Rescue operations in car accidents: airbags and the potential for injury
Airbags were mandatorily introduced in all cars and light trucks in the United States in 1998 (Intermodal Surface Transportation Efficiency Act of 1991)
Studies show that, in general, airbags reduce injury rates and save lives
In particular, airbags reduce the risk of life-threatening injuries to the head, neck, face, chest and abdomen of occupants.
However, they can also cause minor to serious injuries, including death.
Minor injuries caused by airbag deployment can include skin and throat irritations, abrasions, bruises, lacerations, strains and sprains.
Serious injuries may include cardiac damage, burns, eye injuries, ear trauma or hearing loss, haematomas and/or bleeding of internal organs, damage to major blood vessels, bone fractures, brain trauma/concussion, spinal injuries and foetal trauma.
FIRST AID: VISIT THE DMC DINAS MEDICAL CONSULTANTS BOOTH AT EMERGENCY EXPO
Car occupant injuries are conditioned by the use and operation of restraint systems (seat belts, pretensioners, airbags…)
It is not always easy to recognise the injury mechanism, which is often linked to several circumstances, including seat belt malfunctioning and malpositioning, inadequate posture of the occupant, proximity to the airbag and others.
Current restraint systems, particularly the three-point seat belt, while reducing potentially fatal injuries, can be responsible for multiple and scattered minor injuries.
For example, in high-speed accidents, exceeding the limits of organ or bone strength can lead to bruising, bone fractures and even severe visceral damage.
The mobility of the head in relation to the thorax restrained by the belt promotes the occurrence of distractions of the cervical spine with possible vertebral involvement; the immobilised clavicle promotes the torsion of the counter-lateral shoulder with the possibility of impact of the latter against the structures of the passenger compartment.
Moreover, it has been observed that direct injuries are linked to the mechanical effect induced by the belt on pressure areas (liver, chest, etc.), while indirect injuries are unrelated to the use of the belt and occur through mobilisation of certain organs by acceleration-deceleration mechanisms and transmission of forces.
In the indirect mechanism, spinal injuries are prevalent: in the mildest cases they induce a simple distraction of the vertebral ligaments, while in the most severe cases they can lead to interbody fractures with exposure of the speculum and spinal cord section.
The lumbar spine is often the site of external torsion (roll-out) injuries, which occur when the upper body of the belted person tends to make a rotation around the axis of the thoracic girdle, while the pelvis is blocked by the abdominal belt.
This is an anterior flexion-rotation proportional to the inertia of the body: the most frequent outcome is a characteristic anterolateral wedge compression fracture of the vertebral body.
At the thoracic level, frequent thoracic cage injuries are observed, mostly rib fractures, produced with a direct mechanism by the seat belt, the stumps of which can induce pulmonary injuries with pneumothorax and subcutaneous emphysema.
In the area of visceral injuries, the tract least protected by belts is the gastroenteric tract, followed by the hypochondriac organs (kidney, diaphragm, bladder and pancreas).
Visceral injuries are induced by a direct mechanism by compression-crushing, or by indirect mechanism by deceleration and force transmission. Hepatic injuries in belted subjects are due to direct compression of the ventral belt, especially in the case of ‘submarining’, i.e. slipping of the body anteriorly and downwards.
Incongruous positioning of the belt below the shoulder, on the other hand, can lead to injury of the spleen to the point of rupture, with massive retroperitoneal haemorrhage.
Tearing of the aorta at the isthmus is due to an indirect mechanism by the action of acceleration-deceleration forces on a sessile structure.
Involvement of the carotid artery is also possible due to direct crushing of the vessel by a malpositioned belt or hyperextension of the neck.
TOP AMBULANCES AND MEDICAL INTERVENTION EQUIPMENT? VISIT THE DIAC MEDICAL BOOTH AT EMERGENCY EXPO
Most airbag injuries, predictably, affect the face and head, in the form of abrasions, contusions and not infrequently, eye injuries
The mechanism, responsible for these injuries, is induced by the violent impact of the exploded airbag against facial structures.
Eye damage can be varied, from simple corneal abrasions to retinal detachment.
Ear complications resulting from the airbag deployment must also be considered, with possible hearing loss, vertigo and sensorineural hearing deficits.
These injuries may involve a direct traumatic mechanism due to the impact of the airbag on the auricle in a person whose torso is rotated with respect to the direction of travel, or due to acoustic trauma induced by the noise caused by the airbag deployment.
Injuries to the cervical region related to contact of the head against the airbag are also possible.
Emergency Room, what to look for in medical records when an airbag injury is suspected or diagnosed:
- Rescuers’ photos of soft tissue injuries, including burns, cuts, skin tears and lacerations.
- X-rays of bones to diagnose fractures
- Chest X-ray to diagnose lung trauma
- Scintigraphy and/or MRI of the head to diagnose traumatic brain injury, eye and/or optic nerve injury, ear and/or auditory nerve injury
- Ultrasound and/or MRI of the chest to diagnose damage to heart vessels, liver or spleen damage, injuries to cartilage, muscles and tendons
- Ultrasound and/or MRI of the pelvis to diagnose traumatic soft tissue injuries, injuries to cartilage, muscles and tendons
- Scintigraphy and/or MRI of the spine to diagnose herniated discs
- Ultrasound studies of internal organs
- Laboratory studies: haematocrit/haemoglobin to confirm haemorrhage; white blood cell count to demonstrate stress/trauma; pro-calcitonin and C-reactive protein to confirm stress/trauma; creatinine/blood urea nitrogen to diagnose kidney injury; pancreatic enzymes to diagnose other internal organ injuries; liver enzymes to diagnose liver injury; cardiac enzymes to diagnose cardiac injury
- capillary oxygen to suspect trauma to the respiratory system.
Unfortunately, serious injuries can be caused by a correctly deployed airbag
Airbags must inflate rapidly to be effective in an accident.
The speed and force of the airbag can cause injuries regardless of whether it malfunctions or not.
One factor that determines airbag injuries is the distance between the occupant and the airbag when the airbag deploys.
If a person is close to the steering wheel when the airbag deploys, the deployment force can cause serious injury or even death.
Another factor in airbag injury is seat belt use: one source notes that 80 per cent of passengers killed by an airbag were not wearing a seat belt.
In addition, children or people of short stature are more at risk of airbag injury.
Read Also
Emergency Live Even More…Live: Download The New Free App Of Your Newspaper For IOS And Android
What To Do After A Car Accident? First Aid Basics
First Aid For Road Accident Victims: What Every Citizen Needs To Know
RICE Treatment For Soft Tissue Injuries
First Aid: How To Place The Injured Person In A Safe Position In Case Of An Accident?
CPR – Are We Compressing In The Right Position? Probably Not!
What Is The Difference Between CPR And BLS?
Perform First Aid On A Toddler: What Differences With The Adult?
How To Carry Out Primary Survey Using The DRABC In First Aid
Heimlich Maneuver: Find Out What It Is And How To Do It
Germany, Survey Among Rescuers: 39% Would Prefer To Leave The Emergency Services
Exoskeletons (SSM) Aim To Relieve Rescuers’ Spines: The Choice Of Fire Brigades In Germany
Why Do You Need Airbag Protection During Rescue?
The Golden Rules Of Extrication For Firefighters
Smartphone Use During Road Accidents: A Study On The ‘Gaffer’ Phenomenon In Germany
Emergency Call, Do ECall Systems Slow The Arrival Of Help? The ADAC Firm, The German Automobile Club
New Secunet III Airbag Protection Cover From Holmatro
Hesitation When Driving: We Talk About Amaxophobia, The Fear Of Driving