WhiteCoat

It’s an MVA, dammit

If you’re an EMT, don’t start lecturing me in front of the patient you just brought in about how she was involved in a “motor vehicle collision” and not a “motor vehicle accident.” I was half joking when I asked you if you meant that she was in a motor vehicle “accident” when she rolled her car in a ditch. Your dissertation about the difference between accidents and collisions afterwards … you aren’t going to win that one.

Unless your patient was in a demolition derby or intentionally ran into another vehicle (which I haven’t seen in 15 years), the wreck was an “accident.” We’ve been using the same terminology for decades. It serves us well. We don’t need to change it.

Yes, in most cases, patients are brought to the emergency department because two vehicles “collide.” So technically, most MVAs are also “collisions.” But what about the rollover that your patient was involved in? What did her vehicle “collide” with? And if a vehicle runs into a ditch before coming to a stop on the other side of the ditch, did it really “collide” with the ditch? Collisions are usually considered a contact between two moving bodies.
I’m also aware of the old argument by “traumatologists” that motor vehicle accidents should be called motor vehicle “crashes” because most fatal crashes are caused by speeding, intoxicated, or distracted drivers, so they shouldn’t be considered “accidents.”

If you want to go all brainiac on me and use the scientific definition of “collision,” then perhaps cars do “collide” with ditches. They also collide with gravel when they’re rolling down a gravel road and I suppose that their tires even collide with the asphalt when they’re driving down the street. So if we’re going to use the scientific definition of “collision,” we probably should use it consistently.

Somehow, the following inbound report, although scientifically proper, just doesn’t work: “the car was colliding on the street asphalt when it collided less frequently with the street at a stop sign and subsequently another vehicle that wasn’t able to collide with the street at the same rate of deceleration accidentally collided with the vehicle in the rear, causing the patient’s shoulder to collide with the seat belt and the patient’s face and upper torso to collide with the air bag.”

Can’t we just agree that the report should be something like “a restrained driver was rear-ended in an MVA with air bag deployment”?

And if you give me an inbound report saying that you’re “en route to your emergency room with a patient who is A and O times four who was involved in a motor vehicle collision and has a low grade fever of 99.1″ … well … let’s just not go there.

Oh, and you left the engine running in your patient transport vehicle.

Why do we call it an “ambulance”, anyway?

13 Responses to “It’s an MVA, dammit”

  1. Vladimir von Winkelstien says:

    So people are trying to use a change in terminology to point out that motor vehicle deaths are largely preventable, with the goal of holding people accountable for their reckless behavior and reducing the number of deaths.

    Deaths which amount to around 35,000 per year in this country. That’s about one 9/11 per month, to give you a little perspective. Every month.

    And you, for some reason, oppose this. Why?

    • WhiteCoat says:

      A driver in an MVA is intoxicated. How exactly does calling it an MVC either change or reflect the fact that alcohol was involved or that the driver was being reckless – if indeed that was the case?

      • Vladimir von Winkelstien says:

        Did the driver accidentally get drunk? Did he accidentally get behind the wheel? Did he accidentally go 50mph in a resedential area? No, he did all of those things on purpose. The predictable result of intentional actions is not an accident.

        Labeling a collision an “accident” implies that nobody is at fault. In the vast majority of motor vehicle collisions, somebody is at fault, and that somebody was doing something extremely stupid. By refusing to excuse their stupidity, we promote the idea that reckless driving is socially unacceptable, and should be punished or otherwise deterred.

        And that last bit is what helps keep people from driving drunk or recklessly.

  2. Paul says:

    Well, since it’s your Emergency ROOM, we can be as pedantic as you want!

  3. Snarky Scalpel says:

    And any particular reason why you have traumatologists in ”? It is a perfectly valid surgical subspecialty of people who deal with any and all sorts of trauma, from sprained ankles to complex pelvic fractures, up to and including stabilizing the critical patients upon arrival to the ED. You know, the kind of surgeon who sees to their patients start to finish and doesn’t need you to intubate, start a line and feel like you’ve done most of the job?

  4. CJL says:

    I couldn’t care less if it’s called an MVA or an MVC… but why do you care so much that the emergency department is called the emergency DEPARTMENT and not the emergency room, and then begrudge someone else for trying to add some accuracy to their description of the patient?

  5. Patrick says:

    Your point would be moot except the EMT curricula, national EMS database, and most everything that is holy and modern in EMS all refer to them as MVC’s now. Maybe started with PHTLS or one of the trauma programs?

  6. SeaSpray says:

    Actually … Freud said there are no accidents. ;)

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