The influence of damage distribution on serious brain injury in occupants in frontal motor vehicle crashes

Coimbra, Raúl; Conroy, Carol; Hoyt, David B.; Pacyna, Sharon; May, Murray; Erwin, Sheree; Tominaga, Gail T.; Kennedy, Frank; Sise, Michael J.; Velky, Thomas

doi:10.1016/j.aap.2008.04.004

Cited by 9 publications

(5 citation statements)

References 15 publications

(15 reference statements)

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“…Much of the literature focuses on injuries in isolation, as opposed to patterns or constellations of injuries. Several papers consider individual cases, case series and mechanism type for a variety of individual injuries including limb [26–29], aortic [30–34], pelvic [35–37] brain [38–41], abdominal [30,42,43] and other body areas and injury types [44–50]. Injured obese patients were identified as having worse outcomes [51].…”

Section: Discussionmentioning

confidence: 99%

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Extrication of patients trapped following a motor vehicle collision: a systematic scoping review of the literature

Nutbeam

2024

Preprint

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BackgroundExtrication is the process of removing injured or potentially injured people from their vehicles. The origin of current extrication techniques and paradigms is largely unknown. An understanding of the historical evidence related to motor vehicle collisions (MVCs), injuries and deaths will provide context for accepted, contemporary, extrication practices.MethodsExtrication related search terms were developed and applied across of range of sources including Clinical and health care data, Trial registries, Grey literature, Academic and specific Transport related sources.Results7089 articles were identified, following review, 170 are included in this qualitative synthesis. Key themes / categories included: Extrication training and principles, Injures, Immobilisation, Care during entrapment, Clinical response type, Vehicle deformity intrusion entrapment, and Extrication.ConclusionThere is a paucity of published evidence to support the current approach to extrication of entrapped patients following an MVC. Focused studies identifying in detail the injures and their sequelae associated with entrapment, the biomechanics of current techniques and ensuring that the patient perspective is captured will enable the development of much needed evidence based multidisciplinary guidance.

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Section: Discussionmentioning

confidence: 99%

“…Much of the literature focuses on injuries in isolation, as opposed to patterns or constellations of injuries. Several papers consider individual cases, case series and mechanism type for a variety of individual injuries including limb [26][27][28][29], aortic [30][31][32][33][34], pelvic [35][36][37] brain [38][39][40][41],…”

Section: Injuriesmentioning

confidence: 99%

Extrication of patients trapped following a motor vehicle collision: a systematic scoping review of the literature

Nutbeam

2024

Preprint

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“…& The use of restraint devices in automobiles and helmets during motorcycle riding and sports activities has proven to be beneficial. Their use must be emphasized by the health care system [6,7]. & The role of appropriate nutrition replacements is important in the course of recovery, especially with severe head injuries.…”

Section: Diet and Lifestylementioning

confidence: 99%

Management of Traumatic Brain Injury

Losiniecki

Shutter

2010

Curr Treat Options Neurol

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Traumatic brain injury (TBI) is a complex disease process that requires constant attention as one manages the associated body systems. Even though an "isolated" brain injury may be the cause for admission to the hospital, the injured brain cannot be thought of in isolation from the remainder of the body. All body systems, from cardiac to pulmonary, need to be addressed as one moves from the initial to the long-term management of the TBI. The multiple issues are best addressed with a dedicated neurocritical care team that is in continuous communication with the neurosurgical team throughout the course of treatment. To date, no pharmacologic treatment has led to improved outcomes after TBI, but it is becoming increasingly clear that advances in the critical care of TBI patients are contributing to better results.During resuscitation of the TBI patient, medical management in its simplest form strives to return measurable vital signs and laboratory values (eg, intracranial pressure, mean arterial pressure, blood glucose, PaO(2), or PaCO(2)) to their normal range. The initial goal is to maintain or reestablish normal homeostasis.The initial injury to the brain is irreversible by any medical modalities available today. After the initial resuscitation, medical maneuvers are directed at limiting secondary damage to the brain. Secondary brain injury occurs in response to inflammatory changes, expanding hematomas, cellular swelling, seizures, and systemic complications (ie, hemodynamic or pulmonary changes, fever, pain); vulnerable surrounding brain tissue can be damaged through alterations in cerebral perfusion and metabolism. Treatments to address these issues include, but are not limited to, analgesics, sedatives, anticonvulsants, hyperosmotic agents, and hypothermia.The future of TBI care likely lies in the areas of better injury classification to guide therapeutic interventions, management of secondary injury, improved technology for intracranial monitoring, and regeneration/rehabilitation. Studies focusing on signaling pathways, neural stem cells, and reparative medications are all in the early stages of development; their use is currently experimental at best.There are few areas in medicine where clinicians have the opportunity to impact a patient's life to the degree seen in the management of TBI. Although parts of the proverbial puzzle certainly remain unsolved, it is the remarkable recoveries that patients make with the therapeutic modalities available today that keep management of TBI one of the most exciting areas in medicine.

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“…Intrusion of the occupant compartment has been related to occupant injury (Coimbra et al 2008;Conroy et al 2008;Stefanopoulos et al 2003). Blum et al (2008) suggested that the front stiffness of vehicles should be increased to reduce intrusion; however, there is a need to balance vehicle structures for compatibility in vehicle-to-vehicle collisions.…”

Section: Introductionmentioning

confidence: 98%

Injury Risks in Frontal Crashes by Delta V and Body Region With Focus on Head Injuries in Low-Speed Collisions

Viano¹,

Parenteau²

2010

Traffic Injury Prevention

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The influence of damage distribution on serious brain injury in occupants in frontal motor vehicle crashes

Cited by 9 publications

References 15 publications

Extrication of patients trapped following a motor vehicle collision: a systematic scoping review of the literature

Extrication of patients trapped following a motor vehicle collision: a systematic scoping review of the literature

Management of Traumatic Brain Injury

Injury Risks in Frontal Crashes by Delta V and Body Region With Focus on Head Injuries in Low-Speed Collisions

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