Injuries Following Automobile Accidents
Impact and intensity of automobile injury depends on direction of traveling, speed of traveling and collisions. If vehicle is hit from behind then chances of severe vehicle damage and injury is less likely, unless vehicle is rolled over multiple time or rear impact leads to turning of vehicle upside down. Intensity of automobile injury depends on use of the seat belt and injuries to vital anatomical structures. Life threatening or restricting car injuries are often seen following injuries of head, neck, chest and abdomen. Car accidents resulting in head-on collision at high speed is often fatal. Car accident involving side impact in most cases results in moderate impact and restricted destruction of vehicle, unless heavy trucks bump automobile from the side.
Report of U.S. Census Bureau of Fatal Automobile Accidents
U.S. Census Bureau had published in 2012, statistical data of the fatal automobile accident in United States. Information was obtained from data of U.S. National Highway Traffic Safety Administration report. Data was analyzed from 1999 to 2009. In 1999, total number of accident was 11.5 million and fatal outcome were 46,800 deaths. Number of automobile accident decreased in 2009 to 10.8 million and mortality rate was 35,900 patient, who were found dead either at the site of car accident or in the hospital. Number of car accidents and deaths (fatal injuries) has decreased since 2009. Fatalities in 2010 was 32,885 and in 2011 it was was 32,310.
Automobile Association of America (AAA) had published a report in 2008 of average cost of providing treatment for fatal and non-fatal accident. Reports suggest cost of treatment for non-fatal accident was $68,170 and for fatal cases cost of treatment was 3.2 million dollar per patient. AAA estimates total annual cost of 166.7 billion dollars for treatment of all automobile accident.
Types of Injury Following Automobile Accident
Injuries often seen following automobile accident are mild, moderate or severe injuries. Few accident victims are found fatally injured following head-on collision or multiple impacts causing brain injury or neck fracture. Multiple injuries are often seen with multiple collisions, multiple impacts, and vehicle turning upside down or having rolled over. In few instances, senior citizens may suffer with severe heart attack causing sudden death.
Mild Injuries Following Automobile Accident:
Skin Abrasion: Skin abrasion may result from brushing and/or contact against uneven surface. Abrasion without hematoma suggests mild impact and less often severe internal injury.
Subcutaneous Hematoma With Or Without Abrasion: Hematoma is collection of blood within subcutaneous tissue. Subcutaneous hematoma may occur from tear of blood vessels within skin, subcutaneous tissue or muscles. Mild impact may cause subcutaneous hematoma from tear of blood vessels within skin or subcutaneous tissue. Further investigation is necessary to rule out internal tissue damage like fracture, dislocation or visceral (internal organ) tear depending on area of body indicating hematoma and size of hematoma. Hematoma if extensive and spread over 2 to 4 inches in diameter then further investigation should be conducted. Injured victim should be seen in emergency room.
Whiplash Injury: Whiplash of any unsupported body part can causes negligible or serious injuries.
Moderate Injury Following Automobile Accident
Subcutaneous Hematoma: Moderate subcutaneous hematoma is over 2 to 4 inch diameter, spread within subcutaneous tissue, and indicates further investigation is necessary to rule out fracture, dislocation or visceral injury. Accident victim should be seen at ER. Physician should decide on further investigations. There is no standard guideline for transfer of victim to ER. Every victim after accident is given a choice to go to ER.
Whiplash Injury: Neck is the most vulnerable anatomical part of the body, which could get whiplash in head-on, side or rear impact. Lower body injury is also described as whiplash injury depending on impact and position of the body at the time of accident and site of injuries. Whiplash injury can cause muscle tear, joint injury, joint dislocation, ligamental injury and tear of viscera or blood vessels.
Joint Injury: Blunt injury at the time of impact to the joint may not cause dislocation or fracture but may result in ligamental or joint capsule tear or sprain causing moderate injury needing further investigation like X-Ray or MRI.
Skeletal Injury: Low back pain, neck pain and extremity pain may be secondary to moderate bump to bones of vertebral column or extremities. Moderate injury may cause mild disk bulge, ligamental sprain around joints and muscle tear around joint or extremities causing severe excruciating pain.
Concussion: Whiplash injury and moderate impact of neck and head can cause concussion of brain and neck injury. Victim may complain of headache, dizziness or vertigo. Asymptomatic concussion may not drive an attention, while a symptomatic concussion suggest further investigation should be conducted as soon as possible to rule or any life threatening brain injuries. Asymtomatic concussion is considered a moderate injury.
