Crash Site Research Articles

A Case Study of the High-speed Train Crash Outside Santiago de Compostela, Galicia, Spain.

The worldwide use of rail transport has increased, and the train speeds are escalating. Concurrently, the number of train disasters has been amplified globally. Consequently, railway safety has become an important issue for the future. High-velocity crashes increase the risk for injuries and mortality; nevertheless, there are relatively few studies on high-speed train crashes and the influencing factors on travelers' injuries occurring in the crash phase. The aim of this study was to investigate the fatal and non-fatal injuries and the main interacting factors that contributed to the injury process in the crash phase of the 2013 high-velocity train crash that occurred at Angrois, outside Santiago de Compostela, Spain. Hospital records (n=157) of all the injured who were admitted to the six hospitals in the region were reviewed and compiled by descriptive statistics. The instant fatalities (n=63) were collected on site. Influencing crash factors were observed on the crash site, by carriage inspections, and by reviewing official reports concerning the approximated train speed. The main interacting factors that contributed in the injury process in the crash phase were, among other things, the train speed, the design of the concrete structure of the curve, the robustness of the carriage exterior, and the interior environment of the carriages. Of the 222 people on board (218 passengers and four crew), 99% (n=220) were fatally or non-fatally injured in the crash. Thirty-three percent (n=72) suffered fatal injuries, of which 88% (n=63) died at the crash site and 13% (n=9) at the hospital. Twenty-one percent (n=32) of those admitted to hospital suffered multi-trauma (ie, extensive, severe, and/or critical injuries). The head, face, and neck sustained 42% (n=123) of the injuries followed by the trunk (chest, abdomen, and pelvis; n=92; 32%). Fractures were the most frequent (n=200; 69%) injury. A mass-casualty incident with an extensive amount of fatal, severe, and critical injuries is most probable with a high-velocity train; this presents prehospital challenges. This finding draws attention to the importance of more robust carriage exteriors and injury minimizing designs of both railway carriages and the surrounding environment to reduce injuries and fatalities in future high-speed crashes.

Missing Aircraft Crash Sites and Spatial Relationships to the Last Radar Fix.

Few studies have examined the spatial characteristics of missing aircraft in actual distress. No previous studies have looked at the distance from the last radar plot to the crash site. The purpose of this study was to characterize this distance and then identify environmental and flight characteristics that might be used to predict the spatial relationship and, therefore, aid search and rescue planners. Detailed records were obtained from the U.S. Air Force Rescue Coordination Center for missing aircraft in distress from 2002 to 2008. The data was combined with information from the National Transportation Safety Board (NTSB) Accident Database. The spatial relationship between the last radar plot and crash site was then determined using GIS analysis. A total of 260 missing aircraft incidents involving 509 people were examined, of which 216 (83%) contained radar information. Among the missing aircraft the mortality rate was 89%; most occurred in mountainous terrain (57%); Part 91 flight accounted for 95% of the incidents; and 50% of the aircraft were found within 0.8 nmi from the last radar plot. Flight characteristics, descent rate, icing conditions, and instrument flight rule vs. visual flight rule flight could be used to predict spatial characteristics. In most circumstances, the last radar position is an excellent predictor of the crash site. However, 5% of aircraft are found further than 45.4 nmi. The flight and environmental conditions were identified and placed into an algorithm to aid search planners in determining how factors should be prioritized.

