Car Crash Studies Help Save Lives, Create 'Smarter Cars'

The Crash Injury Research and Engineering Network (CIREN) Center at the Medical College of Wisconsin is up and running, working to reduce automobile accident injuries and fatalities through on-site investigations of car crashes followed by intensive data collection and analysis.

By using the real-world laboratory of city and country roads and highways, the CIREN Center contributes to a variety of health and public safety efforts: increasing knowledge about what specifically causes serious injuries in car crashes, improving the care provided by emergency response teams, training other health care providers, raising public awareness, comparing outcomes of real crashes to those from controlled crash tests, and even helping the auto industry create "smarter" cars with better safety features.

"What is unique about CIREN is our ability to analyze the car crash data of both adults and children," said CIREN Center co-director Dennis J. Maiman, MD, PhD, Professor of Neurosurgery and chief of the Froedtert & Medical College Spinal Cord Injury Center. "That has been particularly helpful because it's become increasingly clear that under many circumstances children's movements in vehicles, the things that happen to them in accidents, are different from those for adults. They're not just miniature adults."

The Medical College was chosen as a CIREN center in 2001 because of its international reputation in biomechanics and commitment to biomedical research, the Level 1 trauma centers of Froedtert Hospital and Children's Hospital of Wisconsin (MCW's primary adult and pediatric partners), and its research facilities at the Zablocki VA Medical Center in Milwaukee.

All of those resources and alliances are necessary to the work of the CIREN Center, which investigates crashes that involve serious injury in an area of roughly 200 square miles with a population of about two million people.

Solid Team Provides a Unique Perspective
"We continue to be a very active CIREN center," said Dr. Maiman. "We're making major contributions to not only the database but also to how data is analyzed. The reason for that is the unique strength of our engineering."

"Doctors Pintar and Yoganandan (Frank Pintar, PhD, and Narayan Yoganandan, PhD, both Professors of Neurosurgery), are constantly involved with crash testing and what we call occupant kinematics, meaning how people inside of vehicles move with certain kinds of forces in certain kinds of accidents. We offer a unique perspective on what's happening in the real world."

Several research nurses contribute to the data collection and analysis work, often dealing directly with family members for clinical assessments. Because CIREN activities are part of research projects, accident victims must consent to the interactions and use of individual medical records.

CIREN also incorporates regular use of state-of-the-art computer modeling techniques, and a full-time crash investigator visits accident scenes for the center to take detailed photographs for study by the CIREN team.

The field investigator gets "elaborate" shots of the vehicles involved in accidents as well as pictures of "exemplar" vehicles, Dr. Maiman said, so that crashed vehicles can be compared to undamaged vehicles of the same make and model. "He looks at every little speck of damage, even if it's a hair on a pillow. That could be significant to us in the course of our investigation. He gets police reports, looks at tire marks, he recreates the scene. And he brings all x-rays and medical records for examination.

"Then, we as a group sit down and look at the information that's available to us and evaluate and determine what happened. We're becoming stronger and stronger within the national program because of the scientific capabilities of our team," said Dr. Maiman. "One of our biggest interests is in head and spine injuries, so we take advantage of any one of those that we can analyze."

Self-Funded Project Thrives on Cooperation
Dr. Maiman noted that this CIREN project is also unique in two other respects: it uses its own Medical College impact testing facilities and it has been self-funded by the Medical College and Froedtert Hospital. National Transportation Safety Administration funds and other grants are being applied for.

CIREN centers each gather and study data from about 50 crashes a year to reach a goal of 1,000 "data points," according to Dr. Maiman. The Medical College maintains databases of all care records for patients transported by Milwaukee County paramedic units and is the largest provider of emergency medical services in the state.

Cooperation from area police and sheriff departments has been excellent, Dr. Maiman said, and that cooperation has helped facilitate site visits and the timely collection of data.

The center only studies crashes that result in severe injuries and involve vehicle that have safety devices. "NTSA does not want us to analyze accidents where the vehicles do not have crash protection," said Dr. Maiman. "If they don't have seat belts, shoulder harnesses or those types of things we don't look at those vehicles. Frankly, more often than not people are injured by not wearing their restraints."

The automobile industry has been very interested in using findings from the CIREN centers to aid in the design and manufacture of safer cars, Dr. Maiman said. He predicted that the day will come when the "black box" data recorder in new vehicles will not only be able to help determine what may have gone wrong with a vehicle, but also be able to send information directly to paramedics on the way to an accident scene describing what types of injuries to anticipate as a result of that particular crash.

"What it all comes down to is to evaluate and determine what happened in a crash, then find out what we can do to make better vehicles, how we can build better crash protection, and what can we do for road safety to make that episode less likely to happen again," said Dr. Maiman. "We need smarter cars, and we need smarter drivers."

Dan Ullrich
HealthLink Contributing Writer

For more information, visit the web page of the Medical College of Wisconsin Crash Injury Research and Engineering Network Center.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.