Seat Belt Injury: Skin abrasion, laceration and hematoma over the chest wall may be secondary to tight seat belt. Accident victim, if suffering with shortness of breath, should be taken to ER to rule out lung injury and fracture of ribs. Seat belt injury if not associated with shortness of breath or severe pain may be considered as moderate injury.
Severe Injury Following Automobile Accident
Subcutaneous Hematoma Following MVA: Wide spread hematoma with signs of severe pain can be secondary to severe injury. Hematoma over extremities may be associated with fracture or dislocation of underlying bone or joint. Hematoma over abdomen may be associated with penetrating wound or blunt trauma causing visceral or major vessel tear or laceration. Such automobile accident injury could be life threatening. History of dizziness and inability to stand may be secondary to low blood pressure. Low blood pressure may be caused due to loss of significant blood. Such a condition needs immediate medical attention and intravenous fluid to maintain blood pressure and immediate transfer to nearest ER. Further investigation is must to rule out life threatening conditions.
Whiplash Injury Following MVA: Severe whiplash injury to neck and head needs immediate stabilization of upper body and neck. Neck movement should be restricted until further investigation is completed. Severe neck whiplash injury can cause neck dislocation or severe herniation of disk in neck vertebrae resulting in spinal stenosis and quadriplegia (paralysis of all four limbs). Whiplash injury to lower abdomen with belt in locked position can caused severe visceral injury and lumbar disk herniation or facet joint injury.
Joint Injury Following MVA: Severe impact of knee joint against dashboard can happen in head-on or side collision. Impact and crush injury can cause fracture as well as dislocation of knee joint needing emergency surgery. Similarly hip, ankle, shoulder elbow and wrist joint can get injured resulting in fracture or dislocation. Severe injuries should be evaluated immediately in ER.
Skeletal Injury Following MVA: Skeletal injury of chest wall may result in multiple fractures of ribs and pneumothorax. Pneumothorax is air pocket out side the lung and results in collapsed lung. Lung collapse because of severe pressure from air pocket outside lung prevents lung expansion. Victim is unable to inhale oxygen and unless immediate medical help is provided, victim may succumb due to lack of oxygen. Skeletal injuries may involve the vertebral column of thorax (mid back) and lower back. Injuries like disk herniation and bulge disk may not be emergency. But fracture, dislocation or subluxation of lumbar or thoracic vertebrae is emergency and may result in paraplegia (paralysis of lower extremities). Victim with history of weakness in leg or numbness in the extremities should be evaluated for serious injury in ER as soon as possible.
Brain Contusion or Bleeding Following MVA: Severe whiplash injury of upper body or impact of head to solid surface can cause brain contusion or bleeding inside the skull covering brain. Brain contusion may be secondary to brain laceration or blunt trauma. Bleeding inside the skull could be bleeding within or outside the brain. Bleeding can result in blood clot. Depending on size of the clot, brain can get compressed or shift. Such injury also results in contusion. Patient, following contusion or bleeding within skull, may be unconscious or conscious. Conscious patient may be confused following brain contusion or bleeding. Any abnormal sign of verbal response by patient suggest possible brain injury and may need immediate further investigation. Bleeding within the brain, if continues, can cause shutting down of all vital function controlled by brain.
Face Injury Following MVA: Driver or passengers can suffer with face injury from impact against dashboard or front seat. Face injury may result in bleeding, loose tooth, and mandibular joint dislocation or eye injury. Face injury is more often associated with severe whiplash injury and brain injury because of either whiplash or brain contusion with impact. Victim indicating moderate to severe face injury should be considered for further investigations.
Seat Belt Injury: Severe seat belt injuries can cause chest wall injury as described in skeletal injuries.
Medical Management of Injuries Following Automobile Accident
Automobile accident victims are driver, passenger or both. Automobile accident injuries may be visible or may not be visible to non-medical personnel. Injuries may have symptoms such as pain, headache, dizziness, breathing difficulties and inability to walk. Medical Assistant accompanying the ambulance does initial evaluation. Medical assistant (MA) is trained for emergency treatment only. The medical assistant can stabilize neck instability, fracture, dislocation and any penetrating injuries. Medical assistant (MA) is also involved in stabilizing vital signs such as low blood pressure, low heart rate and breathing difficulties. Medical assistant (MA) may occasionally overlook significant injuries which may be presented with marginal symptoms because of patient’s ignorance as well as Medical assistant’s hassle of paying attention to multiple injured patients. In any events, patient should make it a point to go to ER after automobile accident. Serious life threatening injuries may not be symptomatic for few hours. The condition may be irreversible and life threatening when symptoms are observed.
Seek advice of experts and/or physicians of the concerned specialty related to your injury when you are in doubt of serious and severe injury. Visit nearest ER as soon as possible.
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