What is Seat Belt Injury?
Seat belts have undoubtedly saved countless lives. In fact, many deadly incidents, such as severe head injuries from car crashes, have been avoided due to the use of vehicle restraints.
The concept of seat belts dates back to 1885 when the original designs were patented. They became a standard fixture in cars, specifically as front lap belts, in 1964. Then, in 1973, the simple lap belt was improved upon, evolving into a three-point harness, largely thanks to the work of a man named Bohlin. This upgrade had a massive impact, significantly reducing car collision fatalities by nearly 50%.
Seat belts, described as “active restraints,” require the user to put them on. On the other hand, airbags and head restraints, termed as “passive restraints,” work automatically without the driver or passenger having to do anything. Despite the clear benefits, seat belts are not used by everyone. According to a 2008 report by the National Highway Traffic Safety Administration (NHTSA), only 83% of people in the United States were using seat belts.
What Causes Seat Belt Injury?
Using seat belts in cars can prevent serious head injuries and stop you from being thrown out of the car during a crash. They keep you in your seat, which can save your life. However, they can also cause certain types of injuries.
The normal adult seat belt is a three-point harness that goes over your shoulder, across your chest, and around your waist. If there’s a car crash, the seat belt can press into these areas with a lot of force, depending on the situation. This can lead to what are known as seat belt injuries – these are injuries caused by the force of the seat belt pressing against the passenger during a crash.
The areas where the seat belt rests, such as the neck, chest, or stomach can be hurt by the blunt force, or the heavy blow, caused by the seat belt during a car crash.
Risk Factors and Frequency for Seat Belt Injury
About 35,000 deaths occur in the United States every year due to motor vehicle crashes, according to 2015 data. However, fatalities from such incidents have fallen significantly, from 16 per 100 million miles in 1930 to just 1.8 per 100 million miles today. Seatbelts are a substantial contributing factor to this decrease, with reports suggesting they can reduce life-threatening injuries by around 43%.
Injuries directly related to seatbelt use are varied. Signs of injury to the neck and chest linked to seatbelt use tend to be less serious and are found in less than 5% of patients. Injuries to the abdomen and lower spine might be somewhat more common if there are visible signs of injury, but the data on this is not conclusive.
- As of 2015, about 35,000 people die in the US each year due to car crashes.
- Death rate from car accidents has fallen from 16 to 1.8 deaths per 100 million miles since 1930.
- Seatbelts can reduce fatal injuries by approximately 43%.
- Injury to the neck and chest due to seatbelt use is usually less serious, affecting less than 5% of patients.
- Injuries to the abdomen and lower spine due to seatbelt use may be slightly more common when there’re visible signs of harm, but the data isn’t definitive.
Signs and Symptoms of Seat Belt Injury
When assessing patients involved in car accidents, it’s crucial to gather a comprehensive history as quickly as possible. Useful information includes whether seatbelts or airbags were used, the vehicle’s speed, where the patient was seated, the cause of the accident, the time taken to get the patient out of the vehicle, any loss of consciousness, and the injuries of other people in the accident. This data is all valuable in evaluating the patient’s condition.
Patients should also be asked about any pain they’re experiencing, keeping in mind that some injuries can distract from others.
Lastly, it’s important to get a full record of the patient’s previous medical and surgical history, along with any medications they are on and drug allergies they have. This is especially critical because many of these patients may end up needing surgery.
Testing for Seat Belt Injury
In all patients, the first thing that should be checked are the airways (while ensuring neck protection), breathing, and circulation. A quick neurological assessment should also be done. The patient’s whole body should be exposed to make sure no injuries are overlooked. It is important to observe any changes in vital signs like heart rate, blood pressure, and the shock index as these can indicate if the condition is getting worse.
Lab tests can be conducted but they may not always be accurate in patients involved in motor vehicle crashes. Certain signs from the lab tests, such as increased white blood cells, low red blood cell count, elevated liver enzymes, and high blood acid levels, can help the doctor identify severe injuries. A urine test can also reveal injuries to the urinary system.
Plain x-rays of the chest and pelvis are usually done in patients who’ve had a severe accident. An ultrasound scan of the lungs, heart, and organs in the stomach should also be done in patients who are unstable. This helps doctors get a quick understanding of the patient’s internal condition.
CT scans are crucial in evaluating patients who’ve suffered blunt trauma. Doing a comprehensive scan (which includes head, neck, chest, abdomen, and pelvis along with the spinal cord) seems to be beneficial as it helps doctors diagnose quickly, may not add much to the cost, and does not add much radiation exposure.
Physical check-ups, lab values, and selected imaging may need to be reevaluated in critical patients, or in cases where hidden injuries are suspected.
Treatment Options for Seat Belt Injury
The treatment for someone with a seat belt injury truly depends on what kind of injury they have. If someone has a severe injury, like damage to their blood vessels, organs, or their spine, they will likely be admitted to the hospital, and also preferably to a center specialized in treating trauma.
However, injuries to areas like the ribs, the sternum (the long flat bone in the middle of our chests), and soft tissues such as muscles might be managed more gently, possibly without needing to stay in the hospital. These could be treated with methods aimed at controlling pain and might be handled in a less intensive setting.
The particular treatment that is chosen always follows local practices and established guidelines for care. This means that the treatment will vary based on what works best in their community and follows proven and accepted methods in medicine.
What else can Seat Belt Injury be?
When dealing with patients involved in major vehicle crashes, doctors have to consider a wide range of potential injuries. Any part of the body can be hurt, and sometimes these injuries aren’t immediately obvious. If a patient shows clear signs of wearing a seat belt during the crash, doctors need to be especially alert for hidden injuries.
What to expect with Seat Belt Injury
How well someone recovers from seat belt injuries largely depends on the type of injury sustained.
Damages to the mesentery or bowel – parts of the digestive tract – can cause serious health problems, especially if not discovered early on. However, if surgery is done promptly, most people will recover without any ongoing issues.
Injuries of the cervical, thoracic, or lumbar spine – parts of your backbone – can also have different outcomes depending on how severe the injury is and whether there are any nerve-related issues.
Vascular injuries, or injuries to the blood vessels, are also crucial to diagnose early. However, some injuries to the carotid or vertebral – arteries in your neck or spine – can result in irreversible neurological disability, even if diagnosed early. This means that even if these injuries are found and treated quickly, there might still be some long term damage to the nervous system.
Recovery from Seat Belt Injury
It’s crucial that patients are aware they shouldn’t get behind the wheel until all of their symptoms have completely disappeared. They should know how to use painkillers and ice packs to help with swelling and discomfort. Additionally, it is important to have their vehicle checked out to ensure that it’s safe.