Road Traffic Accidents Outline PDF

**OUTLINE** I. **Automotive Crash** A. Dynamics of Vehicular Injury B. Mechanisms of Injury C. Pattern of Injury in Car-Occupants II. **Pedestrian- Vehicle Collisions** A. Mechanisms of Pedestrian Injury B. Pedestrian Injuries III. **Considerations in Autopsy** A. Autopsy of Road Tra...

**OUTLINE** I. **Automotive Crash** A. Dynamics of Vehicular Injury B. Mechanisms of Injury C. Pattern of Injury in Car-Occupants II. **Pedestrian- Vehicle Collisions** A. Mechanisms of Pedestrian Injury B. Pedestrian Injuries III. **Considerations in Autopsy** A. Autopsy of Road Traffic Death B. Natural Disease in Road Traffic Accidents C. Manner of Death in Road Traffic Accidents D. Suicidal Crash +-----------------------+-----------------------+-----------------------+ | **LEGEND** | | | +=======================+=======================+=======================+ | ⭐ | 🖊️ | 📖 | | | | | | Must | Lecture | Book | | | | | | Know | *\[lec\]* | *\[bk\]* | +-----------------------+-----------------------+-----------------------+ I.AUTOMATIC CRASH {#i.automatic-crash.TransOutline} ================= A. DYNAMICS OF VEHICULAR INJURY {#a.-dynamics-of-vehicular-injury.TransSubtopic1} ------------------------------- - Pattern of Injury - **Direction of Impact** - 🖊️ Whether the impact is coming from behind or coming from the front or the side; whether the impact would cause the vehicle to roll over. - 🖊️ This would affect injuries from the car's occupant. - **The position and restraint of the occupant** - 🖊️ For instance rear-seat passenger is expected to display different injury patterns compared to the driver or front-seat passenger in a frontal type of injury. - **Intrusion of structural parts into the passenger compartment** - 🖊️ If there are structural parts of the vehicle that came into the passenger compartment all the way to the original seating position of the car occupant, then that can cause injury. B. MECHANISM OF INJURY {#b.-mechanism-of-injury.TransSubtopic1} ---------------------- FRONTAL IMPACT, DRIVER (VIOLENT DECELERATION) {#frontal-impact-driver-violent-deceleration.TransSub-subtopic2} --------------------------------------------- - 🖊️ Unrestrained Driver **Figure 1**. Frontal Impact, Driver (unrestrained) - **Frontal type** of injuries would cause **violent deceleration** that would be transmitted to all the car occupants. - The driver would be moving towards, in general. Wherever the impact is, that is where the car occupant is thrust towards. - 🖊️ In a frontal impact type of injury, the car occupants would be thrust towards the front of the vehicle. - What might happen is his **lower limbs might be thrust towards the dashboard**, his **chest might be thrust towards the steering wheel**, and his **head might hit the windshield** or whatever that is in front of him, it could be the dashboard or the A-frame, or the front corner pillar. FRONTAL IMPACT, FRONT-SEAT PASSENGER (VIOLENT DECELERATION) {#frontal-impact-front-seat-passenger-violent-deceleration.TransSub-subtopic2} ----------------------------------------------------------- - 🖊️ The driver and the front seat passenger will probably be impacting the same structures except that if you're a driver, there's the steering wheel that might come into contact with. - So, the front seat passenger side has **no steering wheel but there's still the dashboard, A-frame, windshield**. All these can cause injury to the passenger. **Figure 2.** The intrusion of the roof or 'A'-frame - 🖊️ Apart from the direct impact of the car occupants on the internal structures of the vehicle, if there is intrusion of any vehicular structure into the passenger's compartment that is not supposed to be there. That can also cause injury. - In the illustration, the **A-frame or the front corner pillar is caving in**, **there's nothing that the seatbelt** can do. A restraint cannot protect the front seat passenger from the caving in of the A-frame. Also, if the parts in the front of the vehicle like the engine or the front wheel assembly intrude on the passenger compartment. Even if the passenger is restrained, the intrusion might get into the limbs of the passenger and cause injury to the lower extremities. FRONTAL IMPACT, REAR-SEAT PASSENGER (VIOLENT DECELERATION) {#frontal-impact-rear-seat-passenger-violent-deceleration.TransSub-subtopic2} ---------------------------------------------------------- - 🖊️ If the passenger is seated at the back, a **frontal impact injury would also cause him to be thrust forward** because of **violent deceleration**. Because he is seated at the back, the expectation is that the injuries that result to the **rear seat passenger would not be as severe as the front seat passenger.