Automatic collision notification availability and emergency response times following vehicle collision-an analysis of the 2017 crash investigation sampling system.

OBJECTIVE

To determine whether occupants of collisions involving at least one vehicle with an available Automatic Collision Notification (ACN) system have quicker times from collision to 1) Emergency Medical Services (EMS) notification and 2) arrival to a medical center.

METHODS

Using data from the 2017 Crash Investigation Sampling System, vehicles were categorized as whether ACN was available using data from the CISS's dataset of crash avoidance system availability (in which ACN is included though notably not a crash avoidance system). A Cox proportional hazards model-overall and stratified by urbanization-was used to compare the time from collision to both EMS notification and EMS arrival to a medical center.

RESULTS

A total of 2,034 collisions (weight n: 2,775,512) involving 4235 occupants (weighted n: 4,987,669) were included. An estimated 259,021 (9.3%) and 546,223 occupants (11.0%) were in a collision in which one vehicle had ACN equipped. The median time to EMS notification was longer for collisions in which no involved vehicles had ACN available (median 4, IQR 2-9 minutes) than ACN-exposed collisions (median 2, IQR 1-5 minutes). There was a marginally significant higher hazard (i.e., instantaneous risk) of EMS notification for collisions with at least one vehicle having ACN available (HR 1.77, 95% CI 0.99-3.15). Likewise, there was a higher instantaneous risk of medical center arrival for occupants (HR 1.80, 95% CI 1.41-2.30) involved in collisions in which at least one vehicle had ACN available. ACN was associated with quicker EMS notification only in urban areas (HR 3.06, 95% CI 1.57-5.97) and associated with a greater reduction in time to medical facility in less urban areas (median 36 vs 45 minutes, HR 2.12, 95% CI 1.22-3.63).

CONCLUSIONS

This is the first study to directly compare EMS response-related times between collisions involving vehicles with and without ACN available. The current data corroborate prior literature reporting quicker EMS notification times among collisions involving ACN-equipped vehicles. This is the first study to find that ACN is also associated to quicker times to medical center arrival, particularly for collisions occurring in less urban areas. Future research examining whether these decreased times are associated with better clinical outcomes are needed in order to fully assess ACN's ability to prevent trauma-related mortality and morbidity.