I have made a point of asking the question: ‘What is the most likely thing to cause us harm at the scene of any road traffic collision?’ and I would estimate that well over 90% of the time the answer is simple: airbags.
I recently published an online article using the headline photo which is, of course, fake and created by me. Most of my articles may get 1,000–2,000 views, but as I write, the piece in question has been seen by over 33,000 people and counting. This has taught me two things. Firstly, the issue of undeployed airbags at the scene of a road traffic collision (RTC) is still a big topic of conversation for emergency responders all around the world and secondly, when writing an article, choose the right picture!
For the last decade, my work with the world’s emergency services has led me to conclude that this issue dominates their thought processes when it comes to scene safety.
Whilst awareness of airbags and supplementary restraint systems (SRS) is vital for the safety of responders, the risks must be kept in context, especially when compared to other potential hazards that are present at the scene of an RTC. So why does this issue dominate discussion? Why does it appear to be at the top of everyone’s list when it comes to risk? Well firstly, let’s discuss the likelihood of this happening.
Data relating to any area of RTC extrication is scarce and there are very few studies that have been done. To my knowledge, there is no statistical data relating to the number of airbags that have gone off during an extrication (causing injury or not), and as an industry we simply have to rely upon reported incidents which, while far from scientific, is the best information we have. Those of us who work, or have worked, in the emergency services know that it is a global family, and instances of death or serious injury soon reach us no matter where we are. This has been expedited by the use of the internet and social media, and communication is now almost immediate. If there is a serious event involving an emergency responder and an airbag, we will hear about it very quickly, no matter where in the world it occurs.
We have only one documented occurrence of an airbag deploying during an extrication; luckily it was also caught on camera, but I will discuss the merits of that video later. It was in Dayton, Ohio, USA and it occurred in August 1994. It caused injury to two firefighters on the scene. As part of the follow-up to the incident, emergency responders tried to recreate the conditions under which it happened. They used the same vehicle (Mitsubishi Galant) and tried to create a short circuit in the vehicle’s electronic control unit (ECU) by contacting the tips of their hydraulic spreaders – this being the cause of the original incident. Despite all their efforts, they were unable to deploy the airbag.
To be fair, I have been notified of several other instances of airbag deployment, but they have only ever been anecdotal, and I have never seen any factual reports or details of causation, consequence or injury.
So, if we have only one notable occurrence in 37 years (airbags were introduced widely to the market in some high-end vehicles in 1981), does this constitute a problem? Do those statistics warrant the subject of airbags being uppermost in the mind of the world’s emergency responders and should it be the first thing mentioned regarding scene safety? Consider how many extrications have taken place around the world in that time, many tens of thousands. Yet we have only one notable occurrence.
Let me go back to the Dayton incident and the subsequent video that is widely available. That video is the reason why this issue has become what it is. I have no doubt that the news reel has done brilliant work in raising awareness of the subject, but it has long been counterproductive by taking the issue way out of context. Additionally, almost on a daily basis I see extrication training courses where the instructors demonstrate an airbag by firing one off. Whilst this is a spectacular demonstration, and certainly memorable, I doubt that the risks from deployment during extrication are truly being put into context in the minds of the students.
Just as worrying is the fact that this is not just confined to the minds of technical rescuers. The increase in multi-agency training means that this mindset is not firmly planted in the approach adopted by medical responders. I often train doctors and paramedics, and when I ask them the same question in relation to scene safety, once again the first answer is nearly always airbags.
This brings me onto the subject of patient care. I have witnessed first-hand how our approach can restrict our operational options and adopting the 5-10-15-20-inch safety rule (5 inches from a side airbag, 10 inches from a driver’s airbag, 15 inches from a side curtain and 20 inches from a passenger airbag) leaves us very little space to enter the vehicle or to treat a patient if we apply that rule to the letter of the law. My view is quite simple: the 5-10-15-20 rule is outdated and does not take into account additional airbag systems and other SRS. It was conceived 20 years ago when most vehicles had a minimum number of airbags. The answer is to limit your exposure to the areas around undeployed systems, but do not allow it to compromise patient care.
The final consideration in the ‘likelihood’ debate is the most difficult: operational skill and competency. Many of the world’s emergency responders are well trained. They have a good knowledge of safe systems of work, procedures, equipment and techniques. Additionally, they have a good working knowledge of vehicles in terms of anatomy, construction and safety systems. They understand the patient and the medical aspects of rescue. Yet, the vast majority of the world does not operate at the highest level in terms of skill and understanding. It is a sad fact, but it is the reality. For many political and financial reasons, there is a huge disparity across the world.
So, when we look at the environment in which we have to contextualise the risks from undeployed airbags we must consider the following factors:
- Airbags have been available commercially since 1981 and they are now prevalent on most of the world’s road-going vehicles, usually with a minimum of six airbag systems
- The number of collisions and subsequent extrications that take place every year around the world – many tens of thousands
- The disparity in skill level and understanding across the world’s emergency responders, which includes a lack of understanding of vehicles and their safety systems
Remember too, we have become very adept at dealing with these systems and for most, removing ignition keys and powering down vehicles is now second nature. Additionally, newer vehicles have capacitors that drain in seconds, not minutes. Therefore, the vehicle loses any electrical charge even before the emergency services have responded from their department or station.
If we consider the real likelihood of activation during extrication and use a standard risk-assessment methodology, it would score very low, and much lower than other issues on scene. I am not saying for one minute that there is not a risk from these systems; that would be foolish, but I cannot comprehend why, in 2018, it still dominates discussion.
Whilst there is no data relating to airbag injuries to first responders, there is data published by many countries in relation to injuries and deaths suffered by firefighters and paramedics/EMS. We really should be discussing issues like passing traffic, sharp edges, falling over, manual handling issues and cardiac arrests, all of which cause more serious injuries and deaths to emergency responders than airbags.
Airbags have been widely available since the early 1980s and despite tens of thousands of extrications in that time, we have only one documented case of an airbag deploying during rescue operations – an incident that could not be replicated under controlled conditions. Despite this one event in nearly 40 years, I can report that worldwide this issue dominates discussions in relation to scene safety; our collective focus is on this one single topic which can directly affect patient care. This approach is now spreading to other agencies, perpetuating the issue while the 5-10-15-20-inch rule is outdated and serves little purpose with most of today’s modern vehicles having multiple systems. It is simply unworkable.
We must keep the issue of undeployed airbags in context, limit our exposure in the identified areas of ‘risk’ and ensure we power down the vehicle. Then we can get on with the business of rescue.
Finally, please remember that statistically you are more likely to be injured whilst cooking in your fire department, getting dressed into your fire kit, or travelling home from work than you are from an undeployed airbag during an extrication. It’s funny that no one ever mentions these risks; I guess they are just not interesting enough.
For more information, go to www.iandunbartrainingandconsultancy.com