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Automatic Crash Notification (ACN) technology provides an opportunity to rapidly transmit crash characteristics to emergency care providers in order to improve timeliness and quality of care provided to occupants in the post crash phase. This study evaluated the relative value of crash attributes in providing useful information to assist in the identification of crashes where occupants may be seriously injured. This identification includes an indication of whether a crash is likely to require a level of emergency response with higher priority than is needed for most crashes reported by ACN Systems. The ability to predict serious injury using groupings of variables has been determined. In this way, the consequence of not transmitting each variable can be estimated. In addition, the incremental benefit of voice communication is shown.

In December 2003, fifteen participating Automobile Manufacturers announced the adoption of voluntary standards for geometric compatibility in frontal crashes. In an October 2003 report, Insurance Institute of Highway Safety (IIHS) estimated that an 8 to 28 percent fatality reduction might be achieved with better geometric and stiffness compatibility (O’Neill, 2003). This benefit was based on comparing the fatality risks of car occupants in car-to-car collisions and in car-to-SUV collisions. Reduced occupant compartment intrusion was cited as the principal advantage gained by compatibility improvements. However, the study did not actually examine the role that intrusion played in causing the fatalities. This study examines the magnitude of serious injuries in frontal crashes that could be addressed by reducing occupant compartment intrusion. Each frontal vehicle-to-vehicle case in William Lehman Injury Research Center (WLIRC) data was examined to determine the cause of each injury.

The U.S. Department of Transportation-sponsored Crash Injury Research and Engineering Network (CIREN) program offers a reasonable look at the efficacy of second-generation air bags. This paper examines the data from the William Lehman Injury Research Center (WLIRC). The WLIRC data is a near census of crashes in the Miami-Dade region with occupants that appear to be severely injured. The percentage of deaths among trauma patients in the WLIRC data as a function of delta-V for first-generation air bags was higher than expected at lower delta-V's. There were nine driver fatalities at delta-V's of less than 20 mph (four involving short stature occupants, four with elderly occupants, and one due to significant intrusion and/or vehicle incompatibility). The data supported NHTSA's conclusion that first-generation air bags were too aggressive for occupants in close proximity to the deploying air bag and too aggressive for older persons.

The URGENCY algorithm uses data from on-board crash recorders to assist in identifying crashes that are most likely to have time critical (compelling) injuries. The injury risks projected by using the NASS/CDS data are the basis for the URGENCY algorithm. This study applied the algorithm retrospectively to a population of injured occupants in the database from the University of Miami School of Medicine, William Lehman Injury Research Center (WLIRC). The population selected was adult occupants in frontal crashes that were protected by three-point belts plus an air bag. For the cases with greater than 50% predicted MAIS 3+ injury probability, 96% of the occupants in the study had MAIS 3+ injuries. For the cases with less than 10% predicted MAIS 3+ injury probability, 63% did not have MAIS 3+ injuries. Most of the of MAIS 3+ injuries not predicted involved injuries in multiple impact crashes, pole crashes or close-in occupants injured by air bag deployment.

The National Highway Traffic Safety Administration (NHTSA) Special Crash Investigations database contains twelve completed cases of child fatalities in rearward facing child seats caused by deploying air bags. Three of these are now available for examination. An additional two cases were investigated by the William Lehman Injury Research Center at the University of Miami School of Medicine. These five cases are examined to evaluate crash environment, injury mechanisms, and circumstances which caused the child to be in front of the passenger side air bag Four of the cases were crashes with impacts with the side of other cars with crash severities less than 15 mph. The predominate injury mechanism was brain and skull injury from a blow transmitted to the rear of the head through the child seat back. In one case, the force to the head was transmitted downward, directly from air bag contact.

The William Lehman Injury Research Center has conducted multi-disciplinary investigations of one hundred seventy-eight crashes involving adult occupants protected by safety belts and air bags. In all cases, serious injuries were suspected. Nine cases involved serious heart injuries. These cases are not representative of crashes in general. However, when used in conjunction with National Accident Sampling System; Crashworthiness Data System (NASS/CDS) they provide insight into the most severe injuries suffered by restrained occupants in frontal crashes. Heart injuries are rare, but when they occur they are usually life threatening. NASS/CDS shows that heart injuries comprise about 0.2% of the injuries in frontal tow-away crashes. In the NHTSA file of Special Crash Investigations (SCI) of air bag cases, heart injuries are reported in 1% of the occupants over 15 years of age. Twenty-five percent of the fatally injured occupants had heart injuries, and 83% of those with heart injury died.