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Gurien LA, Nichols L, Williamson P, Letton RW. Rethinking pediatric trauma triage. Semin Pediatr Surg 2022; 31:151214. [PMID: 36371842 DOI: 10.1016/j.sempedsurg.2022.151214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Despite advances in the delivery of trauma care, trauma remains the leading cause of death amongst the pediatric population within the United States and is one of the leading causes of death in children worldwide. Accurately triaging pediatric trauma patients is essential to minimize preventable mortality without burdening the system by utilizing unnecessary resources. This article will review the accuracy of current pediatric trauma triage practices and how it will evolve in the future including moving away from mechanism of injury towards physiologic scoring tools such as the pediatric age-adjust shock index, and intervention-based systems including. Need for Surgeon Presence and Need For Trauma Intervention. This paper will also present evidence regarding over-utilization of air transport for pediatric trauma patients and the associated unnecessary costs placed on the trauma system.
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Affiliation(s)
- Lori A Gurien
- Nemours Children's Healthcare, 807 Children's Way, Jacksonville, FL 32207, United States; Wolfson Children's Hospital, 800 Prudential Drive, Jacksonville, FL 32207, United States.
| | - Lisa Nichols
- Wolfson Children's Hospital, 800 Prudential Drive, Jacksonville, FL 32207, United States
| | - Patsy Williamson
- Wolfson Children's Hospital, 800 Prudential Drive, Jacksonville, FL 32207, United States
| | - Robert W Letton
- Nemours Children's Healthcare, 807 Children's Way, Jacksonville, FL 32207, United States; Wolfson Children's Hospital, 800 Prudential Drive, Jacksonville, FL 32207, United States
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Kikuchi K, Hashimoto H, Hosokawa T, Nawata K, Hirao A. Relationship between pedestrian detection specifications of parking sensor and potential safety benefits. ACCIDENT; ANALYSIS AND PREVENTION 2021; 151:105951. [PMID: 33360876 DOI: 10.1016/j.aap.2020.105951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/23/2020] [Accepted: 12/12/2020] [Indexed: 06/12/2023]
Abstract
Measures to protect vulnerable road users during low-speed maneuvers are required. For example, systems that use cameras to display the vehicle's rearview are popular. However, some vehicles are difficult to equip with a rear view camera system. To avoid a crash when driving in reverse, it is also effective to identify the presence of pedestrians via an audible warning using a device (e.g., clearance sonar). It may be cheaper to install than a rearview camera system. Installation cost is also important for the spread of equipment that reduces a crash. It is necessary to clarify the minimum specifications that balance cost and reduce crashes. Device specifications (e.g., detection distance and response delay) may affect the crash reduction rate. There should be a detection distance required for the sonar to have the same crash reduction effect as the rear view camera system. Thus, in this study, we conducted experiments and obtained data about how a vehicle moves and driver reactions to audible warnings when driving in reverse. Based on the acquired data, a numerical simulation was performed to determine whether a driver could avoid a crash under various circumstances. As a result, it was shown that the clearance sonar must have a detection distance of 0.8 m or more to expect the same effect as a rearview camera system. In other words, to expect sonar to have the same performance as a rearview camera, a detection distance of at least 0.8 m should be set as a specification.
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Affiliation(s)
- Kazunori Kikuchi
- Safety Research Division, Japan Automobile Research Institute (JARI), 2530, Karima, Tsukuba, Ibaraki 305-0822, Japan.
