Transportation Injuries

Question 1

What are the most common injuries ?

Answer 1

1- RTA
2- train ( railway) accidents
3- aircraft accidents

Question 2

RTA injuries is divided into

Answer 2

1- pedestrians injuries
2- vehicles occupants injuries

Question 3

Talk about pesdestrians patterend injuries

Answer 3

1- primary impact injury
-Def : injuries due to direct impact of the vehicle with victim

• MLI :
  ( blunt trauma )
• patterend abrasions
• patterned bruises
  Taking the shape of the vehicle
  Along with torn clothes indicating the point of impact

2- secondary
-Def : injuries when the victum hits the ground or any object

• MLI :
  ~Its more dangerous than primary
• sliding abrasions
• bruises
• lacerations
• skull or spine fractures
  ~ site : typically present on the opposite side to primary injury but it if the victim is thrown multiple times the injuries can occur in any part of body

3- run over injuries
-def : when the vehicle passes over victim’s body

• MLI :
  ~ vary according to involved site of body , weight of vehicle, surface area of contact

~ tyre marks imprints on victim body , helps in identification of vehicle

Question 4

What are vehicle occupants injuries ?

Answer 4

1- driver seat occupant inj ( most common)
2- front seat occupant inj ( most serious )
3- rear seat occupant inj

Question 5

Talk about driver seat occupant inj

Answer 5

1- head injuries
~ extra cranial ( scalp)
Blunt : abrasions
Sharp : lacerations, superficial cuts

~ cranial ( skull)
Fractures

~ intracranial
Hemorrhage , brain lacerations, diffuse axonal injury ( DAI )

2- neck
- deceleration accidents cause whiplash injuries : the head is thrown violently forwards ( hyperflexion ) followed by severe hyperextension which is more dangerous as it can cause dislocation or fracture of spine in cervical region causing spinal cord injuries or paralysis

3- chest
~Skin , soft tissues : abrasions, bruises, laceration due the steering wheel

~ sternal and rib fractures are common ( flial chest ) that may lead to lung injuries

~ organs : myocardial , lung contusions
~ aorta : aorta transection may occur at the junction between arch , desending aorta

4- abdomin
~Liver can develop lacerations , can occur as shallow , mullitple , deep which is fatal , the right lobe is more common as it is unprotectable by thoracic cage

~spleen can develop shallow tears around its hilum

5- bony fractures
~ lower limb injuries occurs in 30 % in cases while upper limb injuries occurs in 15%

~ knee impacts on dashboard causing fractures of patella , distal part of femur

~ hip dislocation , fractures in neck of femur

Question 6

Talk about front seat occupant inj

Answer 6

1- it is called * la place du mort *
2- similar to driver injuries but more dangerous as there is no steering wheel preventing extensive forward projection , the driver pays more attention to the road

Question 7

Talk about rear seat occupant inj

Answer 7

• it is the least affected except if ejection occurs

Question 8

Talk about seat belt injuries

Answer 8

(5)
1- bruises are more common especially on chest wall or abdomin

2- visceral lesions: rupture of mesentry , small , large gut , bladder

3- crushed aorta
4- fractures or dislocation of lumbar spine
5- seat belt syndrome: rupture of small or large intestine with fractures of lumbar spine in the plane of lab seat

Question 9

What is the role of doctor in mass disaster

Answer 9

• Treatment in mass disaster is priority involving decision making about triage which is a process to determine the priority of treating the victim according to the severity conditions, dividing the victim into

❤️ high priority: victim is in imediate danger , could be saved

💛 medium priority: victim is not in imediate danger , no need to imediate medical care

💚 ambulatory : those who have minor trauma or psychologically traumatizied beeding sedation or reassurance

🖤 beyond the emergency care , death : victim is in imediate danger , but couldn’t be saved due to inadequate medical care

🖤death : the priority is identification