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Mechanisms of motor vehicle accidents that predict major injury

Sylvia Palanca¹, David McD Taylor, Michael Bailey

¹Emergency Department, Royal Melbourne Hospital. sylvia.palanca@wh.org.au

Emergency Medicine (Fremantle, W.A.)

|March 3, 2004

Abstract

Objective:

To assess whether prehospital triage guidelines, based on mechanistic criteria alone, accurately identify victims of motor vehicle accidents (MVA) with major injury.

Methods:

Retrospective analysis of the Royal Melbourne Hospital trauma database. Mechanisms analysed were those outlined by the American College of Surgeons Committee on Trauma and Advanced Trauma Life Support/Early Management of Severe Trauma prehospital triage guidelines.

Results:

There were 621 MVA analysed, 253 with major injury (40.7%). Multivariate logistic regression indicated prolonged extrication time (P < 0.0001), cabin intrusion (P = 0.047), high speed (P = 0.003) and ejection from vehicle (P = 0.04) were statistically associated with major injury. Vehicle rollover and fatality in the same vehicle were not statistically associated with major injury.

Conclusions:

These data suggest that existing guidelines for the prehospital triage of MVA victims, based on mechanistic criteria alone may need revision.

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