23. Car Accidents

Question 1

What are the 2 MAIN Types of Injuries in Traffic Accidents?

Answer 1

1) Injuries occurring inside the vehicle

2) Injuries to the pedestrian

Question 2

What are the 2 Patterns of Trauma in Pedestrians?

Answer 2

1) Primary Impact Injuries = 1st part / initial struck

2) Secondary Impact Injuries = further injuries by vehicle or victim striking objects (ground)

Question 3

What do Primary Impact Injuries depend on?

• Give Examples

Answer 3

• Position of Body in relation to vehicle when struck
• Person’s Height
• Parts of Vehicle - bumper, fenders, radiator
• Bumper Fracture = To the Lower Limbs
• Whiplash = To the Neck
• Skull Fractures

Question 4

What are Examples of Secondary Impacts?

Answer 4

• Abrasions, contusions or Lacerations
• Fractures of bones - skull, ribs, vertebral column or pelvis
• Direct impact to the thorax = Resulting in Aortic Rupture, below arch / of heart - due to increased intra-vascular pressure
• Indirect Impact to humerus, femur or radius

Question 5

What are Typical Injuries in a Driver?

Answer 5

• Thoracic Trauma = Fractures of Sternum + Ribs, aka Flail Chest - due to the horn
• Head Trauma = Either Coup / Counter-Coup
• Fractures in Legs around knee-level
• Hand Injuries = Due to wheel gripping - wrist fractures, or lacerations btw thumb + forefinger
• Crushing of Liver, Spleen or Kidneys = Due to the Wheel-rim

Question 6

What are Examples of Seat Belt & Airbag Injuries?

Answer 6

• Bruises / Abrasions across the chest
• Clavicle + Rib Fractures
• Abdominal Trauma
• Chemical Burns - from the airbags
• Le-Fort 1 - 3 Fractures - also from the airbags

Question 7

What are the Attributes in a Run-Over Accident?

Answer 7

• Tyre-marks
• Extrusion of Abdominal Wall or Scrotum (Men)
• Complete Amputation or Decapitation
• Deep Crushing of the Internal Organs
• Flattening Deformities - of head, chest + pelvis
• NB! = if a child is run over, there’ll be NO fractures - due to elasticity of partly cartilaginous skeleton

Question 8

What are Deceleration Injuries?

Answer 8

• Injuries to internal organs = Due to pendulum swaying-motion of the organs
• Followed by them striking against walls of cavities - when they’re coming to a sudden stop

Question 9

What are Examples of Deceleration Injuries?

Answer 9

• Rupture of Ascending / Descending Aorta
• Contusion of the Heart, and Lungs (Hilum + Parenchyma)
• Contusion / Rupture of Mesentery of Intestines, aka “bucket-handle tear”

Question 10

What’s important for a Forensic Autopsy for a Car Accident CASE?

Answer 10

• Constructing the accident, to determine its case
• Determine Cause + Manner of Death
• Establish identity of Victims
• Identify the Driver + Occupants in Vehicle
• Differentiate Injuries caused by being hit from those who got run over
• Identify the type of vehicle, in the case of hit + run