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Determination of Injury Mechanisms

Chapter

Abstract

This chapter discusses the methods used by investigators to determine injury mechanisms in vehicular crashes. Determination of injury mechanisms is a process that requires complete injury identification through the review of medical records and imaging studies (The Person) and the correlation of identified injuries or groups of injuries with information related to the crash (The Crash) and to the vehicle or vehicles involved (The Vehicle). Preliminarily determined injury mechanisms may be corroborated by published injury studies or by testing, when required. Topics related to the person include classification of traumatic injuries, identification of injuries, determination of injury severity, determination of occupant kinematics, and relationship of the crash to human tolerance to acceleration and blunt force impact. Data related to the crash includes a complete description of the crash dynamics, the scene, and various derived crash parameters such as change in velocity, principal direction of force, and crash pulse. Inspection of the vehicle identifies areas of impact, deformation of structure into the “survival space,” identification of occupant contacts, the presence and distribution of body fluids and tissues, and the condition of internal vehicle items such as the controls, seats, and restraint systems including air bags and pretensioners.

Keywords

Injury Mechanism Restraint System Abbreviate Injury Score Frontal Crash National Highway Traffic Safety Administration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. AAAM. (1990). The abbreviated injury scale, 1990 revision. Barrington, IL: Association for the Advancement of Automotive Medicine.Google Scholar
  2. Adamec, J., Praxl, N., Miehling, T., Muggenthaler, H., & Schonpflug, M. (2005, September 21). The occupant kinematics in the first phase of a rollover accident – experiment and simulation. 2005 International IRCOBI conference on the biomechanics of impacts (pp. 145–156), IRCOBI, Prague.Google Scholar
  3. Agaram, V., Xu, L., Wu, J., Kostyniuk, G., & Nusholtz, G. S. (2000, March 6). Comparison of frontal crashes in terms of average acceleration. SAE 2000 World Congress. SAE paper no. 2000-01-0880 (pp. 1–21), SAE, Warrendale, PA.Google Scholar
  4. Alem, N. M., Nusholtz, G. S., & Melvin, J. W. (1984, November 6). Head and neck response to axial impacts. Proceedings of the 28th Stapp Car Crash Conference. SAE paper no. 841667, SAE, Warrendale, PA.Google Scholar
  5. Alsop, D., & Kennett, K. (2000). Skull and facial bone trauma. In A. M. Nahum & J. W. Melvin (Eds.), Accidental injury: biomechanics and prevention (pp. 254–276). New York: Springer.Google Scholar
  6. Anderson, P. A., Rivara, F. P., Maier, R. V., & Drake, C. (1991). The epidemiology of seatbelt-associated injuries. The Journal of Trauma, 31, 60–67.PubMedCrossRefGoogle Scholar
  7. Backaitis, S. H., DeLarm, L., & Robbins, D. H. (1982, February 22). Occupant kinematics in motor vehicle crashes. SAE International Congress and Exposition. SAE paper no. 820247 (pp. 107–155), SAE, Warrendale, PA.Google Scholar
  8. Baker, S. P., & O’Neill, B. (1976). The injury severity score: an update. The Journal of Trauma, 16, 882–885.PubMedCrossRefGoogle Scholar
  9. Baker, S. P., O’Neill, B., Haddon, W., Jr., & Long, W. B. (1974). The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. The Journal of Trauma, 14, 187–196.PubMedCrossRefGoogle Scholar
  10. Baker, S. P., Brady, J. E., Shanahan, D. F., & Li, G. (2009). Aviation-related injury morbidity and mortality: data from U.S. health information systems. Aviation, Space, and Environmental Medicine, 80, 1001–1005.PubMedCentralPubMedCrossRefGoogle Scholar
  11. Berg, F. A., Walz, F., Muser, M., Burkle, H., & Epple, J. (1998, September 16). Implications of velocity change delta-v and energy equivalent speed EES for injury mechanism assessment in various collision configurations. International IRCOBI conference on the biomechanics of impacts. 1998-13-0004 (pp. 57–72), IRCOBI, Bron, France.Google Scholar
