It can happen to anyone. All it takes is a nano-second of distraction for a collision to occur. You didn't see it coming or perhaps he didn't notice you in time. And though it may sound like the stuff of suburban legend, statistics show that most traffic accidents occur close to home. On familiar streets you're more relaxed and thus prone to forgo basic safety measures like wearing a seatbelt. You're also less likely to notice subtle changes like a new stop sign or a speed bump and more apt to check your cell phone.
Never mind the bump on your head or the pain in your neck. Your first worry is the damage to your car. Upon further inspection the dent or ding you feared is hardly detectible. Insurance information gets exchanged just in case you notice something more significant later and off you go.
But experts note little correlation between damage to a car and damage to a body. Fender benders can result in hidden injuries that develop into pain and headaches. "Even low-impact collisions can cause injuries, some not appearing until days after the accident," says former emergency room physician's assistant turned college professor Scott Massey, PhD, PA-C. "Car accidents—even small ones—can be traumatic and often during times of trauma people don't perceive pain. They walk away thinking they're okay but they may not be."
Massey recalls a patient who had been in a minor motorcycle accident. "He walked around for a week with internal bleeding before he realized he had seriously injured his spleen. The poor guy ended up having life-saving surgery."
Minor injury can be defined as non-life threatening and includes: sprains, strains and fractures; whiplash; shoulder, neck, and lower back pain; seatbelt injuries; air bag injuries to the face, eyes, and chest; hitting your head on the steering wheel, dashboard, or side window; headaches; hematomas; numbness and dizziness.
Pain is the body's way of getting you to pay attention, says Holly Herron, RN, MS, CNS, EMT-P Clinical Coordinator, Department of Nursing, Otterbein University in Ohio. "Cracked ribs typically get evaluated due to the pain they cause. The chest hurts so badly people take little bird breaths that don't fully expand the lungs and doing this puts you at risk of developing pneumonia which can be worse than the rib fractures."
Aches, pains, and bruises that aren't examined by a doctor can also be worrisome. "Banging your head is a bigger deal than sometimes people realize. A bad headache—even a few days after an accident—should be evaluated," says Herron who has seen her share of tragic motor vehicle accidents during her 30 years as a flight nurse and paramedic with MedFlight of Ohio. "The head may look fine but problems can develop from bleeding or swelling inside the skull." Seek medical help right away if an accident victim vomits, loses consciousness (even briefly), becomes drowsy, behaves abnormally, develops a severe headache, or stiff neck.
Some large and painful hematomas (bruises) can belie larger issues underneath, according to Herron. "A large bruise that is swollen and very painful may indicate that the underlying structure has been damaged," says the nurse. "If the bruise isn't particularly painful or swollen, you are probably okay."
Both experts agree that neck pain should never be dismissed. Herron and Massey suggest having an x-ray to rule out any kind of fracture in the neck structure. "Sometimes the pain can be the result of a soft tissue or muscle strain," says Herron. "But taking a chance is foolish. Fractures in the neck or vertebrae that aren't properly immobilized can lead to much worse problems." Older people are particularly susceptible to thoracic compression fractures from the bouncing and banging that typically happens in car accidents.
At speeds over 45 mph some kind of trauma or injury to the spine is almost guaranteed. The instant force can jolt the body with enough impact to cause injuries ranging from dislocation and bruising of ligaments and muscles to broken vertebrae. Abnormal twisting of the head, neck, or back can result in bleeding, fluid accumulation, and swelling inside or outside of the spinal cord that can compress and damage it.
Herron points out the danger of using airbags incorrectly. "Airbags save lives, but when deployed in the absence of seatbelts, [it] deliver[s] a 75 mph punch to the face and chest that can break your nose or other bones and possibly cause you to lose your eye," she says explaining that many people have allergic reactions and get burned by the powder released with the airbag.
Recent Safety Advances Lead to Safer Roads
The good news is trauma is down significantly across the U.S. thanks to education and prevention efforts, laws prohibiting texting while driving, and driving under the influence of drugs and/or alcohol, and better safety systems. According to the National Highway Traffic Safety Administration, since 2005, fatalities in motor vehicle crashes have declined by roughly 25 percent.
Safety improvements such as rumble strips which help keep people from falling asleep (studies show sleepy drivers are as dangerous as drunk ones), water-filled traffic barriers that absorb impact better than concrete and metal, and barely visible wires that keep cars from crossing the median strip have done much to improve safety on the highway and reduce fatalities.
So buckle up and stay focused at the wheel. To learn more visit the National Safety Council's website.
Sources:
Interview with Scott Massey, PhD, PA-C, founding program director and professor of physician assistant studies at Misericordia University in Dallas, PA
Interview with Holly Herron, RN, CNS, EMT-P Clinical Coordinator, Department of Nursing, Otterbein University and flight nurse, MedFlight of Ohio; LifeLink & EMS Education Program Manager, Grant Medical Center, Ohio.
National Safety Council
http://www.nsc.org
National Highway Traffic Safety Administration
http://www.nhtsa.boe