** REAR IMPACT (VIOLENT DECELERATION) {#rear-impact-violent-deceleration.TransSub-subtopic2} ---------------------------------- - 🖊️ In rear impact injuries where the **impact is coming from the back of the vehicle**, the passengers or the occupants are **subjected to a violent acceleration**, and if the vehicle is cannoned into **another obstruction** at the front that would also subject them to a subsequent **violent deceleration.** SIDE IMPACT {#side-impact.TransSub-subtopic2} ----------- - **Less crushable structural components to absorb the impact** - 🖊️ There's a tendency for much of the kinetic energy to be transmitted directly to the passenger or the car occupant. - 🖊️It makes the car occupants **more susceptible to severe injury.** - The side of the vehicle is less rigid - The occupant on the side of impact suffers the most ROLL-OVER (TURN-TURTLE IMPACT) {#roll-over-turn-turtle-impact.TransSub-subtopic2} ------------------------------ - More likely to cause **ejection** - Rolling processes cause **different sides of the vehicle to absorb the force** (limits injuries) - 🖊️These are the types of collisions wherein the vehicle is **turned upside-down.** - 🖊️ It would tend to **limit the injury** because the rolling process would cause the different sides of the vehicle to absorb the force so **there's less transmission of kinetic energy directly to the car occupants** but again it only works when the occupants are restrained, there's no ejection. - 🖊️But if there's an **ejection**, it would **increase mortality** by up to 5-fold according to research. +-----------------------+-----------------------+-----------------------+ | **Table 1.** ⭐ | | | | **SUMMARY TABLE** | | | +=======================+=======================+=======================+ | Frontal Impact, | Frontal impact type, | - Lower | | Driver (Violent | the car occupants | limbs=dashboard | | Deceleration) | would thrust forward | | | | | - Chest= steering | | | | wheel | | | | | | | | - Head=windshield | +-----------------------+-----------------------+-----------------------+ | Frontal Impact, | | A frame caving in, | | Front-Seat Passenger | | Windshield, | | (Violent | | dashboard, and | | Deceleration) | | intrusion of any | | | | vehicular structure | | | | into the passenger's | | | | compartment can cause | | | | the injury | +-----------------------+-----------------------+-----------------------+ | Frontal Impact, | A frontal impact | rear seat passenger | | Rear-Start passenger | injury would also | would not be as | | (Violent | cause him to thrust | severe as the front | | Deceleration) | forward because of | seat passenger. | | | violent deceleration | | +-----------------------+-----------------------+-----------------------+ | Rear Impact (Violent | - Impact is coming | | | Acceleration- Violent | from the back of | | | Deceleration) | the | | | | vehicle=Subjected | | | | to violent | | | | acceleration | | | | | | | | - Another | | | | obstruction at | | | | the front= | | | | violent | | | | deceleration | | +-----------------------+-----------------------+-----------------------+ | Side Impact | kinetic energy to be | Occupants at the side | | | transmitted directly | of impact suffer the | | | to the passenger or | most | | | the car occupant | | | | | More severe | +-----------------------+-----------------------+-----------------------+ | Roll-Over (Turn- | Most likely to cause | Tend to limit | | Turtle Impact) | ejection | injuries | | | | | | | Different sides of | But if there's an | | | the vehicle to absorb | ejection, it would | | | the force (limits | increase mortality by | | | injuries) | up to 5-fold | | | | according to | | | | research. | +-----------------------+-----------------------+-----------------------+ C. PATTERN OF INJURY IN CAR OCCUPANTS-UNRESTRAINED AND UNPROTECTED {#c.