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  University of Washington, Harborview Medical Center

The Harborview Injury Prevention and Research Center has been operating as the Seattle CIREN center since the inception of the program in 1996, and is a component of both the University of Washington and Harborview Medical Center. To date, the team has completed over 600 cases into the CIREN network database and has published numerous articles regarding crash injury mechanisms. Led by Dr. Eileen Bulger, the investigators have utilized CIREN data with focus on vehicle incompatibility, roof crush in rollovers, spinal injuries, childhood injury patterns due to restraint misuse and the analysis of injury severity predictors for Automatic Crash Notification (ACN) systems. For many years, the team has given numerous presentations using CIREN findings to train thousands of first responders and trauma care providers throughout the northwest and nationally to improve the triage and treatment of crash victims.



Giana H. Davidson, MD, MPH, Frederick P. Rivara, MD, Christopher D. Mack, MS, Robert Kaufman, BS, Gregory J. Jurkovich, MD, and Eileen M. Bulger, MD, Seattle, Washington Validation of prehospital trauma triage criteria for motor vehicle collisions, J Trauma Acute Care Surg. Volume 76, Number 3, 2014.

Bradley D. Figler, MD, Christopher D. Mack, MS, Robert Kaufman, BS, Hunter Wessells, MD,Eileen Bulger, MD, Thomas G. Smith III, MD, and Bryan Voelzke, MD. Crash test rating and likelihood of major thoracoabdominal injury in motor vehicle crashes: The new car assessment program side-impact crash test J Trauma Acute Care Surg - Volume 76, Number 3, 2014


Kaufman R, Ching R, Mack C, Gross J, Bulger E. Burst Fractures of the Lumbar Spine in Frontal Crashes, Accident Analysis and Prevention – 59 (2013 Oct.) pp. 153-163 - DOI: 10.1016/j.aap.2013.05.023.


Ayoung-Chee P, Mack C.D., Kaufman R., Bulger E., Predicting Severe Injury Using Vehicle Telemetry Data - Journal of Trauma, Vol.74, Number 1 –2012 AAST Plenary Paper


Burns, S Mack C, Kaufman R, Bulger E. "Cost of Spinal Cord Injuries Caused by Rollover Automobile Crashes." Injury Prevention 2010; 16:74-78

Mandell S, Kaufman R, Mack C, Bulger E. "Mortality and Injury Patterns Associated with Roof Crush in Rollover Crashes" Accident Analysis and Prevention 42 (2010) 1326-1331

Mandell S, Kaufman R, Mack C, Bulger E."Describing a Problem: Rear Seatback Malfunction and Unsecured Cargo Prehospital and Disaster Medicine 2010; 25 (2) 152-157

Smith TG 3rd, Wessells HB, Mack CD, Kaufman R, Bulger EM, Voelzke BB. Examination of the Impact of Airbags on Renal Injury Using a National Database Journal American College Surgeons. 2010 Sep: 211(3):355-360, Epub 2010 Jul 14. PMID: 20800192


Maheshwari R , Mack C, Francis D, Kaufman R, Bulger E, Nork S, Henley B. The Effect of Obesity on Outcomes among Trauma Patients with Lower Extremity Orthopaedic Injuries (Journal of Orthopaedic Trauma, 23(9): 634-639, October 2009


Bulger E, Kaufman R, Mack C. "Childhood Crash Injury Patterns Associated With Restraint Misuse: Implications for Field Triage." Prehospital Disast Med 2008;23(1):9-15.

Dissanaike S, Kaufman R, Mack C, Mock C, Bulger E. “The Effect Of Reclined Seats On Mortality In Motor Vehicle Collisions”. The Journal of Trauma, Injury, Infection and Critical Care. 2008 Mar; 64(3):614-9


Kuan JK, Kaufman R, Wright JL, Mock C, Nathens AB, Wessells H, Bulger E. - Renal Injury Mechanisms in Motor Vehicle Collisions: Analysis of the Crash Injury Research and Engineering Network (CIREN) Cataset. Journal of Urology -Vol. 178, 935-940, September 2007

Linnau K., Blackmore C., Kaufman R., Nguyen, T., Routt M., Stambaugh L., Jurkovich G., Mock C. Radiographic patterns of pelvic ring disruptions: Do initial radiographs tell the truth about the crash? Journal of Orthopaedic Trauma. 21(6):375-380, July 2007.


