Estimation of Injury Limits at Vulnerable Impact Locations Along the Forearm Via THUMS AM50 Finite Element Model at Airbag Loading Rates.

Side and frontal airbag deployment represents the main injury mechanism to the upper extremity during automotive collisions. Previous dynamic injury limit research has been limited to testing the forearm at either the assumed most vulnerable location to fracture, the distal 1/3rd, or the midpoint. Studies have varied the surface to which impacts were applied, with no clear consensus on the site of greatest vulnerability. The unpredictability of airbag impact location, especially with altered hand positioning, limits the effectiveness of existing forearm injury limits determined from impacts at only one location. The current study quantified the effect of impacts at alternative locations on injury risk along the forearm using the THUMS FE model. Airbag-level impacts were simulated along the forearm on all four anatomical surfaces. Results showed the distal 1/3rd is not the most vulnerable location (for any side), indicating forearm fracture is not solely driven by area moment of inertia (as previously assumed). The posterior forearm was the weakest, suggesting that current test standards underestimate the fracture risk of the forearm. Linear regression models showed strong correlation between forearm fracture risk and bone geometry (cross-sectional area and area moment of inertia) as well as soft-tissue depth, potentially providing the ability to predict forearm injury tolerances for any location or forearm size. This study demonstrated the forearm's vulnerability to fracture from airbag deployments, indicating the need for safety systems to better address injury mechanisms for the upper limb to effectively protect drivers.

Protection Effect of Elbow Joint Airbag on Patients with Upper Limb Fractures: A Quasi-Randomized Controlled Trial.

Objective: Wound healing is delayed because of swelling after upper limb fracture, and the traditional rehabilitation device used in physical therapy cannot flexibly adjust the fixation. This study aims to evaluate the effect of the designed elbow joint airbag protection device used in patients with upper arm fractures. Methods: This is a quasi-randomized controlled trial. From November 2022 to March 2023, 70 hospitalized patients with unilateral upper arm fractures were recruited from a general tertiary hospital in eastern China. The patients were divided into an experimental group and a control group according to the random number table at 1:1. Among them, 35 patients who received elbow joint airbag protection for post-traumatic limb swelling were assigned to the experimental group, and the other 35 patients were assigned to the control group. The degree of swelling regression, a score of resting pain, and patient comfort level was compared between the two groups. Results: The waiting time from swelling to allowing for surgery and pain score at rest were significantly lower in the experimental group than in the control group (P < .05 and P < .001 respectively). The comfort score of the experimental group was higher than that of the control group (P < .05), and these differences were statistically significant. Conclusions: The elbow joint airbag protection can significantly reduce the waiting time for surgery, lessen the degree of swelling regression, reduce the pain in patients' hands caused by swelling, and significantly improve the comfort level. Hence, it is worth promoting in the clinical practice of orthopedic nursing.

TinyFallNet: A Lightweight Pre-Impact Fall Detection Model.

Falls represent a significant health concern for the elderly. While studies on deep learning-based preimpact fall detection have been conducted to mitigate fall-related injuries, additional efforts are needed for embedding in microcomputer units (MCUs). In this study, ConvLSTM, the state-of-the-art model, was benchmarked, and we attempted to lightweight it by leveraging features from image-classification models VGGNet and ResNet while maintaining performance for wearable airbags. The models were developed and evaluated using data from young subjects in the KFall public dataset based on an inertial measurement unit (IMU), leading to the proposal of TinyFallNet based on ResNet. Despite exhibiting higher accuracy (97.37% < 98.00%) than the benchmarked ConvLSTM, the proposed model requires lower memory (1.58 MB > 0.70 MB). Additionally, data on the elderly from the fall data of the FARSEEING dataset and activities of daily living (ADLs) data of the KFall dataset were analyzed for algorithm validation. This study demonstrated the applicability of image-classification models to preimpact fall detection using IMU and showed that additional tuning for lightweighting is possible due to the different data types. This research is expected to contribute to the lightweighting of deep learning models based on IMU and the development of applications based on IMU data.

Driver Injury from Vehicle Side Impacts When Automatic Emergency Braking and Active Seat Belts Are Used.