-pattern-of-injury-in-car-occupants-unrestrained-and-unprotected.TransSubtopic1} ------------------------------------------------------------------ FRONTAL IMPACT {#frontal-impact.TransSub-subtopic2} -------------- - **Lower Limb Injuries** - Abrasions, lacerations, and fractures - **Pelvic Injuries** - Posterior hip dislocation - 🖊️ Particularly in the sacroiliac joint - Fracture - **Thoracic Injury** - Thoracic spine fracture and dislocation - Fractures of the ribs and sternum - Lung and cardiac contusion/laceration - 🖊️ When it comes to the heart, it's typically the **right side of the heart** that is more often contused compared to the left side. - 🖊️ The right side of the heart is closer to the anterior chest wall. - Hemothorax, pneumothorax - Ruptured aorta - 🖊️ Catastrophic, very fatal injury - 🖊️ When the aorta is ruptured, it's typically ruptured just distal to the left subclavian artery. It is the common side of the rupture of the aorta. - **Abdominal Injury** - Rupture of **liver and spleen** - The organs that are most susceptible to rupture. - **Upper limb injuries** - Not as common as lower limb injuries - **Facial Injuries** - Lacerations - 🖊️ Sometimes may appear as **v-shaped** as a result of **the cuboidal break of the windshield** coming into contact with the facial skin. - Fractures - **Head Injuries** - Typical in **frontal impacts**, especially in the front seat passengers and drivers when the head comes into contact with the windshield. - Scalp laceration, hematoma - Skull fractures - Intracranial hemorrhage - Brain parenchymal injury - **Neck Injuries** - Fractures - Dislocation - 🖊️ typically at **the atlanto-occipital joint** (most common) - 🖊️ **C5-C6** (second most common) - **Seating arrangement matters when it comes to vehicular crashes.** - **Driver** - Presence of the steering wheel - May be **more aware** of an impending impact - The steering wheel may be something that the driver can brace himself and he may be able to minimize the injury to himself. - **Front-seat passenger** - Same pattern of injuries as the driver but maybe worse - Might not be as aware of the impending impact as the driver and because of that, the front-seat passenger might be more susceptible to injury from frontal impact. But they usually have very similar pattern injuries except that there's no steering wheel to create steering wheel injuries. - **Rear-seat passenger** - May not be as severe as front-seat occupants - Do not typically incur very severe injuries as compared to those in the front seat. REAR IMPACT {#rear-impact.TransSub-subtopic2} ----------- - **Whiplash Injury** - Double whiplash - 🖊️The car occupants are **subjected to a violent acceleration followed by a violent deceleration** if the vehicle is cannoned to another fixed object. - 🖊️The head is **acutely hyperextended** followed by an **acute hyperflexion**, which is not really preventable even if you're strained by a seatbelt unless you have a head and neck support device, as worn by racing drivers. **Figure 3.** Head and Neck Support  SIDE IMPACT {#side-impact-1.TransSub-subtopic2} ----------- - Rib fractures - Contusions/laceration of the lungs - Laceration of the spleen, kidneys, liver - Pelvic fracture EJECTION INJURIES {#ejection-injuries.TransSub-subtopic2} ----------------- - Any unrestrained occupant - More likely in roll-over crashes - Almost any kind of injury, usually multiple EFFECTS OF SEATBELTS {#effects-of-seatbelts.TransSub-subtopic2} -------------------- - Standard: **lap-strap and shoulder diagonal type (3-point attachment belt)** - Reduces deaths and serious injury by a factor of **20-25%** - Ineffective against passenger compartment intrusions that reach the original sitting position. - Prevent displacement of the occupant from the seat (dashboard and windshield) - Increases stopping distance by substantial stretching of the belt fabric - When the **belt fabric stretches it allows greater stopping distance** which then reduces the transfer of kinetic energy and thereby reduces injury to the car occupant. - Spreads the area of application of deceleration forces - 🖊️Imagine a portion of your head hitting a windshield, the concentration of kinetic energy transferred to that small portion of your forehead will subject you to a greater likelihood of injury. - 🖊️ **The greater the surface area through which the kinetic energy will be transferred, the less likelihood there be tissue damage.