| | - Hiroshi Hashimoto
- Safety Research Division, Japan Automobile Research Institute (JARI), 2530, Karima, Tsukuba, Ibaraki 305-0822, Japan
| | - Takashi Hosokawa
- Safety Research Division, Japan Automobile Research Institute (JARI), 2530, Karima, Tsukuba, Ibaraki 305-0822, Japan
| | - Katsumi Nawata
- Japan Automobile Standards Internationalization Center (JASIC), 3-2-5, Yotsuya, Shinjuku-ku, Tokyo 160-0004, Japan
| | - Akinari Hirao
- Japan Automobile Standards Internationalization Center (JASIC), 3-2-5, Yotsuya, Shinjuku-ku, Tokyo 160-0004, Japan
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Matsui Y, Hosokawa N, Oikawa S. Pedestrian Detection During Vehicle Backing Maneuvers Using Ultrasonic Parking Sensors. STAPP CAR CRASH JOURNAL 2019; 63:343-358. [PMID: 32311064 DOI: 10.4271/2019-22-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ultrasonic parking sensors are an active technology designed to alert drivers to the presence of objects behind their vehicle but not the presence of a human. The purpose of this study was therefore to ascertain if these sensor systems can successfully detect a human subject. We accordingly conducted experiments using four vehicles equipped with both rear-facing center and corner ultrasonic parking sensor systems to determine the detection distance between the vehicle and a 1-m tall, 75-mm diameter pipe, a child, an adult woman, and an adult man. The detection of human subjects was evaluated under front-facing and side-facing conditions behind each vehicle. The results indicate that for a front-facing and side-facing child, the center sensor detection distances were 50-84% and 32-64%, respectively, shorter than that of the pipe. For front-facing and side-facing adults, the center sensor detection distances were just less than or roughly equivalent to that of the pipe at 89-102% and 78-97%, respectively. A similar trend was seen for the corner sensors. Notably, under the side-facing condition, the sensor detection distances were slightly shorter for all subjects than under the front-facing condition. These results reveal that ultrasonic parking sensor systems can not only detect objects but also humans, indicating that ultrasonic sensors are an available countermeasure to prevent backover accidents involving pedestrians. To address the shorter detection distance of children, a combination of ultrasonic parking sensors with other systems, such as backup cameras, may be more effective for avoiding backover collisions.
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Cicchino JB. Real-world effects of rear cross-traffic alert on police-reported backing crashes. ACCIDENT; ANALYSIS AND PREVENTION 2019; 123:350-355. [PMID: 30580146 DOI: 10.1016/j.aap.2018.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/02/2018] [Accepted: 11/09/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Several parking assistance systems are available to help drivers back up. Rear cross-traffic alert warns drivers when they are reversing and cross-traffic approaches the rear of their vehicle, as might happen when backing out of a perpendicular parking space in a lot. The goal of this study was to examine the effect of rear cross-traffic alert on backing crashes. METHODS Negative binomial regression was used to compare police-reported backing crash rates in 25 U.S. states per insured vehicle year between General Motors and Mazda vehicles with rear cross-traffic alert and the same vehicle models without the optional system, controlling for the presence of other parking assistance systems and additional factors that may affect crash risk. RESULTS Crash involvement rates in backing crashes overall were 22% lower among vehicles with rear cross-traffic alert than among vehicles without the system when averaged between the two manufacturers. Rates were 32% lower among vehicles with the system than without in two-vehicle backing crashes where the vehicles were traveling in perpendicular directions. Both reductions were statistically significant. CONCLUSIONS Rearview cameras and rear automatic braking, which are designed to help drivers detect and brake for obstacles directly behind the vehicle, have been shown in previous research to be effective in reducing backing crashes reported to the police. Rear cross-traffic alert can complement these systems by preventing potential backing crashes that other parking assistance systems are not designed to detect. Manufacturers should equip vehicles with rear cross-traffic alert, in addition to other parking assistance systems like rear automatic braking, to maximize the number of backing crashes prevented.
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Affiliation(s)
- Jessica B Cicchino
- Insurance Institute for Highway Safety, 1005 North Glebe Road, Arlington, VA, 22201, United States.