  12. Biss, D. J. (1990, February 19). Relating three-point belted vehicle occupant kinematics and dynamics to case accident injury patterns and forensic evidence. 42nd Annual meeting of American Academy of Forensic Sciences, American Academy of Forensic Sciences, Cincinnati, OH.Google Scholar
  13. Bready, J. E., Nordhagen, R. P., & Kent, R. W. (1999, March 1). Seat belt survey: identification and assessment of noncollision markings. SAE International Congress and Exposition. SAE paper no. 1999-01-0441 (pp. 1–13), SAE, Warrendale, PA.Google Scholar
  14. Bready, J. E., Nordhagen, R. P., Kent, R. W., & Jakstis, M. W. (2000). Characteristics of seat belt restraint system markings. SAE 2000 World Congress. SAE paper no. 2000-01-1317 (pp. 1–11), SAE, Warrendale, PA.Google Scholar
  15. Bready, J. E., Nordhagen, R. P., Perl, T. R., & James, M. B. (2002, March 4). Methods of occupant kinematics analysis in automobile crashes. SAE 2002 World Congress. SAE paper no. 2002-01-0536 (pp. 1–6), SAE, Warrendale, PA.Google Scholar
  16. Brinkley, J. W., & Raddin, J. H., Jr. (1996). Biodynamics: transient acceleration. In R. L. DeHart (Ed.), Fundamentals of aerospace medicine. Philadelphia, PA: Lippincott Williams & Wilkins.Google Scholar
  17. Burdi, A. R., Huelke, D. F., Snyder, R. G., & Lowrey, G. H. (1969). Infants and children in the adult world of automobile safety design: pediatric and anatomical considerations for the design of child restraints. Journal of Biomechanics, 2, 267–280.PubMedCrossRefGoogle Scholar
  18. Car-Safety.org. (2009). Why rear-facing is safest. http://www.car-safety.org/rearface.html. Accessed 13 June 2009.
  19. Chandler, R. F. (1985). Restraint system basics. Sport Aviation, 1985, 35–39.Google Scholar
  20. Chandler, R. F. (1990). Occupant crash protection in military air transport. AGARD-AG-306.Google Scholar
  21. Cheng, P. H., & Guenther, D. A. (1989, February 27). Effects of change in angular velocity of a vehicle on the change in velocity experienced by an occupant during a crash environment and the localized Delta V concept. SAE International Congress and Exposition. SAE paper no. 890636 (pp. 39–54), SAE, Warrendale, PA.Google Scholar
  22. Cheng, P. H., Tanner, C. B., Chen, H. F., Durisek, N. J., & Guenther, D. A. (2005, April 11). Delta-V barrier equivalent velocity and acceleration pulse of a vehicle during an impact. SAE 2005 World Congress. SAE paper no. 2005-01-1187, SAE, Warrendale, PA.Google Scholar
  23. Clarke, N. P. (1963). Biodynamic response to supersonic ejection. Aerospace Medicine, 34, 1089–1094.PubMedGoogle Scholar
  24. Compton, C. P. (2005). Injury severity codes: a comparison of police injury codes and medical outcomes as determined by NASS CDS Investigators. Journal of Safety Research, 36, 483–484.PubMedCrossRefGoogle Scholar
  25. Crandall, J., Kent, R., Patrie, J., Fertile, J., & Martin, P. (2000). Rib fracture patterns and radiologic detection – a restraint-based comparison. Annual Proceedings of the Association for the Advancement of Automotive Medicine, 44, 235–259.Google Scholar
  26. Crandall, J., Kent, R., Viano, D., & Bass, C. R. (2003). The biomechanics of inflatable restraints – occupant protection and induced injury. In R. Kent (Ed.), Air bag development and performance. New perspectives from industry, government and academia (pp. 69–110). Warrendale, PA: SAE.Google Scholar
  27. Cugley, J., & Glaister, D. H. (1999). Short duration acceleration. In J. Ernsting, A. N. Nicholson, & D. J. Rainford (Eds.), Aviation medicine. London: Arnold.Google Scholar
  28. De Haven, H. (1952, January 14). Accident survival – airplane and passenger car. SAE Annual Meeting. SAE paper no. 520016 (pp. 1–7), SAE, Warrendale, PA.Google Scholar
  29. Department of Defense. (2000, February 10). Standard practice for system safety. MIL-STD-882D, pp. ii–26.Google Scholar
  30. Department of the Army. (1989). Aircraft crash survival design guide: volume 2 – Aircraft design crash impact conditions and human tolerance. USAAVSCOM TR 89-D-22B.Google Scholar
