Pedestrian injuries in road traffic accidents

A Road Traffic Accident ( RTA) can be defined as, an event that occurs on a way or street open to public traffic; resulting in one or more person being injured or killed, where at least one moving vehicle is involved.

1. Pedestrian injuries in road traffic accidents pptx. Michael Kino MBBS,NEIGRIHMS

2. Definition A Road Traffic Accidents( RTA) can be defined as, an event that occur on a way or street open to public traffic; resulting in one or more person being injured or killed, where at least one moving vehicle is involved. Source: Transport Research Wing, Ministry of Road Transport and Highways, Government of India 2011

3. Injuries to Pedestrians Three patterns of injury are often seen. Impact Injuries - when vehicle strike the victim Secondary injuries - due to victim falling on ground or striking and other stationary object Run-over Injuries - vehicle running over some part of victim

4. Impact Injuries Primary impact injuries : Initial impact of the vehicle Height of the pedestrian often determine site of injury Projection of vehicle may cause specific injuries (bumper fracture of tibia & fibula of one or both sides) Body of the victim may bear design/pattern of the part of vehicle in the form of imprint abrasion, pattern bruised. If the vehicle was breaking violently at the moment of impact , the front end of the vehicle dips down and the legs get injured at the lower level Helps out to find out the relative position of pedestrian and vehicle and kind of vehicle involved in the incident.

5. Image source: https://www.scribd.com Primary impact injuries

6. The injuries comprises of damage to skin and fracture of bone also know as Bumper fracture. Bumper fracture usually involves tibia. The fracture is wedge shaped with base of triangular fragments indicating the site of impact. Frequently the bumper fracture are at different level of two legs or absent on one legs, suggesting the victim was walking or running when struck.

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8. Secondary impact injury Impact of the body of the person and the vehicle for the second time Person may be lifted off the ground and thrown of the vehicle Here the person usually strike the windshield, bonnet or placed on the top of car/vehicle. Usually found on parts opposite to primary impact After the second impact injuries, the victim will be thrown on the ground

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10. Extensive abrasion, bruises and laceration may be seen Some pedestrians are ‘run over’ if knocked down by vehicle. This will tend to occur if the pedestrians center of gravity is lower then the impact side or scooped-up victim being run over by the vehicle Injuries are variable, depending on the area of the body involved. The weight of the vehicle and the surface area of contact there may be: Tyre trade marks, grazed abrasion Injuries to pelvis, abdomen, and chest (flail chest) Burning and singeing of skin

11. Image source: www.google.com

12. Secondary Injuries Injuries that occurs after second impact injuries when the victim is thrown off the vehicle on the ground Head injuries is common though injuries to other part may occur Some times the victim may be run over by the same vehicle and the another vehicle Brain damage is frequent without any associated skull fractures Fracture of the skull and the ribs due to direct contact with a surface, and fracture of spine due to hyperflexion or extension may be seen

13. Fracture of the limbs are common but apart from toes of the legs Usually it is very difficult to classify the injuries as primary impact, secondary impact or secondary injuries In pedestrians accidents, the common cause of death is head injuries and fracture dislocation of cervical spine. Injuries of the chest and abdomen are minimal or absent

14. Run-over Injuries vehicle running over some part of victim Severity of the injury will depend upon the parts of the body run over and the weight of the vehicle E.g.- degloving injury, tyre marks, burns, avulsion etc

15. References Pillay VV, Textbook of Forensic Medicine and Toxicology 18 th edition Hyderabad: Paras Medical Publisher(P) Ltd;2017 Dr. Reddy Narayan K S, The Essentials of Forensic Medicine and Toxicology 33th edition New Delhi: Jaypee Bothers Medical Publishers(P) Ltd; 2014 Internet references- https://www.slideshare.net https://www.srcibd.com www.google.com