Motor Vehicle Rollovers

When vehicles roll over as part of a motor vehicle accident, most of the time it is considered a severe event. Researchers wanted to know whether in fact rolling over a vehicle as part of an automobile accident was more severe than a non-rollover event. They wanted to do this in order to see whether there should be a field triage held differently for rollover accidents when compared to non-rollover accidents.

The American College of Surgeons had a Committee on Trauma that held the same triage rules for more than twenty years. The scheme for field triage was based on obvious abnormal findings, abnormal physiological signs and on mechanism of injury and miscellaneous factors like age and other findings. In 2005, a committee looked at the triage scheme and dropped the mechanism of action of a vehicle rollover as a triage criterion. The researchers wanted to know if this was a good idea or not.

The researchers took a good look at the medical literature as well as data published by the Department of Transportation and the National Highway Traffic Safety Administration or NHTSA. They also looked at the proportion of fatal car accidents in rollovers and compared them to non-rollovers.

They found that rollover accidents made up a small proportion of all motor vehicle accidents. Of the 12 million vehicle accidents found by the NHTSA in 2004, only 2.4 percent of these accidents were rollovers. Interestingly, they accounted for a third of all accident-related occupant deaths and about 25,000 severe injuries per year. In fact, rollovers were associated with the second highest amount of vehicle occupant deaths when crash mode was looked at. When looking at crash modes, rollovers accounted for 3 times the risk of injury when compared to other types of crashes.

Head and spinal cord injuries took a really big hit with rollover accidents. The risk of spinal cord injuries and head injuries as well as the risk of death was more than fifteen times the same risks in non-rollover accidents. The researchers decided that there was a grave risk of severe injury and death when a vehicle was involved in a rollover accident so that it needs to be considered at the time of field triage on the part of first responders.

They felt that because it is sometimes difficult to assess a patient at the scene and too look at the presence or absence of specific injuries, the mode of the accident should be taken into account. They felt that it was ill advised of the committee to delete the presence of a rollover accident as a factor that plays into the role of whether or not the patient is likely to be seriously injured or dead as a result of the accident.

The first responder needs to evaluate the physiological signs and look for evidence of anatomic trauma before taking in other factors; however, if the person was in a rollover accident, the first responder should expect more severe trauma to be found on the patient.