Education

``We are on line of position 157-337. Will repeat this message on 6210 kilocycles. We are running north and south.” --Amelia Earhart on 2 July 1937 in her last transmission to Coast Guard cutter Itasca This was the last verified transmission from Amelia Earhart and her navigator Fred Noonan as they were crossing over the Pacific Ocean from Lae to Howland Island in an attempt to fly around the world along an equatorial route. Their disappearance, despite the most exhaustive maritime search in history, made them two of the most famous missing people in the world. Arguably, had their wreckage been rapidly discovered, the artifacts would have led to a clear understanding of what happened to them, and their loss would be much less notable in aviation history. Then and now, we accept failure as long as we learn from it. It never sits well with the public when the best technology, sound reasoning, and concerted effort fails to answer questions like, “Where are they?'' and “What happened to them?” Almost eighty years later, we are considerably more advanced. Long distance commercial airline travel is incredibly safe. Crew members can communicate with an air traffic control facility at any time. Using sophisticated satellite, inertial, radar, and VHF navigation equipment, airline crew and ground stations can determine an aircraft's precise position relatively easily. In fact, commercial aircraft have features which automatically communicate with ground stations at regular intervals. And yet in March of 2014, a state-of-the-art commercial jetliner carrying 239 souls disappeared over the Pacific, and once again, despite the best efforts of several nations, the crash site has yet to be discovered. Similar to the disappearance of Amelia Earhart almost 80 years ago, determining the most likely trajectory and final position is a complex mathematical problem. This Education section features a self-contained module by John Zweck that walks through the mathematics underlying the search for the crash site of MH370. Since MH370 flew for more than six hours after the last known communication between the pilot and air traffic control, the primary evidence in the search is the pings from the automated Aircraft Communications Addressing and Reporting System. Since these pings travel to a satellite and then to a ground station, analysis of ping travel time and Doppler shift provides some information about the aircraft position and speed. The article contains a very understandable derivation that maps the aircraft trajectory on a sphere and satellite positions to ping duration and Doppler shift. Each model for the aircraft's trajectory needs to be reconciled with actual data to determine model parameters, ultimately leading to a classic optimization problem. Using the ideas in this article together with official data from MH370, one can compute something very close to the priority search area used by the Australian Transportation Safety Board, the organization that is coordinating the underwater search. In the time since this article was received, wreckage from MH370 has washed ashore on Réunion Island and later other scattered locations, consistent with Lagrangian trajectories from the priority search area. The underwater search still continues and hopefully will be more successful than the search for Earhart's missing Lockheed Electra 10E, bringing closure to the families of the victims and to a public that still wonders what happened. This article is self-contained and appropriate for an advanced undergraduate course or a project. One interesting feature of the official inquiry into the MH370 disappearance is that the investigation team publicly released the data and their reasoning. This allowed many groups to explore the data and verify the official determination of the most likely trajectory. In addition to the scientific and public relations benefits to this approach, the release of the data had the unforeseen benefit of allowing exciting problems like these to quickly enter the classroom and inspire students with compelling problems.

Experimental Drift Mapping of Indian Ocean Gyre Aircraft Debris

A graphical simulation is developed to calculate the map of the Indian Ocean debris drift, and using the experimental approach to study the alternative crash location of the vanished aircraft MH370. Drawing research used new discovered and known statistics of Oceanic surface currents map, and published satellite data of aircraft tracking to review the new critical data. Theory of prediction in a research for lost transport unit is the successful tool to control ongoing investigation. The entire area of the crash location of plane’s debris drift model is based on the early stage of the Oceanic mapping of underwater investigation. With discovering actual new facts, ongoing efforts are in stage to evaluate interpret factual findings. Appearance of MH370 aircraft wing part—flaperon ignited research trends of Indian Ocean debris drift mapping study with the purpose to isolate final crash location. On experimental basis, the article discusses the comparison of ongoing research of international groups in aim to point underwater search to the the site of plane crash. The process of Oceanic debris transport is a physics task, and the computation of debris drift can be observed on the interval statistics data set of Oceanic debris season. In this experimental simulation, on the base of Indian Ocean drift data—observer studied the possibility of the North Gyre debris transport trace to explain the timeout of single appearance of flaperon, declared in official investigation. The article resumes to study and to conclude the possible alternative approach of North Gyre crash location. Graphical computer visualization presented in a comparison to recent studies is conducted by Australian and Germany groups. Their trends on the scour survey of the first phase stage seabed mapping, oceanic surface search in a mean time, can be described as comparable approximations. Given in a research, experimental simulation graphically visualized the possibility of North Gyre debris transport exchange.

