impact injury

▪ trauma

      the damage caused by the collision of a body with a moving or stationary object. Impact injuries can occur in any accident involving moving vehicles, such as automobiles, motorcycles, and trains, parachute landings, seat ejections, aircraft crashes, rocket accelerations and decelerations, and supersonic windblasts. The extent of injury depends upon the velocity, distance travelled, duration of impact, direction of impact, and absorption of stresses by the body or objects struck.

      Injuries to the head can deform the skull or soft tissue beneath the area of impact, increase the area of impact, increase the pressure within the skull, move the intracranial contents, or shear off part of the head. Usually in such instances there is immediate loss of consciousness, loss of eye reflex, impairment or stoppage of breathing, and a drop in blood pressure. The face is also subject to impact injuries. The severity of the affliction depends upon the area struck. The nose and bridge between the eyes are most susceptible to damage; next most susceptible is the chin. More resistant to injury are the cheek bones and forehead.

      Injury to the neck can occur when the vertebrae are compressed, stretched, or twisted. The vertebrae may be dislocated or fractured, and the spinal cord may be severed. The air passageways located in the neck (the windpipe and the larynx, or voice box) can become obstructed, causing suffocation. Most neck injuries are the result of whiplash.

      The chest and abdomen are also vulnerable to impact stress. Compression of the rib cage and breastbone may produce fractures. The impact wave itself can cause displacement of the heart, tearing of the large vessels, rupture of the heart, and displacement of the uterus, spleen, stomach, and liver. Membranes supporting the internal organs usually tear if organ displacement occurs. Seat belts aid in restraining the victim from being thrown from a vehicle under impact; they can also be a source of injury, however. Perforation, scarring, hemorrhage, lacerations, and tearing of the bowels, kidneys, uterus, and bladder have been attributed to seat-belt restraint. An ideal protective device for prevention of thoracic and abdominal injuries must be secure enough to prevent ejection of the body from the vehicle but slack enough to allow some displacement from the seat during absorption of the impact shock.

      Supersonic speeds (900 miles per hour and greater) may produce impact stress from exposure to the air. Exposed skin may be denuded, dehydrated, lacerated, and burned by the frictional forces of wind velocity against the body. Hemorrhages may occur in the eyes, sinuses, ears, lungs, and skin. If the head is unrestrained neck injuries may occur. The eyelids may be swollen shut and torn; visual distortion may occur. Clothing worn by pilots ejected from planes at supersonic speeds disintegrates if it is not made of heavy nylon or other durable fabrics. To protect the pilot from frictional burns, heat-resistant suits are used; special helmets are also necessary to prevent facial injury.

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