County of San Diego Division of Emergency Medical Services EMS Multivictim Motor Vehicle Crashes in San Diego County Alan M. Smith, MPH; Edward M. Castillo, PhD, MPH; Barbara M. Stepanski, MPH; Leslie Upledger Ray, MA, MPPA County of San Diego Health and Human Services Agency, Division of Emergency Medical Services

County of San Diego Division of Emergency Medical Services EMS Multivictim – Annex D Tour bus rollover in snow 30 miles from nearest hospital 39 casualties 7 Hospitals –5 trauma centers 6 Ambulance Agencies –11 units 3 Law Enforcement Agencies California OES

County of San Diego Division of Emergency Medical Services EMS Background: Multivictim Crashes 7% of crashes 5 or more victims Large demand on resources –Emergency Medical –Hospital –Law Enforcement –Media coordination Incident Command Structure –Triage, crowd control, hazard management Communication –patient destinations

County of San Diego Division of Emergency Medical Services EMS San Diego County EMS Injury Surveillance Integrated Injury Surveillance System –Prehospital –Trauma System –Medical Examiner –SWITRS –GIS

County of San Diego Division of Emergency Medical Services EMS Methods: Data Statewide Integrated Traffic Records System (SWITRS) –Maintained by California Highway Patrol –Injury crashes for San Diego County –MVO crashes stratified by number of victims: 1, 2-4, 5-9, 10+ –Fiscal year 2000/01

County of San Diego Division of Emergency Medical Services EMS Methods: Analysis Number of victims in crash by: –Location –Time Hour, Day of Week, Month –Violation category –Type of collision

County of San Diego Division of Emergency Medical Services EMS Multivictim Crashes During FY 00/01, crashes with 5+ victims accounted for: –7.3% of crashes –21% of MVO victims –15% of MVO injuries –17% of MVO deaths

County of San Diego Division of Emergency Medical Services EMS Death Rate Per 1,000 Injuries by Number of Victims Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Number of Parties Involved Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Leading Violation Categories by Number of Victims in Crash Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Leading Collision Types by Number of Victims in Crash Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Number of Victims by Road Type Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Crashes by Month and Number of Victims Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Multivictim Crashes by Month Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Crashes by Day of Week Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

County of San Diego Division of Emergency Medical Services EMS Multivictim Crashes by Day of Week Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SWITRS database, FY 2000/01

Source: County of San Diego Health and Human Services Agency, Division of Emergency Medical Services, SANDAG Population Estimates, 1999.

County of San Diego Division of Emergency Medical Services EMS Map – Multi Victim Crashes

County of San Diego Division of Emergency Medical Services EMS Map – Multivictim by Number of Parties

County of San Diego Division of Emergency Medical Services EMS Results - Summary Multivictim MVO crashes made up –7% of MVO crashes –21% of victims –17% of deaths Violation categories: –Unsafe speed overall –Traffic signals/signs higher in multivictim Collision types: –Rear end overall –Collision with object lower in multivictim

County of San Diego Division of Emergency Medical Services EMS Results – Summary Time –Peak in summer months, weekends Parties –58% involve one or two victims Location –High population density (3+ parties) –Intercounty travel corridors (1-2 parties)

County of San Diego Division of Emergency Medical Services EMS Conclusions Multivictim crashes more often during non- work times (weekends, summer) Multi-vehicle crashes in areas with high traffic volume Single-vehicle crashes more likely on more open freeway corridors Emphasize importance of passenger safety – no more passengers than seat belts

County of San Diego Division of Emergency Medical Services EMS Conclusions (cont.) BIG events uncommon –1-2 per year with >=20 victims Majority 1-2 parties –Emphasize seatbelt use Majority not on freeways Multiparty crashes in urban settings –Defensive driving

County of San Diego Division of Emergency Medical Services EMS Limitations Only 1 year of data Limited info on drivers –Residence –Destination Not linked to ambulance data

County of San Diego Division of Emergency Medical Services EMS Acknowledgements The data collection efforts of the police and sheriff departments throughout the County are gratefully acknowledged, as is the cooperation of State staff for providing the SWITRS data to San Diego County.

County of San Diego Division of Emergency Medical Services EMS Contact Information Alan M. Smith County of San Diego Health and Human Services Agency Emergency Medical Services 6255 Mission Gorge Road San Diego, CA (619) phone (619) fax