Bayesian Latent Class Safety Performance Function for Identifying Motor Vehicle Crash Black Spots

The state of the practice in black spot identification uses safety performance functions based on total crash counts to identify high-risk crash sites. This paper postulates that total crash count is a result of multiple distinct risk-generating processes (RGPs), including geometric characteristics of the road, spatial features of the surrounding environment, and driver behavior factors. However, these multiple sources are ignored in current modeling methodologies that try to explain or predict crash frequencies across sites. Instead, current practice uses models that imply that a single RGP exists. This misspecification may lead to correlation of crashes with incorrect sources of contributing factors (e.g., concluding a crash is predominately caused by a geometric feature when the cause is a behavioral issue), which may ultimately lead to inefficient use of public funds and misidentification of true black spots. This study proposes a latent class model consistent with a multiple risk process theory and investigates the influence this model has on correctly identifying crash black spots. The paper presents the theoretical and corresponding methodological approach in which a Bayesian latent class model is estimated with the assumption that crashes arise from two distinct RGPs, including engineering and unobserved spatial factors. The methodology was applied to state-controlled roads in Queensland, Australia. The results were compared with an empirical Bayesian negative binomial (EB-NB) model. A comparison of goodness-of-fit measures illustrated superiority of the proposed model compared with the NB model. The detection of black spots was improved compared with the EB-NB model. In addition, modeling crashes as the result of two fundamentally separate RGPs reveals more detailed information about unobserved crash causes.

Urban road traffic deaths: data linkage and identification of high-risk population sub-groups.

This study analyzes the profile of deaths from road traffic accidents in Belo Horizonte, Minas Gerais State, Brazil, by linking two public databases, the Information System of the Urban Transportation and Transit Company (BH10) and the Mortality Information System (SIM). The linked database (n = 306) identified a 24% under-recording rate for deaths and differed in the age distribution from the BH10 database and in roadway user category when compared to the mortality database. The mortality rate for road traffic accidents within the city limits was 10.2 per 100,000 thousand, and was higher among men, young adults, and the elderly. Poisson multivariate regression showed a higher mean death rate for motorcycle occupants (rate ratio - RR: 1.81); pedestrians (RR: 1.32); males (RR: 1.24); single/divorced (RR: 1.27); young adults 18-29 years of age (RR: 1.75); elderly (RR: 1.59); and deaths at the crash site (RR: 1.39) when compared to the reference categories. The study unveils the city's traffic violence, expressed by the large proportion of deaths at the crash site and within the first 24 hours, and confirms the relevance of database linkage for characterizing vulnerable groups and traffic accident mortality in the urban setting.

Supporting Locate and Search Operations Based on Drift Model and Bayesian Probability

With the rapid development of international aviation, air disaster often happens. When the plane crashed in the vast ocean, how to locate the wreckage and fast and effective rescue is worth studying. This paper focuses on locating the crashed plane, determining the rescue area and the search strategies. To locate the crashed plane, the mechanics principle of the crashed plane is analyzed and the dynamic differential equation which can be solved by applying the fourth-order Runge-Kutta algorithm was built. Substituting the related parameters into the numerical solution, We can get the final trajectory and the velocity of the crashed plane. Thus, the crash site can be roughly determined. To determine of rescue, according to the ocean currents of the crash site and the suspicious area, the drifting trajectory of the main plane wreckage to set up rescue area can be roughly confirmed. For the search strategies, the Bayesian probability is applied in the search area. Firstly, the search area can be divided into several small areas which can be represented by appropriate search probabilities in term of the distances between among of drifting trajectories and other subjective information. The closer distance, the greater the priority search probability. Then the search work can be started a prior in the small area with the highest probability. If the crashed plane cannot be found, the priority search probability of every small areas should be updated and repeat the previous work until the end of the search.