  31. Department of the Army. (1994). Army accident investigation and reporting. Department of the Army.Google Scholar
  32. Digges, K. H., Malliaris, A. C., & DeBlois, H. J. (1994, May 24). Opportunities for casualty reduction in rollover crashes. 14th International Technical Conference on the Enhanced Safety of Vehicles. Paper no. 94-S5-O-11 (pp. 863–868), NHTSA, Washington, DC.Google Scholar
  33. Eiband, A. M. (1959, June 1). Human tolerance to rapidly applied accelerations: a summary of the literature. NASA Memo 5-19-59E (pp. 1–93), NASA, Washington, DC.Google Scholar
  34. Estep, C. R., & Lund, A. K. (1996, May 13). Dummy kinematics in offset-frontal crash tests. 15th International Technical Conference on the Enhanced Safety of Vehicles. Paper no. 96-S3-W-12 (pp. 502–510), NHTSA, Washington, DC.Google Scholar
  35. Estrada, L. S., Alonso, J. E., McGwin, G., Jr., Metzger, J., & Rue, L. W., III. (2004). Restraint use and lower extremity fractures in frontal motor vehicle collisions. The Journal of Trauma, 57, 323–328.PubMedCrossRefGoogle Scholar
  36. Farmer, C. M. (2003). Reliability of police-reported information for determining crash and injury severity. Traffic Injury Prevention, 4, 38–44.PubMedCrossRefGoogle Scholar
  37. Felicella, D. J. (2003). Forensic analysis of seat belts. Salem, OR: Kinetic Energy.Google Scholar
  38. Franchini, E. (1969, January 13). Crash survival space is needed in vehicle passenger compartments. International body engineering conference and exposition. SAE paper no. 690005, SAE, Warrendale, PA.Google Scholar
  39. Garrett, J. W., & Braunstein, P. W. (1962). The seat belt syndrome. The Journal of Trauma, 2, 220–238.PubMedCrossRefGoogle Scholar
  40. Hayden, M. S., Shanahan, D. F., Chen, L. H., & Baker, S. P. (2005). Crash-resistant fuel system effectiveness in civil helicopter crashes. Aviation, Space, and Environmental Medicine, 76, 782–785.PubMedGoogle Scholar
  41. Heydinger, G. J., Uhlenhake, G. D., & Guenther, D. A. (2008, April 14). Comparison of collision and noncollision marks on vehicle restraint systems. SAE 2008 World Congress. SAE paper no. 2008-01-0160, SAE, Warrendale, PA.Google Scholar
  42. Horsch, J. D., Viano, D. C., & DeCou, J. (1991, November 18). History of safety research and development on the General Motors energy-absorbing steering system. 35th Stapp Car Crash Conference. SAE paper no. 912890 (pp. 1–46), SAE, Warrendale, PA.Google Scholar
  43. Howard, R. P., Hatsell, C. P., & Raddin, J. H. (1999, September 28). Initial occupant kinematics in the high velocity vehicle rollover. International body engineering conference and exposition. SAE paper no. 1999-01-3231 (pp. 1–18), SAE, Warrendale, PA.Google Scholar
  44. Huelke, D. F., & Melvin, J. W. (1980, February 25). Anatomy, injury frequency, biomechanics, and human tolerances. Automotive engineering congress and exposition. SAE paper no. 800098, SAE, Warrendale, PA.Google Scholar
  45. James, S. H., Kish, P. E., & Sutton, T. P. (2005). Principles of bloodstain pattern analysis: theory and practice. Boca Raton, FL: CRC.CrossRefGoogle Scholar
  46. Kallan, M. J., & Jermakian, J. S. (2008). SUV rollover in single vehicle crashes and the influence of ESC and SSF. Annals of Advances in Automotive Medicine, 52, 3–8.PubMedCentralPubMedGoogle Scholar
  47. Kallieris, D., Conte-Zerial, P., Rizzetti, A., & Mattern, R. (1998, May 31). Prediction of thoracic injuries in frontal collisions. 16th International technical conference on the enhanced safety of vehicles. Paper no. 98-S7-O-04 (pp. 1550–1563), NHTSA, Washington, DC.Google Scholar
  48. Kindelberger, J., & Eigen, A. (2003). Younger drivers and sport utility vehicles (Report no. DOT HS 809 636). Washington, DC: NCSA.Google Scholar
  49. King, A. I., & Yang, K. H. (1995). Research in biomechanics of occupant protection. The Journal of Trauma, 38, 570–576.PubMedCrossRefGoogle Scholar
  50. Latham, F. (1957). A study in body ballistics: seat ejection (pp. 121–139). Farnborough: R.A.F. Institute of Aviation Medicine.Google Scholar