** With the deceleration force spreading over the seatbelt, there's less likelihood of injury. **Figure 4.** 3-point attachment belt. SEATBELT INJURIES {#seatbelt-injuries.TransSub-subtopic2} ----------------- - **Bruising: most common** - Fractures of sternum and clavicle - Diaphragmatic rupture - More likely to occur on the **left side compared to the right side**, because of the existence of the liver on the right **\[**⭐ **Transer's note\]:** YUNG SA FRONTAL IMPACT, YUNG THORACIC INJURY, **right side of the heart** that is more often contused compared to the left side. - Visceral injuries: - More common when you're **only using a lap-strap seatbelt** - Vulnerable to **jackknifing of the body** - Rupture of the heart, mesentery, intestines, urinary bladder - Crushed abdominal aorta - Lumbar spine compression fracture or dislocation EFFECTS OF AIRBAGS {#effects-of-airbags.TransSub-subtopic2} ------------------ - Interposes between the **occupant and the frontal structures of the passenger compartment** - Cushion the impact with the frontal structures of the passenger compartment - **Prevent hyperflexion** AIRBAG INJURIES {#airbag-injuries.TransSub-subtopic2} --------------- - Facial injuries - Eye injuries - Head injuries - Cervical spine fractures and dislocation - Amputation of fingers - Upper extremity fractures and dislocation PEDESTRIAN-VEHICLE COLLISIONS {#pedestrian-vehicle-collisions.TransOutline} ============================= A. MECHANISM OF PEDESTRIAN INJURY {#a.-mechanism-of-pedestrian-injury.TransSubtopic1} --------------------------------- - **The type of vehicle makes a difference** in the dynamics of the pedestrian injury. - 🖊️The type of vehicle affects the dynamics of injury patterns seen in pedestrian victims. - 🖊️ One factor would be the front profile of the vehicle. - Bus: the front profile of the vehicle is flat and high - The only tendency is for the pedestrian to be thrown forward. - Sedan: low and sloping - The injury depends on the height of the pedestrian relative to the vehicle. - The **center of gravity is higher** compared to the frontmost portion **scooped up** - The **center of gravity is lower** than the frontmost portion: **Swept under or run over** NO BRAKING {#no-braking.TransSub-subtopic2} ---------- - 🖊️If **there's no braking**, the person will be **scooped up and would likely fly all the way back of the vehicle**, especially if the vehicle is fast. - 🖊️If the **vehicle is coming in very fast**, there is a chance that the pedestrian **might miss the vehicle altogether after being scooped up and land somewhere towards the back**. If not, he might hit his head on the windshield or the roof of the vehicle. **\[**⭐ **Transer's note:**\] - **NO BRAKING= SCOOPED UP AND WOULD LIKELY FLY ALL THE WAY** - **VEHICLE COMING FAST= might miss the vehicle altogether after being scooped up and land somewhere towards the back (MEANING HINDI NA MATATAMAAN YUNG CAR)**  **Figure 5.** At a speed of over 23 km/hour (15 mph), a pedestrian can be scooped up onto a car, suffering head injuries against the windshield. He may then fall off sideways or -- at higher speeds -- be thrown over the roof. A person standing next to a car Description automatically generated **Figure 6.** A pedestrian with a center of gravity lower than the frontmost portion of the low-sloping vehicle may be run over. - ⭐ It is impossible to estimate the speed of impact from the nature of the injuries. - Fatalities seen even at 10 kph - Only minor injuries are sometimes seen at high-speed impacts WITH BRAKING {#with-braking.TransSub-subtopic2} ------------  **Figure 7.** Pedestrian thrown forward. - 🖊️Supposing that the vehicle is a low-sloping type one. **If there is braking, the person would be thrown forward** and it depends on just how fast the vehicle can completely come to a halt. - 🖊️If there is **still residual movement, then you can see that there's a tendency for the pedestrian to be run over.** \[⭐ **Transer's note:**\] - **BRAKING= THROWN FORWARD** - **RESIDUAL MOVEMENT= TENDENCY TO RUN OVER** B. PEDESTRIAN INJURIES {#b.-pedestrian-injuries.TransSubtopic1} ---------------------- - **Primary injuries** - The first impact between pedestrian and vehicle - **Secondary injuries** - Subsequent impact of the pedestrian with the ground after being struck by the vehicle - **Run-over injuries** - 🖊️ Injuries sustained by the pedestrian should the pedestrian be run over by a vehicle. PRIMARY INJURIES {#primary-injuries.TransSub-subtopic2} ---------------- - **Lower limbs** -- most common - Abrasions, lacerations - Fractures to tibia and fibula ("bumper fracture") - Often compound - Tibial fracture is often **wedge-shaped** with the base of the wedge **indicating the point of impact** - **(**🖊️ The configuration of the tibial fracture would tell us where the vehicle was coming from upon impact with the pedestrian.) - 🖊️ The tendency is that the front (tip) of the wedge-shaped tibial fracture would be pointing away from the point of impact. - Tibial fracture tends to be: - **Oblique**= weight-bearing - **Transverse**=lifted. - **Both tibia, different levels**=person was moving at the time of impact - When the level of injury appears too low for the bumper level of any vehicle, the vehicle may have been violently braking at the time of impact. - **Fractures to femur and pelvis (higher vehicles)** - **Head -- next common** - most common cause of death SECONDARY INJURIES {#secondary-injuries.TransSub-subtopic2} ------------------ - Depends mostly on the **force of the ground impact**, the nature of the road, part of the body involved - Accounts for the multiple **abrasions and contusions** - May be concentrated on the **opposite side** of the point of primary impact - The body is thrown down onto the opposite side. - Many times -- no particular pattern RUN OVER INJURIES {#run-over-injuries.TransSub-subtopic2} ----------------- - Any type of internal injury - There may be great internal damage with little surface injury - **Tire tread pattern** abrasion/bruising - 🖊️ **Characteristic of run-over injuries** - 🖊️ Not seen in secondary injuries coming from the impact - **Multiple parallel striae or shallow lacerations** may occur - near the contact area due to ripping tension to the skin - **Flaying injury** - A rotating motor wheel tears the skin and muscle from a limb or head. - 🖊️Characteristic to run over injuries CONSIDERATIONS IN AUTOPSY {#considerations-in-autopsy.TransOutline} ========================= A. AUTOPSY OF ROAD TRAFFIC DEATH {#a.-autopsy-of-road-traffic-death.TransSubtopic1} -------------------------------- - **Body to be seen clothed** - Clothing damage and soiling **matched with injuries** - Blood samples must be retained for analysis - Blood grouping and DNA analysis - Alcohol analysis (🖊️If less than 24 hours ago) - Drugs causing drowsiness - Carboxyhemoglobin (COHb) concentration - The height of major patterned injuries above heel level must be noted - 🖊️ To compare them to the suspected vehicle that caused the accident - Patterned injuries: photographed with a scale in view - Trace evidence should be collected for analysis - Any natural disease: - Old and recent cardiac and cerebral lesions - Evidence of a fit - Lesions affecting visual or auditory acuity B. NATURAL DISEASE {#b.-natural-disease.TransSubtopic1} ------------------ IN ROAD TRAFFIC ACCIDENTS {#in-road-traffic-accidents.TransSubtopic1} ------------------------- - **Natural disease** -- an important consideration as a possible cause or contributor to the accident - Examples: - Cause of **sudden collapse** of a pedestrian who was then run over - Defects in **sight or hearing** of the pedestrian - **Drug or alcohol intoxication** of the pedestrian - **Cardiovascular and coronary heart disease of the driver** C.MANNER OF DEATH IN ROAD TRAFFIC ACCIDENTS {#c.manner-of-death-in-road-traffic-accidents.TransSubtopic1} ------------------------------------------- - No specific pathologic features can assist in the determination of the manner of death - Pathologic features may determine homicides being concealed as accidents D.SUICIDAL CRASH {#d.suicidal-crash.TransSubtopic1} ---------------- - Usually **single vehicle, single-occupant** crash - **Head-on collision** with roadside object at high speed - **No evidence** of any effort to apply the **brake** - **The foot** may still be on the **accelerator** pedal - History of previous **suicidal attempts.