Injury Outcome in Crashes with Guardrail End Terminals

Objective: The goal of this study is to evaluate the crash performance of guardrail end terminals in real-world crashes. Guardrail end terminals are installed at the ends of guardrail systems to prevent the rail from spearing through the car in an end-on collision. Recently, there has been a great deal of controversy as to the safety of certain widely used end terminal designs, partly because there is surprisingly little real-world crash data for end terminals. Most existing studies of end terminal crashes used data from prior to the mid-1990s. Since then, there have been large improvements to vehicle crashworthiness and seat belt usage rates, as well as new roadside safety hardware compliant with National Cooperative Highway Research Program (NCHRP) Report 350, “Recommended Procedures for the Safety Performance Evaluation of Highway Features.” Additionally, most existing studies of injury in end terminal crashes do not account for factors such as the occurrence of rollover. This analysis uses more recent crash data that represent post-1990s vehicle fleet changes and account for a number of factors that may affect driver injury outcome and rollover occurrence.Methods: Passenger vehicle crashes coded as involving guardrail end terminals were identified in the set of police-reported crashes in Michigan in 2011 and 2012. End terminal performance was expected to be a function of end terminal system design. State crash databases generally do not identify specific end terminal systems. In this study, the coded crash location was used to obtain photographs of the crash site prior to the crash from Google Street View. These site photographs were manually inspected to identify the particular end terminal system involved in the crash. Multiple logistic regression was used to test for significant differences in the odds of driver injury and rollover between different terminal types while accounting for other factors.Results: A total of 1,001 end terminal crashes from the 2011–2012 Michigan State crash data were manually inspected to identify the terminal that had been struck. Four hundred fifty-one crashes were found to be suitable for analysis. Serious to fatal driver injury occurred in 3.8% of end terminal crashes, moderate to fatal driver injury occurred in 11.8%, and 72.3% involved property damage only. No significant difference in moderate to fatal driver injury odds was observed between NCHRP 350 compliant end terminals and noncompliant terminals. Car drivers showed odds of moderate to fatal injury 3.6 times greater than LTV drivers in end terminal crashes. Rollover occurrence was not significantly associated with end terminal type.Conclusions: Car drivers have greater potential for injury in end terminal crashes than light truck/van/sport utility vehicle drivers. End terminal designs compliant with NCHRP 350 did not appear to carry different odds of moderate driver injury than noncompliant end terminals. The findings account for driver seat belt use, rollover occurrence, terminal orientation (leading/trailing), control loss, and the number of impact events. Rollover and nonuse of seat belts carried much larger increases in injury potential than end terminal type. Rollover did not appear to be associated with NCHRP 350 compliance.

The Nikumaroro bones identification controversy: First-hand examination versus evaluation by proxy — Amelia Earhart found or still missing?

American celebrity aviator Amelia Earhart was lost over the Pacific Ocean during her press-making 1937 round-the-world flight. The iconic woman pilot remains a media interest nearly 80years after her disappearance, with perennial claims of finds pinpointing her location. Though no sign of the celebrity pilot or her plane have been definitively identified, possible skeletal remains have been attributed to Earhart. The partial skeleton was recovered and investigated by British officials in 1940. Their investigation concluded that the remains were those of a stocky, middle-aged male. A private historic group re-evaluated the British analysis in 1998 as part of research to establish Gardner (Nikumaroro) Island as the crash site. The 1998 report discredited the British conclusions and used cranial analysis software (FORDISC) results to suggest that the skeleton was potentially a Northern European woman, and consistent with Amelia Earhart. A critical review of both investigations and contextual evidence shows that the original British osteological analyses were made by experienced, reliable professionals, while the cranial analysis is unreliable given the available data. Without access to the missing original bones, it is impossible to be definitive, but on balance, the most robust scientific analysis and conclusions are those of the original British finding indicating that the Nikumaroro bones belonged to a robust, middle-aged man, not Amelia Earhart.

