Road Traffic Accidents

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ROAD TRAFFIC ACCIDENTS

WITH EVERY DAY INCREASE IN NUMBER OF VEHICLES, THE INCIDENCE OF VEHICULAR ACCIDENTS LEADING TO DEATH AND INJURIES IS INCREASING ALARMINGLY. A LARGE NUMBER OF DEAD BODIES BROUGHT FOR AUTOPSY ARE OF RTA(ROAD TRAFFIC ACCIDENTS).

MOTOR VEHICLE ORDINANCE 1965

ACCORDING TO THIS ORDINANCE, MEDICAL CERTIFICATE OF PHYSICAL FITNESS FROM A REGISTERED MEDICAL PRACTITIONER IS NECESSARY FOR DRIVING LICENSE.AS PER ORDINANCE, THE CRITERIA FOR FITNESS ARE,

Applicant should be a major i.e. 18 years of age for license of car/ motorcycle and 21-22 years of age for heavy vehicle such as bus, truck.

The applicant should be physically and mentally fit.

Diseases and disabilities which disqualify a person for driving license are,

EPILEPSY LUNACY HEART DISEASES LIKELY TO CAUSE SUDDEN ATTACK OF

GIDDINESS OR FAINTING. INABILITY TO DISTINGUISH WITH EACH EYE EVEN WITH

GLASSES IF WORN, LETTERS AND FIGURES OF SIZE OF NUMBER PLATE OF A CAR AT A DISTANCE OF 25 YARDS IN GOOD DAY LIGHT.

A DEGREE OF DEAFNESS, WHICH PREVENTS THE APPLICANT FROM HEARING, WITHOUT HEARING AIDS, THE ORDINARY SOUND SIGNALS.

COLOUR BLINDNESS OR INABILITY TO DISTINGUISH BETWEEN RED AND GREEN COLOURS.

NIGHT BLINDNESS. LEPROSY.

FURTHER MORE THIS LAW PROHIBITS DRIVING UNDER INFLUENCE OF ALCOHOL OR DRUGS.

CAUSES OF ROAD TRAFFIC ACCIDENTMECHANICAL CAUSES, FAILURE OF BRAKES, BURSTING OF TYRE, BREAKING OF TIE ROD ETC CARBON MONOXIDE POISONING DUE TO DEFECTIVE ENGINE.ENVIRONMENTAL CAUSES, POOR VISIBILITY TRAFFIC DENSITY/SPEED OF THE CAR. AUDIO VISUAL DISTRACTIONS.PERSONAL CAUSES, PHYSICAL DISABILITY. PSYCHOLOGICAL DISABILITY, SUCH AS DEPRESSION,MANIA,

SCHIZOPHRENIA. PATHOLOGICAL CONDITIONS OCCURRING AS ACUTE EPISODES, SUCH

AS CORONARY DISEASE, EPILEPSY. SPONTANEOUS ILLNESSES SUCH AS RENAL COLIC, BILIARY COLIC. SYSTEMIC DISEASES SUCH AS HYPERTENSION, DIABETES. DRUGS,SUCH AS ALCOHOL, TRANQUILLIZERS,AMPHETAMINES. FATIGUE,AFFECTING MENTAL ALERTNESS AND POWER OF DICISION.

ROAD TRAFFIC ACCIDENTS ON THE BASIS OF

NUMBER OF VEHICLES: SINGLE/MULTIPLE DIRECTION OF IMPACT:FRONT/REAR/LATERALMOTIVE: HIT ACCIDENTS --- HOMICIDE/SUICIDE

OR DUE TO INTOXICATION EXTENT OF DAMAGE,MINORMODERATESEVEREFATAL

EXTENT OF DAMAGE TO THE INJURED

MINOR- TRIVIAL INJURIES,VICTIM NOT HOSPITALIZED.

MODERATE- INJURIES SERIOUS, VICTIM HOSPITALIZED FOR A WEEK.

SEVERE- INJURIES ENDANGER LIFE, VICTIM HOSPITALIZED FOR MORE THAN A WEEK.