As an advanced driver assistance system, automatic emergency braking (AEB) can effectively reduce accidents by using high-precision and high-coverage sensors. In particular, it has a significant advantage in reducing front-end collisions and rear-end accidents. Unfortunately, avoiding side collisions is a challenging problem for AEB. To tackle these challenges, we propose active seat belt pretensioning on driver injury in vehicles equipped with AEB in unavoidable side crashes. Firstly, records of impact cases from China's National Automobile Accident In-Depth Investigation System were used to investigate a scenario in which a vehicle is impacted by an oncoming car after the vehicle's AEB system is triggered. The scenario was created using PreScan software. Then, the simulated vehicles in the side impact were devised using a finite element model of the Toyota Yaris and a moving barrier. These were constructed in HyperMesh software along with models of the driver's side seatbelt, side airbag, and side curtain airbag. Moreover, the models were verified, and driver out-of-position instances and injuries were evaluated in simulations with different AEB intensities up to 0.7 g for three typical side impact angles. Last but not least, the optimal combination of seatbelt pretensioning and the timing thereof for minimizing driver injury at each side impact angle was identified using orthogonal tests; immediate (at 0 ms) pretensioning at 80 N was applied. Our experiments show that our active seatbelt with the above parameters reduced the weighted injury criterion by 5.94%, 22.05%, and 20.37% at impact angles of 90°, 105°, and 120°, respectively, compared to that of a conventional seatbelt. The results of the experiment can be used as a reference to appropriately set the collision parameters of active seat belts for vehicles with AEB.

Wilderness Rescue of a Hiker with Multiple Trapped Limbs by a Combined Wilderness and Urban Rescue Team Using High-Pressure Airbags.

We report on the case of a 28-y-old man with both legs and left arm trapped for nearly 6 h after falling and subsequently being trapped by a boulder during a hike in the wilderness. Extrication required equipment designed for urban environments and was operated by an unconventional team of rescue professionals. The patient experienced multiple right lower-extremity orthopedic injuries, acute kidney injury secondary to rhabdomyolysis, and bilateral segmental pulmonary emboli. In this article, we detail the extrication and review the treatment guidelines for crush injuries that focus on aggressive fluid resuscitation prior to and during extrication and medication administration only if hyperkalemia presents. Wilderness rescuers should plan for the use of unconventional rescue equipment in austere prolonged rescue scenarios.

Finite element analysis of changes in tensile strain and deformation by airbag impact in eyes of various axial lengths.

PURPOSE: Airbags have substantially reduced mortality and morbidity, while ocular injuries caused by airbags have been reported. We applied a three-dimensional finite element analysis (FEA) model we have established for evaluation of the deformation of an intact eyeball of various axial lengths induced by an airbag impact at various impact velocities. METHODS: A model human eye we have created was used in simulations with an FEA program, PAM-GENERIS™ (Nihon ESI, Tokyo, Japan). The airbag was set to impact eyes with various axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 30, 40, 50 and 60 m/s. Changes in the shape of the eye and the strain induced were calculated. Deformation of the eye in a cross-sectional view was displayed sequentially in slow motion. RESULTS: We found that considerable damage, such as corneal or scleral lacerations, was observed especially at higher impact velocities, such as 50 or 60 m/s, in eyes with any axial length. Deformation was most evident in the anterior segment. The decrease rate of axial length was greatest in the hyperopic eye, followed by the myopic eye, and the emmetropic eye. CONCLUSIONS: It was shown that hyperopic eyes are most susceptible to deformation by an airbag impact in this simulation. The considerable deformation by an airbag impact on the eye during a traffic accident shown in this study might indicate the necessity of ocular protection to avoid permanent eye damage.

Minimal invasive transnasal endoscopic removal of intracranial foreign body after airbag deployment.

Airbag induced injuries such as skull and cervical spine fractures, epidural and subdural hematomas, atlantooccipital dislocations or brainstem lacerations are already documented in published literature, however, no previous case have been published about a penetrating foreign body of the skull base following airbag deployment. Removal of an intracranial foreign body is very dangerous and difficult, or even if it possible and necessary, requires open surgery in most of the cases. In this article we present the minimal invasive, transnasal removal of a coin from the intracranial, frontobasal region using high-resolution endoscopy combined with image-guided navigation.
We report the case of a 59-year-old male who was brought to the emergency department after a car accident. He suffered a penetrating injury by a coin that was placed on the car’s airbag at the moment of the accident. Upon the airbag being deployed the foreign body entered the skin through the right lower eyelid, crossing the orbital cavity, ethmoid cells, sphenoid sinus and the anterior part of the planum sphenoidale at an equal distance of 2mm from the two internal carotid arteries, extending into the intracranial space, without injuring the pituitary stalk and the chiasm. We proceeded to remove the coin endoscopically using a transnasal transseptal transsphenoidal approach under general anesthesia. The dura was closed with a multilayer skull base reconstruction technique using two layers of abdominal free fat and nasal septal mucoperiosteal flap. There were no postoperative complications, nor CSF rhinorrhea. The patient was discharged 10 days after the operation.
To our knowledge, this is the first publi­shed case of a penetrating foreign body of the skull base, extending into the intracranial cavity following airbag deployment. In some dedicated cases, a minimal invasive endoscopic approach should be considered as an alternative to anterior craniotomy if access is possible when foreign bodies from the skull base area need to be removed. This procedure is efficient, safe and minimally invasive. 

'It was like an airbag, it cushioned the blow': A multi-site qualitative study of bereaved parents' experiences of using cooling facilities.

BACKGROUND: Evidence on the benefits to parents of spending time with their child in the hours after their death means this is now routine practice. UK children's hospices offer parents the opportunity to extend this period by using cooling facilities (i.e. cooled 'bedrooms'; cooling blankets/mattresses) to slow deterioration. AIM: To explore parents' experiences of using cooling facilities and beliefs about how it shaped experiences of the very early days of bereavement, and on-going grieving processes. METHODS: Multi-site study involving in-depth interviews with parents bereaved in the previous 3 years. Grief theories informed data analysis, which employed narrative and thematic approaches. Eight hospices supported recruitment. RESULTS: Twenty-two mothers and eight fathers were recruited, representing 25% of families approached. Duration of use of a cooling facility varied, as did the amount of time spent with the child. All parents treasured this period, valuing the way it eased separation from their child and gave some control over when this happened. They believed all bereaved parents should have the opportunity to use a cooling facility. Using a cooling facility supported parents' engagement with grief tasks including acceptance of loss, processing emotional pain and facing changes to their lives brought about by their child's death. Memories and mementoes created during this period served to support on-going connections with the child. Parents who used a cooling facility at a hospice reported benefits of the setting itself. CONCLUSIONS: As well as easing the very early days of loss, use of cooling facilities may influence longer-term bereavement outcomes.

Prevention of hip fractures in older adults residing in long-term care facilities with a hip airbag: a retrospective pilot study.

BACKGROUND: Hip and pelvic fractures do commonly occur among older adults. This pilot study aimed to evaluate the effect of introduction of the WOLK hip airbag on the incidence of hip fractures. METHODS: A retrospective study was performed among 969 participants residing within 11 long-term care facilities for older patients, belonging to one large healthcare organization in The Netherlands. The intervention concerned application of 45 WOLK hip-airbags, distributed among selected residents of the long-term care facilities. Inclusion criteria; physically active participants with a pelvic circumference between 90-125 cm able to wear the hip airbag. Exclusion criteria; participants who continuously removed the hip airbag themselves or participants who depended on a wheelchair for mobility. Main outcome measures were the occurrence of falls and hip, pelvic and other fractures. RESULTS: The incidence of hip and pelvic fractures declined from 3.3/100 person years to 1.8/100 person years during the study for an Incidence Rate Ratio (IRR) of 0.55 (95% confidence interval (95%CI) 0.34-0.87) in the entire study population. The incidence of other fractures did not decline during the study period (IRR 0.72;95%CI 0.37-1.40). The incidence of falls declined to some extent during the study (IRR 0.88; 95%CI 0.83-0.93). CONCLUSIONS: After introduction of the WOLK hip airbag a reduction of the incidence of hip and pelvic fractures by almost half was observed in older patients residing in long-term care facilities, even though only 45 hip airbags were distributed among the 969 residents. As selection bias cannot be ruled out in this study, the results of this pilot study warrant replication by a future clinical trial to determine true effectiveness of this intervention.

Wearable airbag technology and machine learned models to mitigate falls after stroke.

