Deceleration Injuries of Heart and Lungs

THE advent of relatively extensive and high-speed motoring has posed a new problem for medical diagnosis and care, namely, the diagnosis and treatment of deceleration injuries. The figures of deaths from motor car accidents in the U.S.A. make salutary reading-I946, 34,000 deaths; 1954, 36,ooo, and the estimate by the National Safety Council that I966 will produce 53,000 deaths (Woodward, 1957). In this country the total number of casualties recently announced for I962 were 341,696 and deaths numbered 6,709. If the basis of io injured to i killed is taken it will be seen that these figures constitute a problem as important to medical care as cancer or arteriosclerosis. Braunstein (1957) quotes the figure of i,000,000 injured annually in the U.S.A. and quite a large proportion of these cases are the results of deceleration injuries. Livingstone (1954), in reporting 1,475 victims of automobile collisions from 1949 to 1954, who had been under the care of a group of doctors in Cambridge, Mass., noted that the commonest explanation pointed to an inability of the occupant to control his motion in relation to that of the automobile at the time of collision. In a detailed analysis of the various regions of the body involved, head injuries, with 72.3%, were the most frequent, but only 3% of these injuries were classed as dangerous and an additional 3% were fatal. 43.8%/ of head injuries are associated with injuries to other regions. Injuries to the thorax and thoracic spine were third in frequency and constituted 36.6% but according to Livingstone they represented the second highest percentage of dangerous and fatal injuries. The majority of injuries affected the thoracic cage and consisted of fractured ribs and sternum, but i0o/ of all chest injuries were due to a crushed chest with a corresponding high fatality rate. The thorax and its contained structures are especially vulnerable to deceleration injuries and