** SUMMARY {#summary.TransOutline} ======= - Factors affecting an automotive crash - 🖊️Seating arrangement where the impact is coming from front impact, rear impact, or roll-over type. Are there intrusions of car structures in the car? - Dynamics of vehicular injury - Mechanism of car occupant injury - Pattern of car occupant injuries - Seatbelts and airbags - 🖊️ The most common type of seatbelt injuries are bruises. As for airbags you can have blowout fractures facial injuries, or fingers amputated because of flying objects as the airbag deploys. - 🖊️ Ejection injuries - Pedestrian-vehicle collisions - Mechanism of pedestrian injury - 🖊️How tall is the bumper colliding with the pedestrian? Was there braking or not? - 🖊️Most common cause of death would be head injury - Primary - 🖊️Most common primary injury: lower limb injuries - 🖊️Characteristic injuries in run-over injuries: flaying - Autopsy considerations - 🖊️Anything that might exclude the possibility of natural disease being a factor or anything that could affect visual acuity, and alertness level like drugs in the system. Cerebrovascular and cardiovascular disease can be a factor. - 🖊️Manner of death can't be determined just by examining the injury patterns or pathologic patterns - 🖊️Victims of suicidal crashes have a certain pattern - 🖊️Single occupant, no other cars involved, no effort to apply the brakes GUIDE QUESTIONS {#guide-questions.TransOutline} =============== 1. What are the factors that broadly affect the patterns of injuries seen in vehicle occupants involved in a vehicular crash? - **Direction of Impact** - Whether the impact is coming from behind or coming from the front or the side; whether the impact would cause the vehicle to roll over. - This would affect injuries from the car's occupant. - **The position and restraint of the occupant** - For instance rear-seat passenger is expected to display different injury patterns compared to the driver or front-seat passenger in a frontal type of injury. - **Intrusion of structural parts into passenger compartment** - If there are structural parts of the vehicle that came into the passenger compartment all the way to original seating position of the car occupant, then that can cause injury. 2. What are the mechanisms of injury in case of a frontal impact, rear impact, side impact or roll-over vehicular crash? - Frontal impact, driver - Frontal impact, front-seat passenger - Frontal impact, rear seat passenger - Rear impact - Side impact - Turn-turtle impact 3. What are the patterns of injuries seen in vehicular occupants involved in the different types of vehicular crashes? - Frontal impact - Pelvic injuries - Thoracic injury - Abdominal injury - Upper limb injuries - Facial injuries - Head injuries - Neck injuries - Rear impact - Whiplash injury - Side impact - Rib fractures - Contusions/laceration of the lungs - Laceration of the spleen, kidneys, liver - Pelvic fracture 4. What are the effects and injuries associated with seat belts and airbags? - Seatbelts - Prevent displacement - Increases stopping distance - Injuries: bruising, fractures of sternum and clavicle, diaphragmatic rupture, visceral injuries - Airbags - Cushion the impact - Prevent hyperflexion - Injuries: facial injuries, eye injuries, head injuries, cervical spine fractures and dislocation amputation of finger, upper extremity fracture and dislocation 5. What is the expected trajectory of a pedestrian struck by an oncoming motor vehicle? - If the center of gravity of the pedestrian is higher compared to the frontmost portion of the low-sloping vehicle, the tendency for the pedestrian is to be scooped up. - If the center of gravity of the pedestrian is lower than the frontmost portion of the low-sloping vehicle, then the tendency for the pedestrian is to be swept under or run over by the vehicle instead