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Injuries in pediatric patients with seatbelt contusions
D J Campbell1, L Richard Sprouse, Lisa A Smith
1Department of Surgery, The University of Tennessee College of Medicine-Chattanooga Unit, Chattanooga, Tennessee 37403, USA.
Insights
Children wearing lap belts can suffer severe injuries. Seatbelt contusions in children, especially smaller ones, indicate a high risk of internal abdominal injuries, often requiring surgery.
Area of Science:
- Pediatric Trauma Surgery
- Occupant Restraint Safety
- Abdominal Wall Contusions
Background:
- Lap belts, while intended for safety, can cause significant injuries in children.
- Seatbelt contusions are a visible sign that warrants investigation for internal trauma.
Purpose of the Study:
- To determine the frequency and types of injuries associated with seatbelt contusions in pediatric trauma patients.
- To identify risk factors for severe injuries in children with seatbelt contusions.
Main Methods:
- Retrospective review of trauma patient medical records (1999-2001).
- Inclusion criteria: ICD-9 codes for abdominal wall contusions and documented seatbelt contusions.
- Data collected: age, seat position, weight, restraint type, sex, and injury mechanism.
Main Results:
- 46 pediatric patients (ages 4-13) had seatbelt contusions.
- 33 used lap belts; 13 used lap and shoulder harnesses.
- 22 children required abdominal exploration; small bowel injuries were most common.
- Facial injuries were the most frequent associated injuries.
- 48% of children with seatbelt contusions required surgery.
- Smaller patients showed a higher frequency of abdominal injuries.
Conclusions:
- Seatbelt contusions in children are indicators of potential severe internal injuries, particularly abdominal trauma.
- The type of restraint (lap belt vs. lap and shoulder harness) and patient size influence injury patterns.
- Prompt medical evaluation is crucial for children presenting with seatbelt contusions.
Abstract:
Children restrained with lap belts may sustain severe injuries. We investigated the frequency of each type of injury associated with seatbelt contusions. The medical records of all trauma patients with ICD-9 codes for abdominal wall contusions from January 1, 1999, to December 31, 2001, were reviewed. All patients with seatbelt contusions were included in the study. Age, seat position, weight, restraint-type, sex, and mechanism of injury were noted. There were 1447 admissions for trauma over the 3-year period. Forty-six patients (ages 4-13) had a seatbelt contusion. Thirty-three wore lap belts, and 13 wore lap and shoulder harnesses. Twenty-two children required abdominal exploration. Small bowel injuries were the most common intra-abdominal injuries. Facial injuries were the most common associated injuries. Forty-eight per cent of children with seatbelt contusions in our institution required surgery. The smaller patients tend to have higher frequency of abdominal injuries. The presence of seatbelt contusion indicates the possibility of severe internal injuries.
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Assessment:
1. Clinical Evaluation:
History: