Pedestrian safety: a road safety manual for decision-makers and practitioners <br />Attach <br />BOX 4.9: Crash test procedures to assess pedestrian safety <br />Test procedures to assess the extent to which a <br />vehicle protects a pedestrian in the event of a colli- <br />sion are now well established in both regulation and <br />consumer advisory programmes (46). Unlike impact <br />tests to assess the protection of car occupants, <br />which utilize full-scale crash test dummies, the <br />pedestrian crash tests simulate impact between the <br />car and the legs, hip and head of the pedestrian. This <br />is largely because of difficulties in ensuring repeat- <br />ability in full-scale collisions between a pedestrian <br />dummy and a car, as well as concerns about the <br />ability of a full-scale pedestrian crash test dummy to <br />be life-like in appearance or responses (47). Current <br />pedestrian impact test procedures are largely based <br />on specifications presented by the European Experi- <br />mental Vehicles Committee (EEVC) Working Group <br />in 1987. In particular, 40 km/h was chosen as the <br />vehicle test speed because it was thought in 1982 <br />that it was representative of impact speeds resulting <br />in serious injury to the pedestrian and some doubt <br />about the ability of car designers to satisfy the test <br />requirements at higher speeds (48). <br />4.2.6 Providing care for injured pedestrians <br />The primary goal in pedestrian safety should be to prevent road crashes from <br />happening in the first place. However, pedestrians do get injured, despite the <br />best efforts and intentions. An efficient post-crash care response can minimize <br />the consequences of serious injury, including long-term morbidity or mortality. <br />Pedestrians struck by motor vehicles with high energy transfer end up with high <br />residual locomotion disability and also have significantly higher mortality rates <br />than occupants of vehicles (49). Injury patterns in pedestrians are unique - in adults <br />injuries to legs, head and pelvis are common. In children, injuries to head and neck <br />followed by musculoskeletal injuries are commonly noted. In general, head injuries <br />are more life-threatening while limb injuries are associated with long-term disabilities. <br />The severity of these injuries depend upon many factors, including energy transfer <br />(speed of the vehicle), angle of impact, the body part that first comes into contact with <br />the vehicle and vehicle design (see Module i). The considerations for organization and <br />delivery of post-crash care should take into account these factors (So). <br />Post-crash care includes a sequential set of actions and care aimed to reduce <br />the impact of injury consequences once a road traffic crash has occurred (see <br />Figure 4.1). Patients suffering minor injuries may not need advanced medical care <br />or hospitalization. For victims of major injuries, a chain of care is needed, consisting <br />of action taken by bystanders at the scene of the crash, access to the pre-hospital <br />medical care system, emergency medical services, definitive trauma care at the <br />hospital and rehabilitation services to re-integrate the victims into work and family <br />life. The effectiveness of such a chain and the outcomes of the injured depend upon <br />the strength of each of its links (Sr). In a fully developed trauma system, trauma care <br />delivery is organized through its entire spectrum, from injury prevention to pre- <br />hospital, hospital and rehabilitative care for the injured pedestrian and other road <br />users in an integrated way. <br />85 <br />C <br />B <br />