predicting crash victim injury profile, disability outcome at hospital discharge, and reporting vehicle damage with other crash variables.

Methods: This prospective case series study was undertaken at a Southern California, Level I trauma center certified by the American College of Surgeons. Paramedics transporting crash injured motor vehicle occupants to our emergency department (ED)/trauma center were surveyed. We abstracted ED and in-patient records of injured vehicle occupants. Vehicle and crash scene data were obtained from a professional crash reconstruction, which included the assessment of deformation, crash forces, change in velocity, and the source of each injury.

Results: We used survey, injury, and crash reconstruction data from 22 collision cases in the final analysis. The median Injury Severity Score (ISS) was five (range 1-24). No enrolled patients died, and none were severely disabled at the time of discharge from the hospital. The paramedic crash injury severity predictions were sensitive for an Abbreviated Injury Scale (AIS) of 2-4. Paramedics often agreed with the crash reconstruction on restraint use, ejection, and other fatalities at the scene, and had lower levels of agreement for front airbag deployment, steering wheel damage, and window/windshield impact. Paramedics had 80% accuracy in predicting any disability at the time of hospital discharge.

Conclusion: Paramedic prediction of injury profile was sensitive, and prediction of disability outcome at discharge was accurate when compared to discharge diagnosis. Their reporting of vehicle specific crash variables was less accurate. Further study should be undertaken to assess the benefits of crash biomechanics education for paramedics and other pre-hospital care providers.

No MeSH data available.


Related in: MedlinePlus

Seatbelt-related contusion and abrasion
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC2691511&req=5

f2-wjem-10-62: Seatbelt-related contusion and abrasion

Mentions: Figure 1 shows the amount of crush deformation of the small sedan with crash investigation equipment. These measurements were used to calculate the crash forces at the time of impact and the Delta V. Seatbelt use by the small sedan driver was evident by the neck and chest wall contusion (seat belt sign) noted in Figure 2. The driver of the small sedan suffered a large full-thickness laceration of the left lower extremity (Figure 3) found to be due to impact with the after-market alarm LED shown in Figure 4. The role of this object as a significant source of injury was determined only through the comparison of crash reconstruction with clinical findings. Formal reconstruction of the crash demonstrated that on impact the driver translated forward and slightly underneath the seatbelt (submarine), allowing for pelvic contact with the instrument panel resulting in sacral ala and pubic rami fractures (Figure 5). Once again, the true mechanism and source of these significant fractures could only be determined through an understanding of the crash kinematics offered by crash reconstruction.


Crash injury prediction and vehicle damage reporting by paramedics.

Vaca FE, Anderson CL, Herrera H, Patel C, Silman EF, Deguzman R, Lahham S, Kohl V - West J Emerg Med (2009)

Seatbelt-related contusion and abrasion
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2691511&req=5

f2-wjem-10-62: Seatbelt-related contusion and abrasion
Mentions: Figure 1 shows the amount of crush deformation of the small sedan with crash investigation equipment. These measurements were used to calculate the crash forces at the time of impact and the Delta V. Seatbelt use by the small sedan driver was evident by the neck and chest wall contusion (seat belt sign) noted in Figure 2. The driver of the small sedan suffered a large full-thickness laceration of the left lower extremity (Figure 3) found to be due to impact with the after-market alarm LED shown in Figure 4. The role of this object as a significant source of injury was determined only through the comparison of crash reconstruction with clinical findings. Formal reconstruction of the crash demonstrated that on impact the driver translated forward and slightly underneath the seatbelt (submarine), allowing for pelvic contact with the instrument panel resulting in sacral ala and pubic rami fractures (Figure 5). Once again, the true mechanism and source of these significant fractures could only be determined through an understanding of the crash kinematics offered by crash reconstruction.

Bottom Line: Paramedic prediction of injury profile was sensitive, and prediction of disability outcome at discharge was accurate when compared to discharge diagnosis.Their reporting of vehicle specific crash variables was less accurate.Further study should be undertaken to assess the benefits of crash biomechanics education for paramedics and other pre-hospital care providers.

View Article: PubMed Central - PubMed

Affiliation: University of California, Irvine Medical Center, Department of Emergency Medicine Center for Trauma and Injury Prevention Research, Orange, CA.

ABSTRACT

Objective: The accuracy of pre-hospital crash scene details and crash victim assessment has important implications for initial trauma care assessment and management. Similarly, it is known to influence physician perception of crash victim injury severity. The goal of this feasibility study was to examine paramedic accuracy in predicting crash victim injury profile, disability outcome at hospital discharge, and reporting vehicle damage with other crash variables.

Methods: This prospective case series study was undertaken at a Southern California, Level I trauma center certified by the American College of Surgeons. Paramedics transporting crash injured motor vehicle occupants to our emergency department (ED)/trauma center were surveyed. We abstracted ED and in-patient records of injured vehicle occupants. Vehicle and crash scene data were obtained from a professional crash reconstruction, which included the assessment of deformation, crash forces, change in velocity, and the source of each injury.

Results: We used survey, injury, and crash reconstruction data from 22 collision cases in the final analysis. The median Injury Severity Score (ISS) was five (range 1-24). No enrolled patients died, and none were severely disabled at the time of discharge from the hospital. The paramedic crash injury severity predictions were sensitive for an Abbreviated Injury Scale (AIS) of 2-4. Paramedics often agreed with the crash reconstruction on restraint use, ejection, and other fatalities at the scene, and had lower levels of agreement for front airbag deployment, steering wheel damage, and window/windshield impact. Paramedics had 80% accuracy in predicting any disability at the time of hospital discharge.

Conclusion: Paramedic prediction of injury profile was sensitive, and prediction of disability outcome at discharge was accurate when compared to discharge diagnosis. Their reporting of vehicle specific crash variables was less accurate. Further study should be undertaken to assess the benefits of crash biomechanics education for paramedics and other pre-hospital care providers.

No MeSH data available.


Related in: MedlinePlus