The chances of survival post-collision depend on many things, including:
the speed of response from fire and rescue (FRS) and emergency medical services (EMS)
the ability to extract and treat a victim in the most appropriate manner
the road user themselves (age, gender, size, weight, state of health etc.)
the impairments and physical frailty that come with age. (Older women, in particular, tend to be more frail)
When considering post¬-collision response, it is this physical fragility which is the primary factor leading to a disproportionate injury risk at the time of the collision, and reduced resilience when recovering from these injuries (European Commission, 2015, p.87). This increased risk applies regardless of the severity of the collision.
An older road user is more likely to be killed than a younger road user, even in a moderate collision. One study found that the fatality rate for car drivers is more than 5 times higher for those aged 75 and over than the average for all ages, whereas their injury rate is only two times higher (SafetyNet, 2009, p.4).
Older car occupants (both drivers and passengers), are at a comparative advantage due to the protection given by the vehicle. This is true for car occupants of all ages, but is especially beneficial for older people. Nevertheless, the forces involved in a collision are such that even when inside a vehicle, an older person is more likely to be injured.
For those outside vehicles (the pedestrians, cyclists and powered-two wheeler users), the risks are higher, although overall numbers are relatively low. A 2020 report noted that while people above the age of 65 represent just 20% of the EU population, they account for as many as 47% of all pedestrian deaths and 44% of cyclists killed (ETSC, 2020, p.3).
Once a collision has taken place, the priority for emergency services is to extricate victims and administer medical treatment as required. It is worth noting that in recent years, extrication from vehicles is taking increasingly longer to complete due to more complex vehicle structures (ETSC, 2019). Extrication of any victim is time-critical, but this is especially true for an older person.
Long-term recovery is made more difficult for older people due to physical issues such as reduced mobility, poor health and social issues, including possible isolation and a reduced support network.
One study found that older injured road users had much longer hospital stays and an increased likelihood of being admitted to intensive care units (Oxley et al., (2004), quoted in European Commission, 2015, p.54). A 2012 study found that 43% of all elderly casualties of a road collision were admitted to hospital compared to only 32% of casualties of all ages in total (Broughton et al., (2012), quoted in European Commission, 2015).
Older road users also tend to have a prevalence of certain injury types, such as higher levels of fractures.
For older people, even a small amount of trauma can render them disabled and considerably reduce their quality of life (Monash University, Accident Research Centre, 2004). It is for this reason in particular that rapid and appropriate post-collision care is so important.
Developments in vehicle crashworthiness and vehicle safety technologies in recent years have contributed to improved levels of safety for car occupants in particular. This trend is set to continue as collision avoidance and mitigation systems become more sophisticated and are mandated across vehicle fleets.
A key result of these technologies is a reduced likelihood of severe and life-threatening injuries for all road users, and especially vulnerable ones. The severity and type of collision has a direct bearing on how the post-collision response is delivered and ultimately, how successful it is.
Another recent development in vehicle technology is eCall, which will contact the nearest emergency call centre following a collision. If a passenger or bystander is unable to speak, the system will identify the location of the incident and dispatch the relevant emergency services (European Commission, 2014). Such systems will be of huge benefit to older road users as they will help deliver timely emergency response in situations where those involved are unable to call for assistance.
It is worth noting that the developments in vehicle safety that are so beneficial to car occupants and others, have made vehicle structures increasingly robust and complicated. This leads to much longer extrication times for fire and rescue crews, all of which complicates the process of removing victims and administering care.