A prospective observational analysis of ambulation after motor vehicle collisions

Predicting injury patterns of patients based only on mechanism of injury is difficult and is well described in the literature. Characteristics of patients on-scene immediately following injury(ies) may lead to predicting injury patterns. Although reported frequently, the significance of victim ambulation after a motor vehicle crash is poorly understood. It was hypothesized that ambulation at the scene is not predictive of injury severity following a motor vehicle crash (MVC).

A prospective, cohort study of 117 consecutive injured patients who were ambulatory after MVCs were enrolled. Paramedics in a large urban Emergency Medical Services (EMS) system were mandated to document "ambulatory" or "nonambulatory" for motor vehicle collisions in order to complete their prehospital electronic medical records. This assured accuracy and completeness in the data collection. All charts were abstracted for trauma-induced injury and imaging results.

A total of 608 (10.9%) persons were ambulatory at the scene, of which 284 had an injury pattern documented in the prehospital or emergency department record. The average age was 35.9 (SD = 16.8) years, and 158 (55.6%) were male. A total of 707 injuries were identified in the 284 patients who had sustained injuries.

Ambulation after motor vehicle collisions appears to be only infrequently associated with major injuries, although this population still may present with significant injuries. A larger, prospective study is warranted.