Air bags alone compared with the combination of mechanical restraints and air bags: implications for the emergency evaluation of crash victims.
BACKGROUND
Air bags (ABs) may be perceived by the public and physicians as protection for thoracoabdominal injuries. This study compares injury patterns when air bags are used alone with injury patterns when air bags plus mechanical restraints (MRs) are used.


METHODS
Patients treated over a 4-year period with emergency medical services-documented AB deployment alone (n = 16) or AB plus MR (n = 22) were identified by trauma registry query. Medical records were reviewed and injuries recorded.


RESULTS
Air bag-alone users had more severe overall (injury severity score > or = 15:9 vs 5), chest (abbreviated injury score [AIS] > or = 3:5 vs 1), and abdominal injuries (AIS > or = 3:6 vs 0). They required more tube thoracostomies (5 vs 0) and laparotomies (6 vs 0), longer hospitalizations (11.9 +/- 3.2 vs 5.3 +/- 1.4 days), and more intensive care unit admissions (8 vs 1). Craniofacial injuries (AIS > or = 3:6 vs 6) and fractures were similar. More victims using air bags alone required impatient rehabilitation and some patients died (6 vs 1).


CONCLUSIONS
Crash victims using air bags alone (vs AB plus MR) had increased injury severity, hospitalizations, thoracoabdominal procedures, and rehabilitation. Physicians must be aware of the incomplete protection by air bags alone.
Sutyak
J P
JP
Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, USA.
Passi
V
V
Hammond
J S
JS
D015998:Abbreviated Injury Scale; D000007:Abdominal Injuries / Q000453:epidemiology* / Q000517:prevention & control / Q000534:rehabilitation; D000063:Accidents, Traffic; D000328:Adult; D017278:Air Bags; D015505:Chest Tubes / Q000706:statistics & numerical data; D003422:Critical Care / Q000706:statistics & numerical data; D004630:Emergencies; D005147:Facial Bones / Q000293:injuries; D005151:Facial Injuries / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D012622:Seat Belts; D012887:Skull Fractures / Q000453:epidemiology; D015996:Survival Rate; D013898:Thoracic Injuries / Q000453:epidemiology* / Q000517:prevention & control / Q000534:rehabilitation; D013907:Thoracostomy / Q000706:statistics & numerical data