MICROCONTROLLER BASED SMART WEAR FOR DRIVER SAFETY

An accident is a specific, unexpected, unusual and unintended external action which occurs in a particular time and place, with no apparent and deliberate cause but with marked effects. Carelessness of the driver is the major factor of such accidents. The traffic authorities give a lot of instructions to the vehicle operators. But many of them do not obey the rules. Nowadays most of the countries are forcing the motor riders to wear the helmet and not to use the vehicles when the person is in drunken condition. But still the rules are being violated by the users. India has the largest number of road accidents in the world out of which 22.4% of victims are occupants of two wheelers, 30% of road accidents victims die at crash site, 14% in ambulance and rest in hospital. Our proposal is to reduce the number of deaths which occur at crash site and on the way to the hospital due to delay in Emergency Trauma Care Services.

A dynamic Bayesian network model for real-time crash prediction using traffic speed conditions data

Traffic crashes occurring on freeways/expressways are considered to relate closely to previous traffic conditions, which are time-varying. Meanwhile, most studies use volume/occupancy/speed parameters to predict the likelihood of crashes, which are invalid for roads where the traffic conditions are estimated using speed data extracted from sampled floating cars or smart phones. Therefore, a dynamic Bayesian network (DBN) model of time sequence traffic data has been proposed to investigate the relationship between crash occurrence and dynamic speed condition data. Moreover, the traffic conditions near the crash site were identified as several state combinations according to the level of congestion and included in the DBN model. Based on 551 crashes and corresponding speed information collected on expressways in Shanghai, China, DBN models were built with time series speed condition data and different state combinations. A comparative analysis of the DBN model using flow detector data and a static Bayesian network model was also conducted. The results show that, with only speed condition data and nine traffic state combinations, the DBN model can achieve a crash prediction accuracy of 76.4% with a false alarm rate of 23.7%. In addition, the results of transferability testing imply that the DBN models are applicable to other similar expressways with 67.0% crash prediction accuracy.

The Influence of Synthetic Cannabinoid UR-144 on Human Psychomotor Performance—A Case Report Demonstrating Road Traffic Risks

Objective: UR-144 [(1-pentyl-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)-methanone] is a synthetic cannabinoid, which has been detected in many “legal highs” seized from the global drug market since the beginning of 2012. It gained popularity as a “legal” alternative to classic cannabis in countries where it was not controlled. The popularity of UR-144 means that this substance is also abused by individuals driving motor vehicles. This article describes a case of driving under the influence (DUI) of UR-144. The aim of the undertaken case analysis and presenting description of pharmacological similarity of THC and UR-144 is to answer the question whether UR-144 can produce effects incompatible with safe driving.Methods: Blood from the driver was obtained by a physician approximately 2 h after the collision and 4.5 h after self-reported dosing. Police from the crash site provided behavioral observations, and the physician performed medical examination. Blood was analyzed by liquid chromatography–tandem mass spectrometry (LC-MS/MS). The developed method was described in detail. The method was linear in the range of 0.5–50 ng/mL; the precision and accuracy values obtained were less than 15%. The symptoms observed by police and physician who collected the blood sample were described.Results: In the blood sample collected from the driver, UR-144 and its major pyrolysis product [1-(1-pentyl-1H-indol-3-yl)-3-methyl-2-(propan-2-yl)but-3-en-1-one] were detected. Whole-blood concentration of UR-144 was 14.6 ng/mL. The result of blood analysis and observed symptoms clearly indicated that the driver was under the influence of UR-144.Conclusions: UR-144 produces effects and impairment similar to or even more dangerous than delta-9-tetrahydrocannabinol (Δ9-THC), making it unsafe for driving. Therefore, UR-144 should be treated as a potentially dangerous substance in traffic safety.