FATAL- VICTIM EITHER DIES ON THE SPOT OR WITHIN 30 DAYS OF HOSPITALIZATION.

INJURIES IN ROAD TRAFFIC ACCIDENT CAN BE DIVIDED IN TO, INJURIES TO THE PEDESTRIANS.

INJURIES TO THE DRIVER.

INJURIES TO FRONT SEAT OCCUPANT

INJURIES TO REAR SEAT OCCUPANTS

INJURIES TO THE PEDESTRIANS

PRIMARY IMPACT INJURIES

SECONDARY IMPACT INJURIES

SECONDARY INJURIES

RUN OVER INJURIES

Height of pedestrian determines site and nature of injuries

Head , thorax in children Abdomen, back , legs in adults Fracture dislocation of lumber or

thoracic spine Tears to abdomen, inguinal region Injuries to chest wall, thoracic

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THESE ARE THE INJURIES SUSTAINED AS A RESULT OF DIRECT IMPACT OF THE PEDESTRIAN WITH THE VEHICLE AND MOST COMMON IS MID SHAFT FRACTURES OF TIBIA AND FIBULA, KNOWN AS BUMBER FRACTURE.

GRILL AND HEAD LIGHT RIMS MAY PRODUCE PATTERNED ABRASION LACERATIONS AND BRUISES.

If point of impact is above centre of gravity, victim is thrown to ground and run over by same car

If below , person thrown to bonnet, hood, road behind vehicle

If contact with wind shield head injuries, lacerations seen.

AFTER THE PRIMARY IMPACT,THE FEET OF THE VICTIM SLIDE AND THE WHOLE BODY IS LIFTED OFF THE GROUND AND THROWN ON TO THE VEHICLE.THE HEAD MAY STRIKE THE WIND SCREEN AND BODY MAY STRIKE THE BONNET OR OTHER PARTS OF THE CAR, PRODUCING CONTUSIONS AND LACERATIONS.

SCOOPING UP ----seen in parts opp. To primary impact

Usually on head or unclothed parts of body

Countre coup injuries seen.

SECONDARY INJURIES AFTER SECONDARY IMPACT THE VICTIM IS

THROWN ON TO THE GROUND AND DUE TO COMING IN CONTACT WITH THE GROUND AND SKIDDING ON ROUGH ROAD, HE MAY HAVE GRAZES,CONTUSIONS, LACERATIONS AND FRACTURES,HEAD INJURIES ARE VERY COMMON.THE MOST IMPORTANT POINT TO BE NOTED IS THAT SECONDARY INJURIES ARE SEEN ON OPPOSITE SIDE OF BODY HAVING PRIMARY IMPACT INJURIES.

RUN OVER INJURIES THE VEHICLE MAY PASS OVER THE BODY

AND LIMBS CAUSING CRUSH INJURIES LEADING TO RUPTURE OF INTERNAL ORGANS AND AVULSION ALONG WITH FRACTURES OF BONES OF THE LIMBS, DEGLOVING OR FLAYING INJURIES

IMPRINT MARKS OF WHEELS OF VEHICLE FOUND ON CLOTHES AND BODY.SOME TIMES SKULL BONES MAY BE CRUSHING WITH BRAIN MATTER OOZING OUT.

INJURIES TO THE DRIVER

STEERING WHEEL INJURIES

WIND SCREEN INJURIES

WHIP LASH INJURIES

INJURIES TO LOWER LIMBS

STEERING WHEEL INJURIES

DUE TO IMPACT OF CHEST AGAINST THE STEERING WHEEL, USUALLY CAUSING TRANSVERSE FRACTURE OF STERNUM AT THE LEVEL OF JUNCTION OF MANIBRIUM WITH THE BODY OF STERNUM.IT MAY BE ACCOMPANIED BY FRACTURE OF RIBS LEADING TO PNEUMOTHORAX, HAEMOTHORAX AND DISPLACED LOWER SEGMENT OF STERNUM MAY CAUSE CARDIAC TEMPONADE.THERE MAY BE TRAUMATIC ASPHYXIA.