of being scooped up. 6. What are primary, secondary, and run-over injuries seen in pedestrian victims of road traffic accidents? - Primary - Lower limbs - Abrasion - Fractures to the tibia and fibula - Fractures to the femur and pelvis - Head (most common cause of death) - Secondary - Multiple abrasions and contusions - No particular pattern - Run-over injuries - Internal injury - Any type of tread pattern abrasion/bruising - Multiple parallel striae or shallow lacerations - Flaying injury 7. What forensic conclusions can be drawn from bumper fractures? - The configuration of the tibial fracture would tell us where the vehicle was coming from upon impact with the pedestrian. - The tendency is that the front (tip) of the wedge- shaped tibial fracture would be pointing away from the point of impact. 8. What are the particular considerations taken in the autopsy of a road traffic accident victim? - Body to be seen clothed Clothing damage and soiling matched with injuries - Blood samples must be retained for analysis - Alcohol analysis - Drugs causing drowsiness - Height of major patterned injuries above heel level must be noted - Any natural disease: - Old and recent cardiac and cerebral lesions - Evidence of a fit - Lesions affecting visual or auditory acuity +-----------------------------------+-----------------------------------+ | **LIVE DISCUSSION \[BATCH | | | 2025\]** | | +===================================+===================================+ | A close-up of a person\'s face | **What is the cause of the | | with blood on his face | scratches on the face?** | | Description automatically | | | generated | *The laceration on the forehead | | | was in contact with the edge of | | | the roof of the car. The | | | lacerations on the side of the | | | face and neck are called sparrow | | | feet lacerations caused by a | | | break in the windshield (parang | | | kinahig ng manok). The guy was | | | ejected out from his car in a | | | vehicular crash.* | +-----------------------------------+-----------------------------------+ |  | | | | - - *You remember the most | | | common injury from a seatbelt | | | is a contusion* | | | | | | - *Seat belt sign is an | | | indicator of possible severe | | | injuries.* | | | | | | - *The victim was seated at the | | | right side by just looking at | | | the diagonal strap of the | | | seatbelt.* | | | | | | *And if you see that, you can | | | make a conclusion as well that | | | this is a high-speed type of | | | vehicular crash because you don't | | | normally see the seatbelt sign in | | | low speed vehicular crash.* | +-----------------------------------+-----------------------------------+ | Graphical user interface | *That's also the seatbelt na | | Description automatically | tumama sa leeg ng ating pasyente | | generated | and when they dissected that, | | | they saw a thrombosis sa carotid | | | arteries. (traumatic thrombosis)* | +-----------------------------------+-----------------------------------+ |  | | | | - *Primary Injury (Bumper | | | Fracture) by a low-slope type | | | of vehicle (e.g., sedan)* | | | | | | - *This is an oblique type of | | | fracture, and it tells you | | | that this foot was planted | | | when he was struck. If it was | | | transverse and not oblique, | | | then it must have been raised | | | at the time when it was | | | struck. If it was planted, he | | | could just be standing | | | there.* | | | | | | **Bakit may scale/ruler? Ano | | | mine-measure nya?** | | | | | | - *It is important to note the | | | height of the bumper fracture | | | from the heel of the victim | | | because you can correlate* | | | | | | - *that with the suspected | | | vehicle that caused the | | | injury.* | +-----------------------------------+-----------------------------------+ | A close-up of a person\'s chest | *This is a run over injury, you | | Description automatically | can see a tire tread pattern. It | | generated | is important to take measurements | | | when you see this pattern.* | | | | | | *If you try to recall your | | | lessons in blunt force trauma, | | | you can call that impact | | | abrasions or contusions.