Forensic odontological observations in the victims of DANA air crash.

IntroductionForensic odontology or forensic dentistry is that aspect of forensic science that uses the application of dental science for the identification of unknown human remains and bite marks. Deaths resulting from mass disasters such as plane crash or fire incidence have always been given mass burial in Nigeria. This was obviously due to the fact that Forensic Pathologists whose roles involve disaster victim identification were not available at that time. However, in the DANA air crash in Lagos in 2012, the Forensic pathologist and dental teams were invited for the first time to identify the victims. The objectives of this paper are to identify the extent of victims’ identification using Forensic odontology alone and its combination with DNA analysis. It also presents the pattern of fractures seen in the mandible and maxilla of the victims.MethodsThe bodies were dissected using following the standard protocol dissection. Prior to this all the victims had Dental Radiological Examination. The oral cavities were exposed after which the Odontology team was invited for photographing first, followed by dental charting. Fractures of the mandible, maxilla including the anatomical regions were all recorded and photographed. Dental prosthesis, restorations, crowns and bridge and other findings were also noted, recorded and compared with ante mortem records where available.ResultsA total of152 bodies were recovered from the crash site while 148 victims were eventually identified through a combination of DNA analysis and forensic odontology. This represented 97.4%. Forensic odontology was the primary identifier in 10%. There were no fingerprinting information in this country at present therefore, it could not be used. A total of 89 (60%) were males while females accounted for 59(40%). This gives a ratio of 1.5:1. Most of the victims were in the age group 30-49years; this represented 52% of the victims while the least involved age groups were victims above 60 years of age which accounted for only 4.7%. Mandibular fractures were seen in 29 victims, maxilla in 15, combined mandibullo/maxillary in 15 victims, while 89victims had nojaw fracture. The most common area of fracture in the mandible was the body which accounted for 36.4%, closely followed byparasymphysealregion 31.9%, symphyseal 22.7% and the angle 9.0%. The most common fracture in the maxillae was palatal split fracture which accounted for 52%, this was followed by pterygoid 24%, alveolar 8% and multiple locations 16%.ConclusionA combination of DNA analysis and forensic odontology was able to identify a total of 148 victims out of 152 representing 97.4%. Forensic odontology was the primary identifier in only 10%. In the latter, poor and lack of dental records were responsible for this very low figure. The most common area of fracture in the mandible was th ebody which accounted for 36.4%, while that of the maxillae was palatal fracture which accounted for 52%. Padding of the back of the seats in the aircraft should be canvassed for to provide Cushing effect for passengers.

車両の衝突事故における速度推定のための標識支柱等のエネルギ吸収量の評価

When traffic accidents happen, investigators observe the state of the vehicle at the crash site of the accident. Here the energy conservation law can be used to estimate the vehicle collision speed. Since the collision speed of the vehicle can be estimated from the energy of its deformed volume, investigators observe and measure the vehicle's crash state. However, when a vehicle collides into traffic signs, both the vehicle and sign will be deformed. Consequently, to estimate correctly the vehicle collision speed, the energy absorption capacity of the signs should be taken into account with the vehicle deformation after the crash. In this study, to improve the estimation of the collision speed of the vehicle, the drop weight tests were done to examine the absorption energy of the signs. The traffic signs used in this test are a road sign, a road mirror and a guard-rail on the roadside. From test results, it can be concluded that the input energy is linearly proportion to the deformed angle of the sign. Also from this test, the relationships between energy and deformed angle of the signs can be formulated. Identification for estimating the vehicle collision speed at an accident hereafter can be done properly with ease.