Francis DO, Kaufman R, Yueh B, Mock CM, Nathens AB. “Air bag induced orbital blow-out fractures” 2006. Laryngoscope, 116 September 2006


Bennet T., Kaufman, Schiff M., Mock C., Quan L. “Crash analysis of lower extremity injuries in children in forward-facing car seat during front and rear impacts.” The Journal of Trauma, Injury, Infection and Critical Care 2006;61-592-597

Tencer A., Kaufman R., Huber P., Mock C. "The Role of Door Orientation on Occupant Injury in a Nearside Impact: A CIREN, MADYMO modeling and Experimental Study." Traffic Injury Prevention, 6:372-378, 2005

Tencer A., Kaufman R., Conway, C. "Reducing Primary and Secondary Impact Loads on the Pelvis During Side Impact" 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV) Conference, Washington, D.C., June 2005 Paper No. 05-0036

Tencer A., Kaufman R., Mack C., Mock C. "Factors Affecting Pelvic And Thoracic Forces In Near-Side Impact Crashes: A Study Of US-NCAP, NASS, And CIREN Data." Accident Analysis and Prevention - 37 (2005) 287-293.


Acierno S, S, Kaufman R, Mock C, Rivara F, Grossman D. "Vehicle Mismatch: Injury Patterns And Severity." Accident Analysis and Prevention 39 (2004) 761-772.

Ebel B., Mack C., Diehr P., Rivara F. "Lost Working Days, Productivity, And Restraint Use Among Occupants Of Motor Vehicles That Crashed In The United States." Injury Prevention 2004; 10:314-319

Nirula, R, Mock C., Nathens A., Grossman, D. "The New Car Assessment Programs: Does It Predict The Relative Safety Of Vehicles In Actual Crashes?" The Journal of Trauma Injury Infection & Critical Care 2004; 57:779-786

Rivara F, Cummings P. "Car Occupant Death According To The Restraint Use Of Other Occupants: A Matched Cohort Study." Journal of the American Medical Association Jan 21;291(3):343-9, 2004


Ebel B, Grossman D. "Crash Proof Kids? An Overview Of Current Motor Vehicle Child Occupant Safety Strategies." Current Problems Pediatric Adolescent Health Care 2003 Feb;33(2):38-55.

Nirula R, Mock CN, Kaufman R, Rivara FP, Grossman D. "Correlation Of Head Injury To Vehicle Contact Points Using Crash Injury Research And Engineering Network (CIREN) Data." Accident Analysis and Prevention, 35: 201-210, 2003.

Nirula R, Kaufman R, Tencer A. "Traumatic Brain Injury And Automotive Design: Making Motor Vehicles Safer." Journal of Trauma Injury Infection & Critical Care, 55:844-8, 2003.


Assal M., Huber P, Tencer A, Rohr E, Mock C, Kaufman R. Are Drivers More Likely To Injure Their Right Foot Or Left Foot In A Frontal Car Crash: A Crash And Biomechanical Investigation? Annual Proceedings of the Association for the Advancement of Automotive Medicine, 46: 273-288, 2002.

Mock C, Grossman D, Rivara F, Kaufman RP, Mack CD, Rivara FP. “The relationship between body weight and risk of death and serious injury in motor vehicle crashes.” Accident Analysis and Prevention, 34: 221-228, 2002.

Rivara FP, Cummings P, Mock C. "Injuries And Death Of Children In Rollover Motor Vehicle Crashes In The United States." Injury Prevention 2003; 9(1):76-80. Advancement of Automotive Medicine, 46: 273-288, 2002.

Tencer A, Kaufman R, Ryan K, Grossman D, Henley B, Mann F, Mock C, Rivara F, Wang S, Augenstein J, Hoyt D, Eastman B. Femur Fractures in Relatively Low Speed Frontal Crashes: The possible role of muscle forces, Accident Analysis and Prevention, 34 (2002) pp 1-11.

Tencer A, Mirza S, Bensel K, Internal Loads in the Cervical Spine During Motor Vehicle Rear-End Impacts, Spine, Vol. 27, No. 1, pp 32-42, 2002.


Rivera, L., Peitzman, A. B. & (2001). Contributions of Age and Gender to Outcomes of Blunt Splenic Injury in Adults: Multicenter Study of the Eastern Association for the Surgery of Trauma. in Proceedings of the Fourteenth Annual Scientific Assembly of the Eastern Association for the Surgery of Trauma (p. page 46).

Pacyna SE, Erwin SM, Vaughan TM, Kracun M. "Crash Injury Research and Engineering Network." Orthopedic Trauma Association 17th Annual Meeting, San Diego CA, October, 2001


Rivara F, Koepsell T, Grossman D, Mock C, “Effectiveness of automatic shoulder belt systems in motor vehicle crashes.” Journal of the American Medical Association, Vol 283, pg. 2826-2828, June, 2000.

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