  51. Levy, P. M. (1964). Ejection seat design and vertebral fractures. Aerospace Medicine, 35, 545–549.PubMedGoogle Scholar
  52. Love, J. C., & Symes, S. A. (2004). Understanding rib fracture patterns: incomplete and buckle fractures. Journal of Forensic Sciences, 49, 1153–1158.PubMedCrossRefGoogle Scholar
  53. Melvin, J. W., Baron, K. J., Little, W. C., Gideon, T. W., & Pierce, J. (1998, November 2). Biomechanical analysis of Indy race car crashes. 42nd Stapp Car Crash Conference. SAE paper no. 983161 (pp. 1–20), SAE, Warrendale, PA.Google Scholar
  54. Moffatt, C. A., Moffatt, E. A., & Weiman, T. R. (1984, February 27). Diagnosis of seat belt usage in accidents. SAE International Congress and Exposition. SAE paper no. 840396, SAE, Warrendale, PA.Google Scholar
  55. Newberry, W., Carhart, M., Lai, W., Corrigan, C. F., Croteau, J., & Cooper, E. (2005, April 11). A computational analysis of the airborne phase of vehicle rollover: occupant head excursion and head-neck posture. SAE 2005 World Congress. SAE paper no. 2005-01-0943, SAE, Warrendale, PA.Google Scholar
  56. NHTSA. (1997). NHTSA announces new policy for air bags. NHTSA Now, 3, 1–3.Google Scholar
  57. NHTSA. (1999). Fourth report to congress: effectiveness of occupant protection systems and their use. Washington, DC: NHTSA.Google Scholar
  58. NHTSA. (2003). Initiatives to address the mitigation of vehicle rollover. Washington, DC: NHTSA.Google Scholar
  59. NHTSA. (2005). NPRM roof crush resistance. Docket No. NHTSA-2005-22143 (pp. 1–93). Washington, DC: NHTSA.Google Scholar
  60. NHTSA, NCSA. (2009). Seat belt use in 2009 – overall results. Traffic Safety Facts DOT HS 811 100.Google Scholar
  61. Obergefell, L. A., Kaleps, I., & Johnson, A. K. (1986, October 27). Prediction of an occupant’s motion during rollover crashes. 30th Stapp Car Crash Conference. SAE paper no. 861876 (pp. 13–26), SAE, Warrendale, PA.Google Scholar
  62. Phillips, L., Khadilkar, A., Egbert, T. P., Cohen, S. H., & Morgan, R. M. (1978, January 24). Subcompact vehicle energy-absorbing steering assembly evaluation. 22nd Stapp Car Crash Conference. SAE paper no. 780899 (pp. 483–535), SAE, Warrendale, PA.Google Scholar
  63. Prasad, P., & Chou, C. C. (2002). A review of mathematical occupant simulation models. In A. M. Nahum & J. W. Melvin (Eds.), Accidental injury: biomechanics and prevention. New York: Springer.Google Scholar
  64. Praxl, N., Schonpflug, M., & Adamec, J. (2003). Simulation of occupant kinematics in vehicle rollover dummy model versus human model. 18th International technical conference on the enhanced safety of vehicles, NHTSA, Washington, DC.Google Scholar
  65. Ridella, S. A., Eigen, A. M., Kerrigan, J., & Crandall, J. (2010). An analysis of injury type and distribution of belted, non-ejected occupants involved in rollover crashes. SAE Government/Industry Meeting and Exposition.Google Scholar
  66. Robertson, L. S. (1989). Risk of fatal rollover in utility vehicles relative to static stability. American Journal of Public Health, 79, 300–303.PubMedCrossRefGoogle Scholar
  67. Rouhana, S. W., Kankanala, S. V., Prasad, P., Rupp, J. D., Jeffreys, T. A., & Schneider, L. W. (2006). Biomechanics of 4-point seat belt systems in farside impacts. Stapp Car Crash Journal, 50, 267–298.PubMedGoogle Scholar
  68. Rupp, J. D., Miller, C. S., Reed, M. P., Madura, N. H., Klinich, K. D., & Schneider, L. W. (2008). Characterization of knee-thigh-hip response in frontal impacts using biomechanical testing and computational simulations. Stapp Car Crash Journal, 52, 421–474.PubMedGoogle Scholar
  69. Rupp, J. D., Flannagan, C. A., & Kuppa, S. M. (2010). Injury risk curves for the skeletal knee-thigh-hip complex for knee-impact loading. Accident Analysis & Prevention, 42, 153–158.CrossRefGoogle Scholar
  70. SAE. (1995). Surface Vehicle Recommended Practice. Instrumentation for impact test-Part 1-Electronic Instrumentation. SAE J211, SAE, Warrendale, PA.Google Scholar
  71. SAE. (2003). Human tolerance to impact conditions as related to motor vehicle design. SAE J885 REV 2003_12. SAE, Warrendale, PA.Google Scholar
