Airbag-mediated craniocervical injury in a child restrained with safety device

Airbag deployment and cervical spine injury in restrained drivers following motor vehicle collisions

PURPOSE

Seatbelts and airbags are the most important devices protecting drivers from cervical spine injury (CSI) following motor vehicle collisions (MVCs). However, there have been few reports on the radiographic characteristics of CSI sustained by restrained, airbag-deployed drivers.

METHODS

A single-center, retrospective observational study was conducted using prospectively acquired data. Between January 2011 and December 2017, 564 restrained drivers, whose vehicle had been severely damaged in MVCs, underwent whole-body computed tomography for evaluation of bodily injuries. The drivers were dichotomized into airbag (+) group (n = 218) and airbag (-) group (n = 139), after excluding 207 drivers in whom airbag deployment status was unknown.

RESULTS

Eight and nine drivers sustained CSIs in the airbag (+) and airbag (-) group, respectively. The frequency of CSI did not differ significantly between the two groups (3.7% vs. 6.5%, p = 0.31). All eight CSIs in the airbag (+) group were classified as hyperextension injuries, and four of them sustained concomitant spinal cord injuries caused by dislocation. Within the airbag (+) group, the drivers with CSIs were significantly older than those without CSIs (65.2 ± 18.5 vs. 44.8 ± 18.7 years, p = 0.002).

CONCLUSION

Although it is without doubt that the combination of seatbelt and airbag reduces the frequency and severity of CSIs following MVCs, the CSIs sustained in restrained, airbag (+) drivers may not always be mild, and elderly drivers may be at an elevated risk of CSI. In addition, the possibility of a causal role of airbags in CSI requires consideration in this population.

A fatal case of air-bag-mediated liver injury in an unrestrained driver

A middle-aged man, who drove a small vehicle while drunken and not wearing a seat belt, crashed head on into a pier wall at a high speed. The rapid air-bag deployment caused abdominal compression of the driver, who was found dead 2 m away from the car. There were facial front-glass injuries and multiple rib fractures, but no head injury. Autopsy disclosed liver laceration with intra-abdominal hemorrhage (2,000 mL), resulting in hemorrhagic shock. This is the first autopsy report of liver laceration caused by the rapid expansion of an air-bag during an automobile crash.

Burn injuries resulting from (accidental) airbag inflation

INTRODUCTION

Airbags are intended to minimize facial injuries, alone and when used in combination with seatbelts in high-velocity motor-vehicle accidents. They may occasionally perforate, resulting in the release of sodium azide or sodium hydroxide, which result in chemical burns when in contact with skin. The force of deployment may itself result in significant blunt trauma, and there is a temperature rise during the inflation causing thermal burns, possibly as a separate and unnecessary consequence of a relatively minor accident.

METHOD

A case report is presented. The literature on such injuries was reviewed and the mechanism of airbag deployment commented.

CONCLUSION

Alternative designs and mechanisms of linking the activation of the device to the velocity of travel or to add a switch which is activated when accessing a motorway are recommended.