title: Analysis of a school bus collision: mechanism of injury in the unrestrained child.
abstract: BACKGROUND
  The most common type of school bus crash resulting in injury and death involves the "rollover" mechanism, which may be linked to bus design. To investigate this possibility, we carried out a detailed investigation of a severe school bus crash.
  
  
  METHODS
  The crash involved 12 children, passengers in the school bus. Analysis included the determination of crash dynamics by examination of physical evidence at the crash site and deformation sustained by the structure of the bus and the other vehicle involved. The mechanism of injury was determined by comparing physical evidence collected inside the bus to injuries sustained by the children.
  
  
  RESULTS
  Two children sustained severe injuries and 1 child was killed. The most common injuries involved the head, neck and shoulder as demonstrated by 3 illustrative reports. Specified changes to school bus design, based on mechanism of injury to the occupants include, in addition to the compartmentalization now in effect, more padding to the sides of the bus, over the window headers and on the panelling between the windows.
  
  
  CONCLUSIONS
  Injuries to the head, neck and spine are the most common types when children are involved in rollover school bus collisions. For additional safety, changes to the current bus design are needed.
authors.affiliation: Division of Pediatric Orthopedics, Children's Hospital of Eastern Ontario, Ottawa, Ont.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Lapner
authors.forename: Duong
authors.initials: D
authors.lastname: Nguyen
authors.forename: Mervyn
authors.initials: M
authors.lastname: Letts
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D002574:Cervical Vertebrae / Q000293:injuries; D002648:Child; D006259:Craniocerebral Trauma / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D019838:Neck Injuries / Q000209:etiology; D016103:Spinal Fractures / Q000209:etiology