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Cicchino JB. Real-world effects of rear automatic braking and other backing assistance systems. JOURNAL OF SAFETY RESEARCH 2019; 68:41-47. [PMID: 30876519 DOI: 10.1016/j.jsr.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/25/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the effects of rearview cameras, rear parking sensors, and rear automatic braking systems on backing crashes. METHOD Negative binomial regression was used to compare police-reported backing crash involvements per insured vehicle year in 23 US states during 2012-2015 among General Motors vehicles with Rear Vision Camera alone; Rear Parking Assist alone (rear parking sensors); Rear Vision Camera and Rear Parking Assist; or the Rear Vision Camera, Rear Parking Assist, and Rear Automatic Braking to vehicles with none of these systems. Modeling controlled for other backing assistance systems on vehicles and factors that may affect crash risk. RESULTS The combination of Rear Vision Camera and Rear Parking Assist reduced backing crash involvement rates by 42%. When Rear Automatic Braking was added to the Rear Vision Camera and Rear Parking Assist, vehicles with all three systems had backing crash involvement rates that were 78% lower than vehicles with none of the systems. On vehicles with Rear Parking Assist alone or Rear Vision Camera alone, backing crash involvement rates were reduced 28% and 5%, respectively, but these reductions were not statistically significant. CONCLUSIONS Rearview cameras and rear parking sensors are preventing some backing crashes, but their effectiveness may be constrained in part by drivers not using or responding to the systems appropriately. Rear automatic braking adds to the effectiveness of these systems because it does not rely entirely on appropriate driver response. Practical applications: Rear parking sensors and rearview cameras are available on most new vehicles, but availability of rear automatic braking is limited. If more vehicles were equipped with rear automatic braking that performed like the system evaluated in the current study, many backing crashes that still occur among vehicles with rearview cameras and rear parking sensors could be prevented.
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Affiliation(s)
- Jessica B Cicchino
- Insurance Institute for Highway Safety, 1005 North Glebe Road, Arlington, VA 22201, United States.
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Cicchino JB. Effects of rearview cameras and rear parking sensors on police-reported backing crashes. TRAFFIC INJURY PREVENTION 2017; 18:859-865. [PMID: 28394632 DOI: 10.1080/15389588.2017.1317758] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 04/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The objective of this study was to examine the effectiveness of rearview cameras, rear parking sensors, and both systems combined in preventing police-reported backing crashes. METHODS Negative binomial regression was used to compare rates of police-reported backing crash involvements per insured vehicle year in 22 U.S. states during 2009-2014 between passenger vehicle models with backing technologies and the same vehicle models where the optional systems were not purchased, controlling for other factors affecting crash risk. Rearview cameras were examined from four automakers, rear parking sensors from 2 automakers, and both systems combined from a single automaker. RESULTS Rearview cameras reduced backing crash involvement rates by 17%. Reductions were larger for drivers 70 and older (36%) than for drivers younger than 70 (16%); however, estimates for older and younger drivers did not differ significantly from one another. The Buick Lucerne's rear parking sensor system reduced backing crash involvement rates significantly by 34%, but the reduction for Mercedes-Benz vehicles fit with a sensor system was small and not statistically significant. When averaged between the 2 automakers, effects were significantly larger for drivers 70 and older (38% reduction) than for drivers younger than 70 (1% increase); effects were significant for older but not younger drivers. Backing crash involvement rates were 13% lower among Mercedes-Benz vehicles with a rearview camera and parking sensors than among vehicles without, but this finding was not significant. DISCUSSION Rearview cameras are effective in preventing police-reported backing crashes. Effects of rear parking sensors are less straightforward; it is unclear whether the Buick Lucerne system's benefits are due to the older age of its drivers, characteristics of the vehicle or system, or a combination. Systems may be especially beneficial to older drivers who might have limitations that make backing challenging. Although effect estimates did not differ significantly between older and younger drivers for both system types, the magnitude of the differences was large and the pattern of results was consistent across 6 of the 7 systems examined. When rear visibility systems become required equipment on new passenger vehicles in 2018, rearview cameras can be expected to prevent 1 in 6 backing crashes reported to police that involve equipped vehicles.
