Head and neck injuries following road traffic crashes are frequently life threatening conditions. and the most common cause of morbidity and mortality. Rapid removal of the casualty to hospital improves the chance of survival. The first aid fundamental decision at pre-hospital assistance is to identify trauma patient not suitable for any resuscitation procedure beyond typical circumstances of obvious death (decapitation; dismemberment; decomposition; incineration). The “Platinum Ten Minutes” have been introduced just to clarify the need of hurry in extricating the seriously injured road crash victim and providing immediate health care to ensure airway control and protection to the cervical spine. We analyse a real situation where death was diagnosed on site after limited resuscitation attempts. A young 14 y.o. boy, car rear passenger, remained severely injured in a road traffic accident. Extracted by his friends from the car he was unconscious and vomiting. First aid volunteers and the medical team arrived on site after around 20 minutes from the car crash and performed assisted AMBU-ventilation (15 min) in the patient with severe head trauma presenting cardiac and respiratory arrest. Death was diagnosed 30 minutes from the car crash. The father of the boy, an intensivist physician, presented a complaint to the police about the inadequate, resuscitation’s procedures performed to his son. At autopsy the pathologist found severe cranial fractures, meningeal and mid-brain haemorrhages, obstruction of the airways by food material and a hepatic superficial injury with scarce, circumscribed hemoperitoneum. Microscopic study confirms the micro-haemorrhages of cerebellar cortex, mid-brain and pons. The young patient was pronounced death at the crash scene after minimal resuscitation procedures. We analyzed the circumstances after the crash, with extrication of the casualty from the car by laymen and the described resuscitation procedures practiced identifying correct procedures in pre-hospital medical approach.
Schillaci, D. (2011). Road Crash Victim:Pre-Hospital Medical Decision Making And Death Diagnosis. In Abstract Proceedings International Symposium on Legal Medicine Osteuropaverein, Tirgu Mures (RO) 23-26 June 2011 (pp.34-35). Targu Mures : INSTITUTE OF LEGAL MEDICINE TIRGU MURES, ROMANIA; “MEDICINA LEGALIS” Professional Society Tirgu Mures.
Road Crash Victim:Pre-Hospital Medical Decision Making And Death Diagnosis
SCHILLACI, DANIELA ROBERTA
2011
Abstract
Head and neck injuries following road traffic crashes are frequently life threatening conditions. and the most common cause of morbidity and mortality. Rapid removal of the casualty to hospital improves the chance of survival. The first aid fundamental decision at pre-hospital assistance is to identify trauma patient not suitable for any resuscitation procedure beyond typical circumstances of obvious death (decapitation; dismemberment; decomposition; incineration). The “Platinum Ten Minutes” have been introduced just to clarify the need of hurry in extricating the seriously injured road crash victim and providing immediate health care to ensure airway control and protection to the cervical spine. We analyse a real situation where death was diagnosed on site after limited resuscitation attempts. A young 14 y.o. boy, car rear passenger, remained severely injured in a road traffic accident. Extracted by his friends from the car he was unconscious and vomiting. First aid volunteers and the medical team arrived on site after around 20 minutes from the car crash and performed assisted AMBU-ventilation (15 min) in the patient with severe head trauma presenting cardiac and respiratory arrest. Death was diagnosed 30 minutes from the car crash. The father of the boy, an intensivist physician, presented a complaint to the police about the inadequate, resuscitation’s procedures performed to his son. At autopsy the pathologist found severe cranial fractures, meningeal and mid-brain haemorrhages, obstruction of the airways by food material and a hepatic superficial injury with scarce, circumscribed hemoperitoneum. Microscopic study confirms the micro-haemorrhages of cerebellar cortex, mid-brain and pons. The young patient was pronounced death at the crash scene after minimal resuscitation procedures. We analyzed the circumstances after the crash, with extrication of the casualty from the car by laymen and the described resuscitation procedures practiced identifying correct procedures in pre-hospital medical approach.
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