BACKGROUND: Falls are a common complication experienced after a stroke and can cause serious detriments to physical health and social mobility, necessitating a dire need for intervention. Among recent advancements, wearable airbag technology has been designed to detect and mitigate fall impact. However, these devices have not been designed nor validated for the stroke population and thus, may inadequately detect falls in individuals with stroke-related motor impairments. To address this gap, we investigated whether population-specific training data and modeling parameters are required to pre-detect falls in a chronic stroke population. METHODS: We collected data from a wearable airbag's inertial measurement units (IMUs) from individuals with (n = 20 stroke) and without (n = 15 control) history of stroke while performing a series of falls (842 falls total) and non-falls (961 non-falls total) in a laboratory setting. A leave-one-subject-out crossvalidation was used to compare the performance of two identical machine learned models (adaptive boosting classifier) trained on cohort-dependent data (control or stroke) to pre-detect falls in the stroke cohort. RESULTS: The average performance of the model trained on stroke data (recall = 0.905, precision = 0.900) had statistically significantly better recall (P = 0.0035) than the model trained on control data (recall = 0.800, precision = 0.944), while precision was not statistically significantly different. Stratifying models trained on specific fall types revealed differences in pre-detecting anterior-posterior (AP) falls (stroke-trained model's F1-score was 35% higher, P = 0.019). Using activities of daily living as non-falls training data (compared to near-falls) significantly increased the AUC (Area under the receiver operating characteristic) for classifying AP falls for both models (P < 0.04). Preliminary analysis suggests that users with more severe stroke impairments benefit further from a stroke-trained model. The optimal lead time (time interval pre-impact to detect falls) differed between control- and stroke-trained models. CONCLUSIONS: These results demonstrate the importance of population sensitivity, non-falls data, and optimal lead time for machine learned pre-impact fall detection specific to stroke. Existing fall mitigation technologies should be challenged to include data of neurologically impaired individuals in model development to adequately detect falls in other high fall risk populations. Trial registration https://clinicaltrials.gov/ct2/show/NCT05076565 ; Unique Identifier: NCT05076565. Retrospectively registered on 13 October 2021.

Fatal automobile accident due to airbag misdeployment.

The purpose of this case report was to demonstrate a fatal motor vehicle accident in which a 33-year-old man died at the scene immediately after his car collided with the roadside curbstone at a normal speed. The autopsy of the deceased body revealed a penetrating injury on the neck as he was struck by the deployed airbag. Pathological examination showed the offending material to be a fractured cylinder-shaped metal piece, which had settled within the fourth cervical vertebral body. Further forensic engineering investigation of the airbag unit found that the metal fragment originated from a defective airbag gas generator, which had exploded upon deployment. These findings reflect on the increasing popularity of airbag-associated trauma across the globe in recent years. We suggest an effective management plan for the evaluation and mitigation of the complications associated with airbag-related incidents.

A Study on the Application of LSTM to Judge Bike Accidents for Inflating Wearable Airbags.

The traffic accident occurrence rate is increasing relative to the increase in the number of people using personal mobility device (PM). This paper proposes an airbag system with a more efficient algorithm to decide the deployment of a wearable bike airbag in case of an accident. The existing wearable airbags are operated by judging the accident situations using the thresholds of sensors. However, in this case, the judgment accuracy can drop against various motions. This study used the long short-term memory (LSTM) model using the sensor values of the inertial measurement unit (IMU) as input values to judge accident occurrences, which obtains data in real time from the three acceleration-axis and three angular velocity-axis sensors on the driver motion states and judges whether or not an accident has occurred using the obtained data. The existing neural network (NN) or convolutional neural network (CNN) model judges only the input data. This study confirmed that this model has a higher judgment accuracy than the existing NN or CNN by giving strong points even in "past information" through LSTM by regarding the driver motion as time-series data.

[A design of anti-reflux gastric lavage tube with built-in airbag].

At present, the gastric lavage tube used in clinical practice only has a few liquid orifices at the distal end of the lumen, and its structure has defects such as residual liquid reflux and aspiration in clinical practice. This article aims to solve the shortcomings of the existing technology and design a gastric lavage tube with built-in airbag with reasonable structure and high safety, in order to optimize the design and apply it to the actual clinical work, and further reduce the complications caused by the gastric lavage tube.

[Design and Application of Intelligent Management System of Artificial Airway Airbag Pressure in Intensive Care].

In order to solve the problem of continuous monitoring and automatic regulation of patient airbag pressure in intensive care unit, the study designed an intelligent management system of artificial airway airbag pressure. It can realize real-time monitoring and automatic control of airbag pressure. Its pressure data was sent to the PC in real time by the serial port. It can realize the display, store, review and analysis of pressure data. Its clinical application effect was discussed. Experiments showed that the system can monitor airbag pressure in real time and control the pressure to stabilize at 25~30 cmH2O. Compared with the control group, the experimental group had a statistically significant difference in the operation time of monitoring patients' airbag pressure, changes in airbag pressure, the instantaneous maximum value during nursing operation, and the number of aspiration and reflux cases. The clinical application of the system can reduce the workload of medical staff greatly, effectively reduce the number of patients with aspiration and reflux, reduce the incidence of ventilator pneumonia.

