Urgency Algorithm

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ADDITIONAL RESOURCES

Read an article by Howard R. Champion on the importance of URGENCY,
“New Tools to Reduce Deaths and Disabilities by Improving Emergency Care: URGENCY software, Occult Injury Warnings, and Air Medical Services Database"

Download the Urgency Algorithm.

URGENCY IN ACTION

One male driver, wearing a safety belt, makes a left turn directly in front of an oncoming car. The second car slams on the brakes, but too late, and collides with the passenger side door of the turning vehicle. Both drivers get out of their cars and appear to be fine. At the point of impact, information about the crash is automatically transmitted to the Urgency Algorithm. In this crash, the Delta Velocity was 25 miles per hour. There was side damage, but no rear damage. Safety belts were used, the driver was a 45-year-old male, there was no entrapment or ejection, and the cars were of average size (3200) lbs.

All of this information would be instantly collected and sent wirelessly to the Urgency Algorithm. In this example, the algorithm would project the probability of a serious injury to be 20 percent. This data would be relayed to the Emergency Medical Dispatcher (EMD), who could then make a more informed decision as to who should be notified of the accident, and what level of medical treatment is likely to be necessary.

If, in the aforementioned example, the occupant of the turning vehicle were female, the probability of a serious injury would jump to 28 percent. If the occupant was male and the force of the impact caused the car to roll over, there would be a 44 percent chance of a serious injury. If during that roll, the driver were to be completely ejected from his vehicle, the probability would become 83 percent. In this last example, the dispatcher would almost certainly dispatch a higher level of care, as it would be extremely likely that a serious injury had occurred.

The Urgency Algorithm is a complex set of mathematical equations developed by a multidisciplinary team of physicians, trauma surgeons, engineers and crash injury statisticians to predict the probability of a serious, potentially life-threatening injury, resulting from a crash.

THE NEED

Currently if a person is involved in a car crash, there is no way, short of visual contact, of predicting the severity of any resulting injuries. Even with visual contact, there is no way to gauge the likelihood of internal injuries or head trauma. The Urgency Algorithm is a predictive tool that provides emergency medical dispatchers with the information they need to anticipate serious injury and respond accordingly.

COMCARE'S APPROACH

The team of experts examined and statistically analyzed the latest crash injury data available from the National Highway Traffic Safety Administration (NHTSA). The parameters currently used in the algorithm are: crash force (Deceleration rate of impact, change in velocity), principle direction of crash force, vehicle weight, safety belt use, age, gender, side damage in the passenger compartment, rear damage, rollover (number of quarter turns), entrapment, and complete ejection.

Each available parameter of data was evaluated based on its ability to predict the probability of serious injury. Those chosen were most likely to affect the probability of serious injury or death in an Wrecked car-FEMA accident. The "golden hour" is a term used by the medical community that asserts that if treatment for a serious injury can be obtained within the first sixty minutes following an accident, there is a significantly greater probability of victim recovery. Because the effects of severe internal trauma may not manifest for several hours, a method of predicting the likelihood of serious injury is instrumental in getting crash victims treated within the "golden hour."

After enough crash data has been collected over time, data from a serious crash can be cross-referenced with existing crash reports to predict the exact type of injuries that are likely to occur in certain situations.

With more data, dispatchers will be able to provide faster, more effective response to emergency situations. In crashes, reducing response time is critical to saving lives and preventing serious injury. The Urgency Algorithm provides a tangible, data-based system that, in conjunction with developing wireless technologies, such as Automatic Crash Notification (ACN), will be instrumental in improving emergency response.

The current crash version can be modified to substitute intrusion for the delta-velocity of a crash, and thus allows it to be used at the scene right now. This is being tested in Charlotte, North Carolina by the National Highway Traffic Safety Administration.

Appendix: The Urgency Algorithm uses the Abbreviated Injury Scale (AIS) of injury classification in its computations. The AIS classifies injuries on a 6-point scale. The ratings are as follows: 1-minor, 2-moderate, 3-serious, 4-severe, 5-critical, 6-fatal. AIS-3 is the point at which injuries become potentially life threatening. Because of this distinction, the Urgency Algorithm's "Projection of Possibility of Casualty" is the probability that an occupant of the vehicle will have sustained an AIS-3 injury or greater.

FROM VISION TO REALITY

COMCARE supports the development, improvement and application of the URGENCY software to predict injury risk based on observed data from the crash site. COMCARE is encouraging the next generation of the Urgency Algorithm to include data from the scene, like patient vitals. Using the Vehicular Emergency Data Set (VEDS) as the data receptacle, data can be fed directly into Computer Aided Dispatch (CAD) systems through an upgrade of Emergency Medical Dispatch, a product of NAED and APCO.

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