* | +-----------------------------------+-----------------------------------+ |  | | | | - This is a steering wheel | | A close-up of a person\'s chest | injury and it is obvious | | Description automatically | since it follows the pattern | | generated | of the steering wheel. | | | | | | - Just looking at the injury, | | | you can tell without the | | | history that this guy is the | | | driver. I'm guessing that | | | he's probably not restrained | | | because there's not even a | | | mark of the seatbelt. | | | | | | The radiograph shows sternal | | | fracture as a result of steering | | | wheel injury. | +-----------------------------------+-----------------------------------+ |  | | | | Frontal impact injury caused by | | | the airbag. The person suffered | | | an orbital roof fracture, na | | | push-in nya yung eyeball. | +-----------------------------------+-----------------------------------+ | A close-up of a person\'s leg | **Would you say that this person | | Description automatically | was run over**? | | generated | | | | - **NO**, this is a pattern of | | | rain grooves of the pavement. | | | | | | They are **second type of | | | injuries**, not run over | | | injuries. | +-----------------------------------+-----------------------------------+ |  | something like this, you can make | | | a conclusion that this victim was | | | run over.* | +-----------------------------------+-----------------------------------+ {#section.ListParagraph} QUIZ {#quiz.TransOutline} ==== Injuries may not be readily observable at all times TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: A. **TRUE** | +-----------------------------------------------------------------------+ Lacerations are usually present over bony prominences TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: A. **TRUE** | +-----------------------------------------------------------------------+ Abrasions are caused by friction against a rough surface TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: A. **TRUE** | +-----------------------------------------------------------------------+ When the level of leg injury seen in pedestrian victims of a road traffic accident appears too low for the bumper level of any vehicle, the vehicle likely did not break at all TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: B. **FALSE** | +-----------------------------------------------------------------------+ A concussion is a mild form of traumatic brain injury TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE** | | | | ANSWER: A. TRUE | +-----------------------------------------------------------------------+ It is possible to estimate the speed of impact from the nature of the injuries TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE: It is impossible to estimate the speed of impact from | | the nature of the injuries. Fatalities seen event at 10 kph. Only | | minor injuries sometimes seen at high-speed impacts** | | | | ANSWER: B. FALSE | +-----------------------------------------------------------------------+ Loss of teeth will result to deformity under the law in all circumstances TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE: Kasi diba hindi kita kapag sa jaw ka sinapak resulting | | to loss of teeth cuz hindi visible** | | | | ANSWER: B. FALSE | +-----------------------------------------------------------------------+ Ping-Pong ball appearance in head trauma is more common in those advanced age TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE:** | | | | ANSWER: B. FALSE | +-----------------------------------------------------------------------+ A child is more likely to be run over than an adult upon vehicular impact TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE:** | | | | ANSWER: A. TRUE | +-----------------------------------------------------------------------+ In bruises, blood accumulates in a newly formed cavity under the skin TRUE FALSE +-----------------------------------------------------------------------+ | **RATIONALE:** | | | | ANSWER: B. FALSE | +-----------------------------------------------------------------------+ REFERENCES {#references.TransOutline} ========== - Bianca Nympha Mundin. (2024) Road Traffic Accidents \[Lecture PPT\] - Batch 2025 Transcription APPENDIX ======== - No appendices