#SEAT BELT SIGN TRAUMA SKIN#
#SEAT BELT SIGN TRAUMA FULL#

Plain x-rays of the chest and pelvis are typically performed in patients with a significant mechanism of trauma. A urinalysis may detect injury to the genitourinary system. Leukocytosis, low hemoglobin, elevated liver transaminases, elevated amylase and lipase, elevated lactate, and a high base deficit can all alert the clinician to the presence of serious injury. Laboratory testing varies in sensitivity and specificity in MVC patients.

#SEAT BELT SIGN TRAUMA FULL#

Neurologic disability should be briefly evaluated, and full exposure of the patient should take place to ensure no missed injuries. Vital signs and the shock index should be trended for deterioration. Thoracic injuries due to seat belt force include sternal fracture, rib fracture, pulmonary contusion, and more rarely myocardial contusion.Īirway (with cervical spine protection), breathing, and circulation should be assessed first in all patients. When the seat belt impacts the neck, the clinician may diagnose the cervical vascular injury, cervical spine fracture, or clavicle fracture. Likewise, injuries to the pancreas, kidneys, and any other visceral organ can occur. Solid-organ injuries such as liver and spleen laceration can occur in these patients.

#SEAT BELT SIGN TRAUMA SKIN#

Skin abrasions and bruising occur on the surface, while common internal injuries are bowel and mesenteric injuries, along with fractures of the lumbar spine. The 'seat belt syndrome' referred to the musculoskeletal and visceral injuries associated with the force transmitted by the seat belt. The 'seat belt sign' was first described by Garrett and Braunstein in 1962 as an ecchymosis across the abdominal wall in the location of a lap belt. The seat belt can act as a fulcrum, with a point of contact remaining fixed in the same location while the areas above and below continuing forward. When a seatbelt rests on the neck or well above the ASIS, force is transmitted to the softer neck area and the more vulnerable abdominal viscera.Īll injury patterns are explained by the transmission of physical force.

Seat belts are designed to transmit the energy to the clavicle, chest wall, and superior pelvis (anterior superior iliac spine ). High vehicle speed, vehicle rollover, passenger ejection, and loss of consciousness with a low Glasgow coma scale (GCS) are predictive of more force transmission and, therefore, severe injury. Routine laparotomy or mandatory evaluation by specific diagnostic tests is not justified rather, a high index of suspicion with a low threshold for appropriate diagnostic evaluation and/or surgical exploration should be maintained for the optimal management of such patients.Injury in MVC trauma is related to change in velocity and dissipation of energy. The presence of the SBM sign should alert the physician to the high likelihood of specific internal injuries. There was a near 4-fold increase in thoracic trauma (22.5% versus 6% P=0.01) and a near 8-fold increase in intra-abdominal trauma (23% versus 3% P < 0.0001) between the groups of patients with and without SBMs. Three patients were found to have myocardial contusion, and 10 patients had intra-abdominal injuries (predominantly bowel and mesenteric lacerations) requiring laparotomy. No significant neck injuries were detected. Of patients with SBMs, 9 per cent had neck bruises, 32 per cent had chest bruises, 40 per cent had abdominal bruises, and 19 per cent had bruises in multiple sites. The injuries of these 77 patients were compared with the injuries of belted patients without an SBM sign. Of 650 car occupants, 410 (63%) were restrained and 77 (12%) had a SBM across the abdomen, chest or neck. The prospective study included consecutive patients involved in road traffic accidents who were admitted at an academic Level I trauma center. The objective of this study was to find the incidence of surgically correctable injuries in belted car occupants with a SBM sign and to define strategies of early detection and treatment of such injuries.

No study has yet defined the exact incidence of injuries requiring intervention at the presence of this sign. Skin bruise corresponding to the site of the seat belt is known as the 'seat belt mark' (SBM) sign and is associated with a high incidence of significant organ injuries. The use of seat belts is shown to cause a specific pattern of internal injuries.

Seat belt sign trauma