Auto Safety Hunt a Smashing Success : Prevention: Researchers learning from dummies how people are injured in accidents and how to help them, as well as how to prevent injuries.

You can learn a lot from a dummy--but not everything.

The William Lehman Study Center at Jackson Memorial Hospital is helping auto safety experts go far beyond where test dummies like Vince and Larry, the stars of television public service announcements, can take them.

Workers at the center, named for a former Florida congressman who was a leader on trauma issues, are learning how people are injured in automobile accidents and how to help them, as well as how to prevent future injuries.

The Miami researchers, for example, have established a link between liver injuries and the use of automatic shoulder belts.

Without the lap belt, a crash victim’s hips zoom forward until the shoulder belt catches the body at about waist level.

“I think we have very good data showing that your liver doesn’t stop your body as well as your shoulder can,” said Dr. Jeffrey Augenstein, the principal investigator. “Up until now, most of the dummy research didn’t give much information about what was going on inside.”

The finding about liver damage was presented to about 200 people at a quarterly gathering on vehicular safety in June in Washington. Attended by doctors, representatives of all domestic and some Japanese auto manufacturers, and people from all U.S. government agencies involved in highway safety, the quarterly meetings give Augenstein and his staff a chance to share what they’ve learned.

Their research indicated that after a frontal collision emergency response teams should lift deflated air bags and look beneath them: If the steering column or wheel is bent, the victims should be brought to a hospital for closer examination, even if they feel fine.

“The telltale signs of injury are masked,” said Louis Lombardo, a physical scientist at the National Highway Transportation Safety Administration’s office of crashworthiness research.

NHTSA has adopted the lift-and-look suggestion as a recommendation for emergency workers.

“They may be lulled into a false sense of security,” Lombardo said. “They’re used to seeing people bloodied and broken. But now, if a person doesn’t have those signs, even physicians may be misled.”

And that can be dangerous.

“Lurking beneath this undamaged skin you have this little spleen laceration or liver laceration and it kind of explodes,” said Dr. Richard Hunt, associate professor of emergency medicine at East Carolina University. “You suddenly have a huge flow of blood in your abdomen and you end up dying of it.”

Hunt, who has studied motor vehicle crashes since the mid-1980s, noted that recommendations from the study can reduce the dollar costs of such accidents as well.

He tells the story of a patient who arrived incoherent, a sign of head trauma. But a photo of the vehicle he had been in didn’t match that indication: it was barely damaged.

Ordinarily, all of a hospital’s trauma resources, such as an array of expensive tests, would have been brought into play in what Hunt described as a “full-court press costing literally thousands and thousands of dollars” to determine exactly what the man’s problems were.

But guided by the photo, a resident gave him a simple blood test, which revealed he was diabetic. The man responded to an intravenous dose of sugar water.

Even in its early stages, the crash study “already has shown the more you know about the crash, the more you know about the patient. The more you know about the patient, the faster you can intervene,” he added.

Jackson’s crash victims and their vehicles are videotaped and photographed. The images are digitalized and entered into a computer along with records and other observations. Sometimes animated depictions of crashes are prepared as well.

Then the study team gathers to look at displays detailing the injuries and damage, taking notes and discussing what they see.

“It really is some of the most in-depth reconstruction of crashes that I’ve ever seen,” said Hunt.

“I mean, the detail they go into, from sort of even pre-crash events to the end point, whatever that might have been, be it the morgue or the disability or they walked away from it . . . It’s like being in the crash, almost,” he said.

A recent case involved a short, stocky driver who suffered arm burns because of her position. She was so close to the steering wheel that the hot gases which inflated her air bag didn’t have room to escape harmlessly.

“The tube was a direct vent from the generator to her arm,” said accident investigator Jim Stratton.

“One day, they may make smarter air bags based on body types,” Augenstein said.

This year, the program is operating on about $300,000 from the U.S. Department of Transportation--enough for about 50 such case studies.

“As this (information) gets out, lives will be saved, and it will repay the government’s investment many times over,” Lombardo said.