Deploying Airbag in Motor Vehicle Collision as the Mechanism of Neurogenic Thoracic Outlet Syndrome: A Case Report.

Neurogenic thoracic outlet syndrome (NTOS) is a disorder that is often misdiagnosed and challenging to treat due to the varied and complex mechanisms that precipitate common sensory symptoms associated with neurovascular dysfunction. In this report, we describe a 21-year-old male who presented with left NTOS after being involved in a motor vehicle collision the previous year. Although NTOS is a condition known to develop after motor vehicle collisions, the mechanism of NTOS in this case, the deploying airbag, has not been documented in existing literature. The patient was first treated conservatively with physical therapy, but treatment failed to relieve his symptoms. A left first rib resection using the transaxillary approach and an anterior scalenectomy was performed without any complications, and the patient's symptoms had improved 3 months postoperation.

Motor Vehicle Collision Injuries: An Analysis of Facial Fractures in the Urban Pediatric Population.

PURPOSE: Motor vehicle collisions (MVC) are a leading cause of unintentional death and injury in the US pediatric population. Compliance with prevention measures such as seatbelts and child safety seats varies considerably with patient demographics. In this study, the authors examine facial fracture secondary to MVC in an urban pediatric population. METHODS: A retrospective chart review was performed of all facial fractures as a result of MVC in the pediatric population in a level 1 trauma center in an urban environment (University Hospital in Newark, NJ). Patient demographics were collected, as well as location of fractures, concomitant injuries, and surgical management strategies. RESULTS: Seventy-five patients met inclusion criteria for the authors' study. Mean age was 14 years old. Common fracture sites included orbital, mandible, nasal bone, and frontal sinus. Patients were more likely to incur fracture of the zygoma, orbit, nasal bone, frontal sinus, and nasoorbitoethmoid (NOE) if involved in an MVC compared to all other etiologies. Common concomitant injuries included traumatic brain injury, intracranial hemorrhage, and skull and long bone fractures. Open reduction and internal fixation with titanium plates was the most common surgical procedure indicated. CONCLUSION: Motor vehicle collisions related injury has significant health implications in the urban pediatric population. Orbital, zygoma, and nasal facial fractures and TBI are injuries commonly associated with MVC. The facial fractures are likely due to lack of proper utilization of safety equipment and airbags. Development of effective prevention techniques relies heavily on analysis of injury patterns and management strategies.

Enhanced Algorithm for the Detection of Preimpact Fall for Wearable Airbags.

Fall-related injury is a common cause of mortality among the elderly. Hip fractures are especially dangerous and can even be fatal. In this study, a threshold-based preimpact fall detection algorithm was developed for wearable airbags that minimize the impact of falls on the user's body. Acceleration sum vector magnitude (SVM), angular velocity SVM, and vertical angle, calculated using inertial data captured from an inertial measurement unit were used to develop the algorithm. To calculate the vertical angle accurately, a complementary filter with a proportional integral controller was used to minimize integration errors and the effect of external impacts. In total, 30 healthy young men were recruited to simulate 6 types of falls and 14 activities of daily life. The developed algorithm achieved 100% sensitivity, 97.54% specificity, 98.33% accuracy, and an average lead time (i.e., the time between the fall detection and the collision) of 280.25 ± 10.29 ms with our experimental data, whereas it achieved 96.1% sensitivity, 90.5% specificity, and 92.4% accuracy with the SisFall public dataset. This paper demonstrates that the algorithm achieved a high accuracy using our experimental data, which included some highly dynamic motions that had not been tested previously.

Rare chemical burns: Review of the Literature.

There are many chemicals that can cause burns. Although they are generally acidic and basic in nature, there are more than one million known chemical compounds, of which 300 have been declared highly hazardous chemical substances by the National Fire Protection Society. Chemical burns account for approximately 10.7% of all burn injuries and 30% of deaths because of burns. Chemicals can be classified as acid, alkali, organic, and inorganic compounds. Acids act by denaturing and coagulating proteins. Alkaline burns cause deeper burns than acid burns.

A life saved at the cost of hand injury - A case of hand burn due to airbag deployment.

According to the Malaysian Department of Statistics motor vehicle accidents are the third leading cause of death in Malaysia and accounts for 7.4% of premature deaths in 2016. With the invention of the airbag, the number of serious injuries and fatalities have been reduced significantly. However, there has also been a corresponding increase in the number of injuries attributable to these devices. The patient narrated in this case report sustained a mixed dermal thickness burn over the upper limb as a result of an airbag deployment. She recovered without other life threatening injuries.