Mechanisms of motor vehicle accidents that predict major injury.
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.
Emergency Department, Royal Melbourne Hospital. sylvia.palanca@wh.org.au
Sylvia
S
Palanca
David McD
DM
Taylor
Michael
M
Bailey
Peter A
PA
Cameron
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003657:Decision Making; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014218:Triage / Q000592:standards*