Flags, Totem Bodies, and the Meanings of 9/11: A Durkheimian Tour of a September 11th Ceremony at the Flight 93 Chapel

Some four miles as the crow flies from the site at which United 93, which was the fourth plane involved in the 9/11/2001 terrorist attack on the United States, struck ground, there sits a small chapel dedicated to the passengers and crew. The Thunder on the Mountain Chapel is considerably less well known than the Parks Department memorial a few hundred yards from the crash site, but it is, arguably at least, equally important in the cultural production of the Flight 93 myth. This article draws from Durkheim’s The Elementary Forms of Religious Life as well as other theoretical sources to look closely at the chapel. I argue that what is going on at the Chapel contributes to a totemic myth that turns the American flag into a representation of the dead national hero and then places the totem object into the beliefs and rituals of an American civil religion.

Safety-based path finding in urban areas for older drivers and bicyclists

This paper presents a safety-based path finding methodology for older drivers and bicyclists in an urban area. The paths are estimated based on costs consisting of both safety and travel time. Safety is evaluated against potential risk of a crash involving an older driver (or a bicyclist) with other vehicles present on the road. To accomplish this, simple formulations are developed for safety indicators of streets and intersections, which are actually generic irrespective of the type of road user. Traffic attributes such as speed and density, driver attributes such as perception-reaction time and street attributes of length and tire-to-road friction coefficient are taken into account in building the safety indicators. Thus, the safety indicators do not necessarily require historical crash data which may or may not be available during path finding. Subsequently, a multi-objective shortest path algorithm is presented that identifies the best path (the non-inferior path) from amongst a set of selected safest paths with due considerations to travel time incurred on each. A simple application example of the proposed methodology is demonstrated on an existing street network system from the City of College Station, Texas. The contributions of this research are twofold – first, the safety indicators can be used by planners in determining high crash potential sites – streets and/or intersections – and second, the safety-based path finding methodology developed in this paper can be integrated with modern day route planning devices and tools in guiding older drivers and bicyclists within an Intelligent Transportation Systems framework.

Challenges in care of trauma patient in Spain. The need for implementation of scientific evidence including secondary prevention

The mortality of trauma patients has improved significantly in recent decades due to a combination of factors: medical care, educational campaigns and structural changes. Generalization of both out-of hospital emergence medical services and the hospital care in specific centers for traumatized has undoubtedly contributed to this decline, but other factors such as periodic campaigns to prevent workplace and traffic accidents, as well as improvements in the road network have played a key role.The challenge now is to contain mortality, for which is essential an analysis of the situation to detect potential areas of improvement.The application of diagnostic or therapeutic actions with scientific evidence is associated with lower mortality, but as in other areas of medicine, the application of scientific evidence in trauma patients is barely 50%. Moreover, nearly 90% of trauma deaths occur in the crash site or during the first 72h of hospitalization, the vast majority as a result of injuries incompatible with life. In these circumstances it is clear that prevention is the most cost-effective activity. As medical practitioners, our role in prevention is mainly focused on the secondary prevention to avoid recidivism, for which it is necessary to identify the possible risk factors (frequently alcohol, illegal drugs, psychotropic medication, etc.) and implement a brief motivational intervention. This activity can reduce recidivism by nearly 50%. In Spain, the activity in this field is negligible; therefore, measures should be implemented for dissemination of secondary prevention in trauma.

Retos asistenciales en la atención al paciente traumatizado en España. La necesidad de implementación de la evidencia científica incluyendo la prevención secundaria

The mortality of trauma patients has improved significantly in recent decades due to a combination of factors: medical care, educational campaigns and structural changes. Generalization of out-of hospital emergence medical services and the hospital care in specific centers for traumatized has undoubtedly contributed to this decline, but other factors such as periodic campaigns to prevent workplace and traffic accidents, as well as improvements in the road network have played a key role.The challenge now is to continue to decrease mortality, for which is essential an analysis of the situation to detect potential areas of improvement.The application of diagnostic or therapeutic actions with scientific evidence is associated with lower mortality, but as in other areas of medicine, the application of scientific evidence in trauma patients is barely 50%. Moreover, nearly 90% of trauma deaths occur in the crash site or in the first 72h of hospitalization, the vast majority as a result of injuries incompatible with life. In these circumstances it is clear that prevention is the most cost-effective activity. As medical practitioners, our role in prevention is mainly focused on the secondary prevention to avoid recidivism, for which it is necessary to identify risk factor (frequently alcohol, illegal drugs, psychotropic medication etc.) and implement a brief motivational intervention. This activity can reduce recidivism by nearly 50%. In Spain, the activity in this field is negligible therefore measures should be implemented for dissemination of secondary prevention in trauma.