WIND SCREEN INJURIES A COMMON INJURY TO THE FACE

SEEN IN ROAD TRAFFIC ACCIDENTS TO THE DRIVER IS BIRD FEET INJURY WHICH IS DUE TO BREAKING OF WIND SCREEN CAUSING PIECES OF BROKEN GLASS TO CAUSE LACERATED WOUNDS OF THE FACE AND IT APPEAR AS IF SOME BIRD HAS INJURED THE FACE WITH CLAWS.(WIND SCREEN INJURIES)

WHIP LASH INJURIES THESE ARE HYPER FLEXION AND

HYPER EXTENSION INJURIES OF NECK KNOWN AS WHIPLASH INJURIES, WHICH ARE MOST COMMONLY SEEN IN MOTOR CAR ACCIDENTS IN DRIVERS WHERE DUE TO SUDDEN STOPPAGE OF A VEHICLE IN SPEED CAUSES HYPERFLEXION AND THEN HYPER EXTENSION OF NECK, PULLING THE NERVES AT THE ROOT OF NECK LEADING TO PARALYSIS OF LIMBS.

INJURIES TO LOWER LIMBS AND OTHER INJURIES

IN AN ATTEMT TO APPLY BRAKES FORCE FROM PEDALS MAY CAUSE FRACTURE OF LEG AND THIGH BONES.

SOME TIMES THE DRIVER MAY BE THROWN OUT OF THE VEHICLE AND DUE TO FALLING ON THE GROUND MAY RECEIVE ALL TYPES OF INJURIES RANGING FROM ABRASIONS, BRUISES, LACERATIONS TO FRACTURES OF HEAD AND OTHER BONES.

INJURIES TO FRONT SEAT OCCUPANT

DASH BOARD INJURIES-DUE TO SUDDEN STOPPAGE OF THE CAR, THE OCCUPANT MAY STRKE THE DASH BOARD CAUSING FRACTURE OF THE NOSE OR DISLOCATION OF TEETH.

HEAD INJURIES ALONG WITH BLACK EYE MAY BE SEEN.

WIND SCREEN INJURIES ARE ALSO SEEN. FRACTURE OF BONES OF LOWER LIMBS MAY

ALSO BE SEEN. WHIP LASH INJURIES. EJECTION INJURIES MAY ALSO BE SEEN DUE

TO THROWING OFF THE VEHICLE DUE TO OPENING OF DOOR.

INJURIES TO REAR SEAT OCCUPANTS

BACK SEAT OCCUPANTS CAN SUFFER INJURIES TO THE HEAD AND CHEST DUE TO STRIKING AGAINST THE BACK OF FRONT SEATS,MORE OVER THERE MAY BE ABRASIONS AND BRUISES OVER BONY PROMINENCES.

WHIP LASH INJURIES. INJURIES DUE TO BREAKING OF DOOR GLASS. SOME TIMES MAY BE THROWN OUT OF THE CAR

AND RECEIVING ABRASIONS(GRAZES),BRUISES, LACERATED WOUNDS AND FRACTURES.

SOME TIMES THE DOORS ARE JAMMED AND IF VEHICLE CATCHES FIRE ALL OCCUPANTS INCLUDING DRIVER MAY SUSTAIN BURNS.

INJURIES TO MOTORCYCLIST

MOTORCYCLIST FRACTURE---base of skull divided in two halves like a hinge.

RING FRACTURE—around foramen magnum

ATLANTO-OCCIPITAL AVUULSION TAILGATING—decapitation seen Fractures of base of skull.

RAILWAY INJURIES

SUICIDAL—decapitation, other injuries due to primary impact

COLLISION—whip lash injury, raiway spine

Head injuries, electrocution.

AIRCRAFT INJURIES

Total disintegration of body Decompression injuries Dysbarism Fire, CO poisoning Hypothermia Fat embolism, rupture of visceras. Leg injuries, fracture of spine.

Road Traffic Accidents

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