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Intestinal injuries are more common in patients wearing a seat belt than those who travel unrestrained and a visible seat belt contusion is associated with a threefold higher incidence of intestinal perforation. This short review aims to increase awareness of the patterns of injury that can often be found in seat belt wearers after an RTC, and encourage clinicians to maintain a high degree of suspicion to ensure early diagnosis and effective management when dealing with trauma patients. Improvements in care might save 450–600 additional lives each year across England. An increase in hollow viscus injuries, thoracic injuries, abdominal wall hernias, and neck injuries have all been recorded in individuals wearing seat belts involved in RTCs.Ī recent report by the National Confidential Enquiry into Patient Outcome and Death in 2007 showed that 60% of major trauma patients received a standard of care that was “less than good practice.” Furthermore, on the basis of an estimate by the National Audit Office, about 3000 deaths in hospitals result from major trauma each year.
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Since then, more complex patterns of injury associated with lap belts, three-point restraint seat belts, and airbags have been reported, with no area of the body immune from injury. The first reported seat belt-related injury was a small bowel injury in a passenger wearing a lap belt. Although the benefits of seatbelts are clear, it must not be forgotten by health professionals that seat belts are associated with their own patterns-of-injury that should be deliberately and specifically looked for when assessing all patients involved in RTCs. In spite of the evidence supporting seat belt use, compliance among the general population is not universal and is estimated to be 93% in the UK. Similar reductions in mortality have been recorded in other countries. The UK government estimates that more than 50,000 lives have been saved by seat belts, and of the fatalities that have been recorded, one-third of these were not wearing seat belts. Since the introduction of seat belt laws, there has been an approximate 25% reduction in fatal and serious injuries from randomized controlled trials (RTCs). They estimated 370 deaths and a further 27,774 people seriously injured every year. Despite this, a survey in 2007 by The Royal Society for the Prevention of Accidents showed that there is still significant morbidity and mortality from passengers' traveling unrestrained. This was then extended to include rear-seat passengers 8 years later. In 1983, legislation was passed making it compulsory for all front-seat passengers to wear seat belts in the UK.