Heuristic Approach for Optimizing Emergency Medical Services in Road Safety within Large Urban Networks

Emergency medical service (EMS) providers participating in vehicle crash-induced incident management aim to offer as wide and efficient coverage as possible to meet the demand for incident responses effectively; however, the design and provision of efficient and cost-effective services are tough issues faced by emergency management authorities. This paper introduces a double standard model (DSM), along with a genetic algorithm (GA) for assigning EMS fleet from vehicle locations to intersection vehicle crash sites such that crash demand sites can be covered in accordance with two service coverage standards. Specifically, all demand sites are required to receive single coverage according to the secondary coverage standard and at least a portion (α) of demand sites need to maintain single coverage as per the primary coverage standard. The proposed model is applied for top 200 intersections in the City of Chicago selected using intersection crash records for 2004–2010 according to crash frequency-based and severity-based scenarios. The top 200 intersections are split into high and low severity sites for model application. Using the EMS vehicle fleet size currently maintained by the Chicago Fire Department as 15 basic life support (BLS) and 60 advanced life support (ALS) ambulances, almost 100% of double vehicle coverage can be achieved. Extended model application is conducted by keeping 15 BLS ambulances unchanged and reducing the 60 ALS ambulances by 50% to 30. Results show that nearly 90% of double coverage according to the primary standard can still be reached.

Effect of 406 MHz ELTs and COSPAS-SARSAT Cessation of 121.5 MHz ELT Monitoring on Search and Rescue Duration for General Aviation Aircraft Accidents in the Contiguous United States

Emergency Locator Transmitters (ELTs) are credited with saving hundreds of lives every year in the United States. Following an aircraft accident, these devices transmit an emergency beacon signal to the COSPAS-SARSAT satellite network, directing search and rescue forces to the crash site. In recent years, this constellation has been plagued by ELT false alarms, propagating a technology transition to new 406 MHz ELT systems. In 2009, the group ceased monitoring of 121.5 MHz ELTs, degrading search and rescue capability for legacy ELTs. The Federal Communications Commission twice attempted to enact regulations to mandate industry-wide transition to 406 MHz ELTs, however, their efforts have met strong resistance by pilot advocacy groups. The purpose of this study was to determine if 406 MHz ELTs resulted in lower search and rescue durations than 121.5 MHz systems. Furthermore, the study sought to discover if the cessation of 121.5 MHz ELT monitoring in 2009 resulted in a change in search and rescue mission duration for legacy ELTs. The study collected data from an Air Force Rescue Coordination Center search and rescue database for search missions occurring between 2006-2011. To compare search durations of 406 MHz and 121.5 MHz ELTs, data was assessed using orthogonal contrast testing between historical mission durations. The same contrast technique was applied to 121.5 MHz ELT missions conducted from 2006-2008, which used the COSPAS-SARSAT network, and missions conducted from 2009-2011, in which 121.5 MHz satellite detection was deactivated. The study revealed 406 MHz ELTs offer a statistically significant advantage in search duration over 121.5 MHz ELT models. Additionally, the study determined there was no significant difference in mission durations for 121.5 MHz ELTs monitored by the COSPAS-SARSAT network and those missions which did not receive satellite coverage. This research will likely aid both regulators and advocacy groups in shaping future policy decisions for mandatory 406 MHz ELT implementation.