AIR BAGS ALONE COMPARED WITH THE COMBINATION OF MECHANICAL RESTRAINTSAND AIR BAGS - IMPLICATIONS FOR THE EMERGENCY EVALUATION OF CRASH VICTIMS

Background. Air bags (ABs) may be perceived by the public and physicia ns as protection for thoracoabdominal injuries. This study compares in jury patterns when air bags are used alone with injury patterns when a ir bags plus mechanical restraints (MRs) are used. Methods. Patients t reated over a 4-year period with emergency medical services-documented AB deployment alone (n = 16) or AB plus MR (n = 22) were identified b y trauma registry query. Medical records were reviewed and injuries re corded. Results. Air bag-alone users had more severe overall (injury s everity score greater than or equal to 15:9 vs 5), chest (abbreviated injury score [AIS] greater than or equal to 3:5 vs 1), and abdominal i njuries (AIS greater than or equal to 3:6 vs 6). They required more tu be thoracostomies (5 vs 0) and laparotomies (6 vs 0), longer hospitali zations (11.9 +/- 3.2 vs 5.3 +/- 1.4 days), and more intensive care un it admissions (8 vs 1). Craniofacial injuries (AIS greater than or equ al to 3:6 vs 6) and fractures were similar. More victims using air bag s alone required inpatient rehabilitation and some patients died (6 vs 1). Conclusions. Crash victims using air bags alone (vs AB plus MR) h ad increased injury severity, hospitalizations, thoracoabdominal proce dures, and rehabilitation. Physicians must be aware of the incomplete protection by air bags alone.