Visual estimates of crash severity and child occupant injury: the ambulance record as a potential data source in crash injury surveillance

Crash severity is an important predictor of injury outcome for vehicle occupants involved in crashes. The best measures of crash severity are ∆v or equivalent barrier speed. Both these measures require detailed inspection and measurement of the vehicles involved in the crash. These methods are resource intensive and limit the ability to include crash severity as a variable in mass crash data bases. This paper presents the results of a multivariate analysis of factors predicting injury outcome in restrained child occupants. The analysis is based on a sample of 152 children aged between 2 and 8 years collected through retrospective review of medical records at a children’s hospital over a 30 month period. The crash severity measure used was based on the rating of ambulance officers attending the scene of the crash. Ambulance officers rated the crash as minor, moderate or severe based on visual assessment of the damage to the vehicle, and reported impact speeds. The analysis demonstrates a significant association between crash severity measured in this manner and injury severity, before and after adjustment for other potential confounders. This association reveals the potential for more widespread use of this relatively simple measure to obtain a de facto estimate of crash severity. Together with a previously reported validation exercise, these results indicate that a visual estimation of crash severity made by on-scene emergency personnel may be an under-utilized source of data. This issue warrants further investigation by those interested in collecting and analyzing mass crash data.