![]() ![]() Laboratory testing varies in sensitivity and specificity in MVC patients. Neurologic disability should be briefly evaluated, and full exposure of the patient should take place to ensure no missed injuries. Vital signs and the shock index should be trended for deterioration. Thoracic injuries due to seat belt force include sternal fracture, rib fracture, pulmonary contusion, and more rarely myocardial contusion.Īirway (with cervical spine protection), breathing, and circulation should be assessed first in all patients. When the seat belt impacts the neck, the clinician may diagnose the cervical vascular injury, cervical spine fracture, or clavicle fracture. Likewise, injuries to the pancreas, kidneys, and any other visceral organ can occur. Solid-organ injuries such as liver and spleen laceration can occur in these patients. Skin abrasions and bruising occur on the surface, while common internal injuries are bowel and mesenteric injuries, along with fractures of the lumbar spine. The "seat belt syndrome" referred to the musculoskeletal and visceral injuries associated with the force transmitted by the seat belt. The "seat belt sign" was first described by Garrett and Braunstein in 1962 as an ecchymosis across the abdominal wall in the location of a lap belt. The seat belt can act as a fulcrum, with a point of contact remaining fixed in the same location while the areas above and below continuing forward. When a seatbelt rests on the neck or well above the ASIS, force is transmitted to the softer neck area and the more vulnerable abdominal viscera.Īll injury patterns are explained by the transmission of physical force. Seat belts are designed to transmit the energy to the clavicle, chest wall, and superior pelvis (anterior superior iliac spine ). High vehicle speed, vehicle rollover, passenger ejection, and loss of consciousness with a low Glasgow coma scale (GCS) are predictive of more force transmission and, therefore, severe injury. Injury in MVC trauma is related to change in velocity and dissipation of energy. ![]()
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