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Kidd DG, McCartt AT. Differences in glance behavior between drivers using a rearview camera, parking sensor system, both technologies, or no technology during low-speed parking maneuvers. ACCIDENT; ANALYSIS AND PREVENTION 2016; 87:92-101. [PMID: 26656150 DOI: 10.1016/j.aap.2015.11.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 09/22/2015] [Accepted: 11/22/2015] [Indexed: 06/05/2023]
Abstract
This study characterized the use of various fields of view during low-speed parking maneuvers by drivers with a rearview camera, a sensor system, a camera and sensor system combined, or neither technology. Participants performed four different low-speed parking maneuvers five times. Glances to different fields of view the second time through the four maneuvers were coded along with the glance locations at the onset of the audible warning from the sensor system and immediately after the warning for participants in the sensor and camera-plus-sensor conditions. Overall, the results suggest that information from cameras and/or sensor systems is used in place of mirrors and shoulder glances. Participants with a camera, sensor system, or both technologies looked over their shoulders significantly less than participants without technology. Participants with cameras (camera and camera-plus-sensor conditions) used their mirrors significantly less compared with participants without cameras (no-technology and sensor conditions). Participants in the camera-plus-sensor condition looked at the center console/camera display for a smaller percentage of the time during the low-speed maneuvers than participants in the camera condition and glanced more frequently to the center console/camera display immediately after the warning from the sensor system compared with the frequency of glances to this location at warning onset. Although this increase was not statistically significant, the pattern suggests that participants in the camera-plus-sensor condition may have used the warning as a cue to look at the camera display. The observed differences in glance behavior between study groups were illustrated by relating it to the visibility of a 12-15-month-old child-size object. These findings provide evidence that drivers adapt their glance behavior during low-speed parking maneuvers following extended use of rearview cameras and parking sensors, and suggest that other technologies which augment the driving task may do the same.
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Affiliation(s)
- David G Kidd
- Insurance Institute for Highway Safety, 1005 North Glebe Road, Arlington, VA 22201, United States.
| | - Anne T McCartt
- Insurance Institute for Highway Safety, 1005 North Glebe Road, Arlington, VA 22201, United States
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Kidd DG, Hagoski BK, Tucker TG, Chiang DP. The effectiveness of a rearview camera and parking sensor system alone and combined for preventing a collision with an unexpected stationary or moving object. HUMAN FACTORS 2015; 57:689-700. [PMID: 25977326 DOI: 10.1177/0018720814553028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 08/26/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This study measured the effectiveness of a parking sensor system, a rearview camera, and a sensor system combined with a camera for preventing a collision with a stationary or moving child-size object in the path of a backing vehicle. BACKGROUND An estimated 15,000 people are injured and 210 are killed every year in backover crashes involving light vehicles. Cameras and sensor systems may help prevent these crashes. METHOD The sample included 111 drivers (55 men, 56 women), including 16 in the no-technology condition, 32 in the sensor condition, 32 in the camera condition, and 31 in the camera-plus-sensor condition. A stationary or moving child-size object was surreptitiously deployed in the path of participants backing out of a parking stall. RESULTS A significantly smaller proportion of participants in the camera condition hit the stationary object compared with participants in the no-technology condition; however, this benefit was greatly reduced when the stationary object was partially or completely in the shade. Significantly fewer participants hit the moving object than the stationary object. The percentage of participants in the sensor, camera, and camera-plus-sensor conditions who hit the moving object was not different from the no-technology condition. CONCLUSION The camera was the only technology that was effective for preventing collisions with the stationary object. The variation in collision outcomes between the stationary- and moving-object conditions illustrates how the effectiveness of these technologies is dependent on the backing situation. APPLICATION This research can help the selection and development of countermeasures to prevent backovers.
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Affiliation(s)
- David G Kidd
- Insurance Institute for Highway Safety, Arlington, Virginia
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