CHICAGO — Automatic crash notification (ACN) systems should become a standard safety feature in every new vehicle, like seat belts and air bags, according to a new paper by members of the American College of Surgeons Committee on Trauma (ACS COT), published in the Journal of the American College of Surgeons (JACS). The authors note that, today, ACN is often offered as a premium connected-vehicle service that may stop working when a subscription expires.
The authors recommend nationwide adoption of ACN and advanced automatic crash notification (AACN), along with a standardized approach to share and interpret crash data among automakers, emergency responders, trauma experts, and federal agencies.
ACN alerts emergency responders after a serious collision. It can provide the vehicle’s location and, in many systems, establish voice communication between an operator and the people inside the vehicle. AACN systems also transmit detailed crash information that helps emergency responders estimate injury severity before arriving at the scene. The paper draws on prior research, including National Highway Traffic Safety Administration modeling that estimated AACN systems could save between 360 and 721 lives each year.
“Seat belts and air bags are standard because they are safety features, not luxury services. Automatic crash notification should be treated the same way,” said lead author Theresa L. Chin, MD, MPH, FACS, a trauma and burn surgeon at UCI Health. “In a serious crash, the system can tell EMS where the crash happened and provide early signs on the severity of crash and potential for significant injury. That can help the right resources start moving sooner, especially in rural communities where help may be farther away.”
Minutes Matter After a Serious Crash
Longer delays between a crash and notification of emergency medical services have been associated with a greater risk of death, particularly in rural areas. ACN can shorten that interval by automatically reporting the crash, its location, the time of the crash, even if occupants are unconscious, disoriented, or otherwise unable to call 911. AACN can add vehicle telemetry (data such as the change in vehicle speed, rollover, airbag deployment, and restraint status) to provide an early estimate of how likely there is to be severe injury.
Information showing that a vehicle rolled over several times may prompt a different response than a low-speed collision. Information on seat belt use and two-way communication with occupants may help responders determine how many people are involved and whether multiple ambulances are needed. The data may support decisions about deploying specialized trauma care such as advanced life support units, air medical transportation, extrication equipment (for example, the “jaws of life”), or direct transport to a trauma center.
Safety Technology Should Not Be Bundled with Convenience Features
Many ACN systems are packaged with paid connected-vehicle services such as remote start, door locking, mobile Wi-Fi, roadside assistance, or concierge features. As a result, drivers may unknowingly lose crash notification when a complimentary trial ends or when they cancel a package of services they don’t otherwise use.
Dr. Chin said she discovered, while working on the project, that ACN in her own family’s vehicle was no longer active because the bundled subscription had not been renewed. In fact, at a conference in a room of trauma professionals, “only one person knew that their vehicle had an active crash notification service,” she added.
The European Union has required inclusion of an emergency notification system known as eCall in all new vehicles since March 2018. The system automatically contacts emergency services following a serious crash and does not require a paid subscription.
How Drivers Can Check Their Vehicle
Drivers can take several steps to determine whether their current vehicle has ACN or AACN:
- Search the owner’s manual or manufacturer’s app for terms such as “automatic crash notification,” “emergency call,” “connected services,” “911 assist,” “eCall,” or “SOS.”
- Look for an SOS or emergency button, often located near the rearview mirror or overhead console. The presence of a button is a clue, but drivers should still confirm that the service is activated.
- Check whether the system requires a paired phone or an active subscription. Some systems use a built-in cellular connection, while others work only when the driver’s phone is connected through Bluetooth.
- Use the vehicle identification number (VIN) when contacting the manufacturer or dealership to confirm whether ACN or AACN was included in that specific model, model year, and options package.
“Most people assume that the safety systems built into their vehicle will be available when they need them,” Dr. Chin said. “Drivers should not have to discover after a serious crash that an emergency feature was tied to a premium service they stopped paying for.”
ACS Calls for Standard Access and Better Data Sharing
The ACS COT has previously issued a statement supporting:
- Making ACN and AACN standard in all new motor vehicles without additional subscription fees, while improving availability and connectivity in rural areas with limited cellular coverage.
- Developing reliable pathways for crash information to reach 911 centers and emergency response systems, with more consistent technical standards across automakers.
- Making ACN and AACN data available for research by injury prevention scientists and trauma system experts studying crashes, EMS response times, and injury patterns.
- Supporting federal research and collaboration with National Highway Traffic Safety Administration and other organizations to better understand how vehicle data can improve communication among 911 centers, EMS agencies, and hospitals.
The authors of the JACS’ paper also emphasize the need for common definitions across manufacturers. A notification that describes a crash as having a “high risk” of severe injury should have a consistent and clinically useful meaning regardless of whether the vehicle was made by one automaker or another. Standardization could help emergency responders and clinicians use the information more efficiently, particularly in communities with limited personnel, transportation, or hospital resources.
“Injury prevention does not end when a crash occurs; it also means reducing the harm that follows,” said co-author Leah C. Tatebe, MD, FACS, chair of the ACS COT Injury Prevention Program Area and associate professor of surgery at Northwestern University Feinberg School of Medicine. “This information could close a dangerous gap between time of crash and treatment. That protection should be built into every new vehicle, not reserved for people who can afford an ongoing subscription.”
Co-authors are Julie Y. Valenzuela, MD, FACS; Thomas Duncan, DO, FACS; Peter E. Fischer, MD, FACS; Alexandra Briggs, MD, FACS; Alexis Moren, MD, MPH, FACS; David S. Shapiro,MD, MHCM, MEd, CPHQ, FCCM, FACS; Anne Rizzo, MD, FACS, DABS; Haley Etskovitz, DO, MBS; Leah C. Tatebe, MD, FACS; Brendan T. Campbell, MD, MPH, FACS; and Eileen Bulger, MD, FACS.
This study is published as an article in press on the JACS website.
Citation: Chin TL, Valenzuela JY, Duncan T, et al. Advanced Automatic Crash Notification Systems: It Is Time to Adopt Potentially Life-Saving Technology. Journal of the American College of Surgeons, 2026. DOI: 10.1097/XCS.0000000000002168
