OK, found a few:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=2331291&dopt=Abstract
Accid Anal Prev. 1990 Apr;22(2):167-75. Related Articles, Links
Restraint effectiveness, occupant ejection from cars, and fatality reductions.
Evans L.
Operating Sciences Department, General Motors Research Laboratories, Warren, Michigan 48090.
The effectiveness of air cushion restraint systems, or airbags, in preventing fatalities is estimated by assuming that they do not affect ejection probability, and protect only in frontal, or near frontal, crashes with impact-reducing effectiveness equal to that of lap/shoulder belts. In order to compute airbag effectiveness, lap/shoulder belt effectiveness and the fraction of fatalities preventable by eliminating ejection are estimated using Fatal Accident Reporting System (FARS) data. Ejection prevention is found to account for almost half of the effectiveness of lap/shoulder belts (essentially all for lap belts only). Airbag effectiveness is estimated as (18 +/- 4)% in preventing fatalities to drivers and (13 +/- 4)% to right front passengers.
Drivers switching from lap/shoulder belt to airbag-only protection increase their fatality risk by 41%.
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accountable to ejection
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A Fatality Associated with the Deployment of an Automobile Airbag
[Case Report]
Brown, Diane K. MD; Roe, E. Jedd MD, FACEP; Henry, Thomas E. MD
From the Department of Emergency Medical Services (DAB., E.J.R.), Denver General Hospital; and the Coroner's Office (T.E.H.), City and County of Denver, Denver, Colorado.
Address for reprints: Diane K. Brown, MD, 2035 Overlook Dr., Grand Junction, CO 81505.
Abstract
Airbags have become an increasingly accepted automobile safety feature that can reduce the morbidity and mortality associated with motor vehicle collisions. We present the following case report of an unusual fatality with multiple internal injuries from a minor mechanism motor vehicle collision. The cause of injuries was determined to be secondary to the deployment of a driver's side airbag without the concomitant use of a lap-shoulder belt.
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CASE REPORT
A 71-year-old woman was the unrestrained driver of a motor vehicle equipped with an airbag system. Her vehicle had rear-ended another vehicle at an estimated collision speed of less than 10 mph and sustained only minor front fender damage. There was no interior damage, and the airbag had been deployed.
The victim was found by paramedics slumped over the steering wheel with pulseless electrical activity. She was extricated with a cervical collar in place onto a backboard and transported by ambulance to a level I trauma center with cardiopulmonary resuscitation in progress. En route the patient was intubated, given epinephrine and atropine through intravenous access, and treated as a medical arrest given the minor mechanism.
On arrival to the emergency department, the patient was unresponsive, cyanotic with pulseless electrical activity. Pupils were fixed and dilated. Frank blood was present from the left ear and mouth. Neck examination was remarkable for palpable crepitus over the upper cervical spine and a 1-cm laceration to the left anterior neck. There was significant ecchymosis present over the anterior neck, chest, abdomen, and extremities. Breath sounds were present bilaterally with mechanical ventilation and the abdomen soft and nondistended.
Despite continued resuscitative efforts, including pericardiocentesis and needle thoracostomy, the patient's status remained unchanged. She was subsequently pronounced dead.
Autopsy results revealed the following findings:
1. Atlanto-occipital dislocation, with tearing of the anterior atlanto-occipital membrane, apical dental ligament, and the tectorial membrane. There was fracturing of the anterior margin of both superior articular facets of the atlas.
2. Pontomedullary laceration anteriorly.
3. Basilar, subdural, and subarachnoid hemorrhage.
4. Rib fractures 1 through 8 on the right and rib fractures 1 through 9 on the left.
5. Partial aortic tear at and slightly above the level of the ductus that involved the total thickness of the wall and approximately 75% of the circumference, with extensive hemorrhage dissecting into the surrounding mediastinum and into the neck.
6. Several linear capsular tears over the left lobe of the liver, with deep stellate lacerations over the anterior and lateral surface of the right lobe that almost transected the liver.
7. Bilateral hemothorax (100 cm3 right, 300 cm3 left) and hemoperitoneum (400 cm3).
Additional findings included mild to moderate arteriosclerotic cardiovascular disease, myxomatous degeneration of the mitral valve, and chronic lymphocytic thyroiditis. Toxicology was positive only for caffeine. Cause of death was reported as secondary to multiple internal injuries.
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http://content.nejm.org/cgi/content...430f14426adba0f1bf6f7b2e&keytype2=tf_ipsecsha
Air-Bag-Associated Rupture of the Right Atrium
To the Editor: We recently encountered an unusual complication associated with the deployment of an automobile air bag.
A 22-year-old woman was in a car traveling 10 to 15 mph that collided with a stopped car. The woman's car sustained relatively minor damage, but the air bag inflated. The woman became unconscious at the scene and was hypotensive when the emergency medical service arrived. No signs of trauma were detectable, and despite the aggressive administration of intravenous fluids, her blood pressure did not respond. Central venous pressure was 27.5 cm of water, and a pericardial effusion was noted on a computed tomographic scan. Pericardiocentesis revealed blood. At thoracotomy, 1100 ml of blood was evacuated from the tamponaded pericardium. A right atrial tear was repaired. The patient did well and was sent home 11 days after the surgery.
Air bags reduce mortality,1 but fatalities may occur in high-speed collisions that result in multiple chest trauma and cardiac rupture. This case is unusual in that it did not involve a high-speed collision and no rib fractures or other signs of trauma were noted.
The velocity of air bags during deployment has been measured at 98 to 211 mph (average, 144)2. This may be sufficient to rupture the right atrium, since it is one of the thinnest vascular structures in the thorax. The absence of a rib fracture can probably be attributed to the patient's youth and relatively pliable thorax.
The fact that she was not wearing a seat belt may have aggravated the situation by increasing the total velocity of the impact as well as by putting her thorax closer to the rapidly inflating air bag.
This case brings up two important points. First, cardiac rupture can occur even in the absence of rib fractures with severe barotrauma. Second, even in low-velocity collisions, the efficacy and safety of the air bag may be enhanced by the use of shoulder seat belts.
Gilead I. Lancaster, M.D.
John H. DeFrance, M.D.
John J. Borruso, M.D.
Danbury Hospital
Danbury, CT 06810