  72. Shanahan, D. F., & Shanahan, M. O. (1989). Injury in U.S. Army helicopter crashes October 1979-September 1985. The Journal of Trauma, 29, 415–422.PubMedCrossRefGoogle Scholar
  73. Smith, W. S., & Kaufer, H. (1967). A new pattern of spine injury associated with lap-type seat belts: a preliminary report. University of Michigan Medical Center Journal, 33, 99–104.PubMedGoogle Scholar
  74. Snyder, R. G. (1970a). The seat belt as a cause of injury. Marquette Law Review, 53, 211–225.Google Scholar
  75. Snyder, R. G. (1970, May 13). Human impact tolerance. International automobile safety conference. SAE paper no. 700398 (pp. 712–782), SAE, Warrendale, PA.Google Scholar
  76. Sochor, M. C., Faust, D. P., Wang, S. C., & Schneider, L. W. (2003, March 3). Knee, thigh and hip injury patterns for drivers and right front passengers in frontal impacts. SAE 2003 World Congress. SAE paper no. 2003-01-0164, SAE, Warrendale, PA.Google Scholar
  77. Stapp, J. P. (1961a). Biodynamics of deceleration, impact, and blast. In H. G. Armstrong (Ed.), Aerospace medicine. (pp. 118–165). Baltimore, MD: Williams & Wilkins Co.Google Scholar
  78. Stapp, J. P. (1961b). Human tolerance to severe, abrupt acceleration. In O. H. Gauer & G. D. Zuidema (Eds.), Gravitational stress in aerospace medicine (pp. 165–188). Boston, MA: Little Brown.Google Scholar
  79. Stucki, S. L., Hollowell, W. T., & Fessahaie, O. (1998, May 31). Determination of frontal offset conditions based on crash data. 16th International technical conference on the enhanced safety of vehicles. Paper no. 98-S1-O-02 (pp. 164–184), NHTSA, Washington, DC.Google Scholar
  80. Takagi, H., Maruyama, A., Dix, J., & Kawaguchi, K. (2003). Madymo modeling method of rollover event and occupant behavior in each rollover initiation type. 18th international technical conference on the enhanced safety of vehicles, NHTSA, Washington, DC.Google Scholar
  81. Tarriere, C. (1995). Children are not miniature adults. International Research Council on the Biomechanics of Impacts. Paper no. 1995-13-0001 (pp. 15–29), Automobile Biomedical Department, Renault Research and Development Division.Google Scholar
  82. Thompson, N. S., Date, R., Charlwood, A. P., Adair, I. V., & Clements, W. D. (2001). Seat-belt syndrome revisited. International Journal of Clinical Practice, 55, 573–575.PubMedGoogle Scholar
  83. Tile, M. (1996). Acute pelvic fractures: I. Causation and classification. The Journal of the American Academy of Orthopaedic Surgeons, 4, 143–151.PubMedGoogle Scholar
  84. Viano, D. C., & Parenteau, C. S. (2008, April 14). Crash injury risks for obese occupants. SAE 2008 World Congress. SAE paper no. 2008-01-0528, SAE, Warrendale, PA.Google Scholar
  85. Williams, J. S. (1970, November 17). The nature of seat belt injuries. 14th Stapp Car Crash Conference. SAE paper no. 700896 (pp. 44–65), SAE, Warrendale, PA.Google Scholar
  86. Williams, J. S., Lies, B. A., Jr., & Hale, H. W., Jr. (1966). The automotive safety belt: in saving a life may produce intra-abdominal injuries. The Journal of Trauma, 6, 303–315.PubMedCrossRefGoogle Scholar
  87. Wonder, A. Y. (2007). Bloodstain pattern evidence: objective approaches and case applications. Amsterdam: Elsevier Academic.Google Scholar
  88. Woolley, R. L., & Asay, A. F. (2008, April 14). Crash Pulse and DeltaV comparisons in a series of crash tests with similar damage (BEV, EES). SAE 2008 World Congress. SAE paper no. 2008-01-0168, SAE, Warrendale, PA.Google Scholar
  89. Yoganandan, N., Pintar, F. A., Skrade, D., Chmiel, W., Reinartz, J. M., & Sances, A. (1993, November 8). Thoracic biomechanics with air bag restraint. 37th Stapp Car Crash Conference. SAE paper no. 933121 (pp. 133–144), SAE, Warrendale, PA.Google Scholar
  90. Yoganandan, N., Pintar, F. A., Gennarelli, T. A., Maltese, M. R., & Eppinger, R. H. (2001). Mechanisms and factors involved in hip injuries during frontal crashes. Stapp Car Crash Journal, 45, 1–12.Google Scholar

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Injury AnalysisLLCCarlsbadUSA

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