AIRBAG PROTECTED CRASH VICTIMS - THE CHALLENGE OF IDENTIFYING OCCULT INJURIES

At the Ryder Trauma Center of the Jackson Memorial Hospital in Miami, Florida, a multidisciplinary, automobile crash investigation team is conducting a detailed medical and engineering study. The focus is on restrained (seatbelts and/or air bag) occupants involved in frontal crashes who have been severely injured. More than 60 such crashes have been included in the study to date. Initial data analysis indicates that restraint systems are working to reduce many of the head and chest injuries which unrestrained occupants suffer. However, internal injuries among air bag-protected occupants may be unrecognized in the field. Also, extremely high severity crashes are presenting trauma management challenges. This paper provides case examples to illustrate types of chest and abdominal injuries associated with air bag cases. To assist in recognizing the extent of injuries to occupants protected by air bags, it is suggested that additional evidence from the crash scene be used in the triage criteria. For the occult chest/abdominal cases in the Jackson study, deformation of the steering wheel was the vehicle characteristic most frequently observed.