TV - biomechanics.docx

** TRAINING VIDEOS** *TBI Med/Legal:* Biomechanics in Car Crashes  https://drive.google.com/file/d/1dlwiW1YamBFeiLC6EMOwPl6AC3cMIlQP/view Dr. Rami Hasish Joke: the quiz, we'll give you a cae study and you have to calculate Cerebrospinal fluid, damage to neurons and axons - which cannot be direc...

** TRAINING VIDEOS** *TBI Med/Legal:* Biomechanics in Car Crashes  https://drive.google.com/file/d/1dlwiW1YamBFeiLC6EMOwPl6AC3cMIlQP/view Dr. Rami Hasish Joke: the quiz, we'll give you a cae study and you have to calculate Cerebrospinal fluid, damage to neurons and axons - which cannot be directly seen in radiologiy Amount of acceleration/deceleration plays a key role in brain injury, not only direct impact A close-up of a logo Description automatically generated Force need not be a direct impact Main cause of TBI - road traffic accident (1), sports and recreation, falls, assaults A diagram of mechanism with words Description automatically generated  A diagram of a contact lens Description automatically generated with medium confidence Contact loading - direct impact or contact - Coup contracoup injury (frontal impact and back impactt)  Manifests in concussion symptoms \[small car v. big car discussion - does not really matter\] - More important considerations: How was the vehicle impacted? How bad was the impact? Under what duration did it sustain the impact?  - Change in velocity, the angle of velocity and angle of impact A screenshot of a medical report Description automatically generated  A diagram of a brain Description automatically generated  - Can be seen radiological A close-up of a brain Description automatically generated - More prevalent in minor TBI  A diagram of the nervous system Description automatically generated  Focus on mild TBI A diagram of a brain Description automatically generated  A diagram of a football Description automatically generated PRIMARY measures of brain injury \> Linear acceleration - skull moving forward and backward \> Angular acceleration Recent study shows that brain injuries are sustained more with rotation of the brain than in just linear movement (more important metric) SECONDARY measures - Head injury criterion (HIC) = more accepted - Abbreviated injury scale (AIS) - Gadd severity index  A white box with blue text Description automatically generated A white paper with black text Description automatically generated - There are different many ways of measuring TBI - Most common is to: 1. Calculate acceleration experienced 1. Done by *physical testing = very costly* 1. Or *Research and analysis* 2. Relate to threshold from peer-reviewed literature A person working on a machine Description automatically generated  A diagram of a skull Description automatically generatedA person driving a car Description automatically generated - How the driver or passenger was seated at the time of the crash - Limitations: if the research or studies are limited to a specific type of collision - Simulation of the impact With \[TESLA\] black boxes, how ar ethe info gong to be helpful? Useful in velocity or change of speed or acceleration, time at which this occurred, the impact angle; a lot of information available also useful for accident reconstruction A sign with text on it Description automatically generated - Limitations useful for cross examination  - Has the biomechanical expert taken all the available data from the accident reconstruction/ist A screenshot of a computer Description automatically generated - Sometimes the scenario lacks information, eg hand placement, how close was the person to the steering wheel  - Reliable validity (reliability is a measurement of consistency, while validity is accuracy) - 1+1 = 3, 1+1 = 3, 1+1 = 3  (reliable but not valid) - Research may be termed valid because it was peer-reviewed and/or published, but may not still be externally valid if applied in other contexts - Eg: most brain injury studies were done with male, high-end athletes in premium conditions A person in orange suit standing in front of a car Description automatically generated  - The "laziness question" A diagram of a brain Description automatically generated \[MVC case study\]