Road-Brain-Injury-Safe-Driving-Teen-Safety-Trauma-Accidents

On the Open Road: Advocating For Safe Driving

The story below is inspired by a true Little Big Fighter! Names and details have been changed.

It was a clear and bright summer morning when Jenny and a friend pulled out of the driveway to spend the day with friends at the shopping mall. For these two 17-year olds, it was a normal summer day: no school, little stress, fine weather, and some spending money from summer jobs. Like all drivers, Jenny reflexively looked left first, then right, then back to left again. With the sun still low to the east it shimmered intensely off the hood of the car causing her to squint and cast everything on her left into amorphous silhouettes. Again, as so many drivers do, she reflexively began pulling out to make a left after the ritual head turning, assuming the coast was clear on this fine, sunny day. However, the glare of the sun was hiding a truck and as the sun beamed off the windshield, blinding Jenny, the truck driver slammed on the breaks, slowing down slightly before crashing into the driver’s side of Jenny’s car. The “t-bone” collision crumpled the door into the car, crushing Jenny’s pelvis against the center console. Her head whipped left and slammed against the window, knocking her unconscious. Jenny’s mom, hearing the collision, ran out of the house to find a mangled vehicle and a daughter in distress. Fighting to stay calm, she quickly dialed 911 while running to the car. There was little else she could do at the moment but hold Jenny’s hand and wait dreadfully for the ambulance to arrive.

Every-Person-Every-Time-Buckle-Up-Driving-SafetyOf all age groups, teen drivers ages 16-19 are at the highest risk of car accidents. They are 3 times more likely to be involved in fatal car accidents than people age 20 and older. In 2015 road injuries were tied with drugs and self-harm as the leading causes of death in the United States for those age 15-19, each causing approximately 11 percent of deaths. According to the Centers for Disease Control and Prevention, teenage drivers are more likely to speed, leave less headway between cars, and not wear seat belts compared to older drivers. They are more likely to underestimate hazardous situations and more likely to make critical errors in decision making. Alcohol also plays a large role: 17 percent of drivers 16-20 involved in fatal crashes had blood-alcohol levels above the adult legal limit.

Jenny and her family lived several hours from the nearest large children’s hospital so the ambulance brought her first to the local community hospital where they performed imaging that showed a fracture of her pelvis. She slowly began to regain consciousness, but remained confused and disoriented. Since her vital signs were stable and an ultrasound was negative, indicating no internal bleeding in her pelvis or belly, she did not need urgent surgery. She was prepared for transfer to the children’s hospital where a multi-disciplinary surgical team could evaluate the best way to fix her broken pelvis. While en route to the second hospital, Jenny began having seizures requiring medication to stop the convulsions. She was not able to breathe properly and, once at the hospital, required a tracheostomy—a tube placed into the windpipe through a slit in the front of her neck in order to allow a machine to assist with breathing. Additionally, she could not follow instructions and made little movement of the left side of her body. The inability to breathe on her own, waning consciousness, paralysis of her left side, and seizures all indicated that she sustained severe brain damage during the accident and that the damage was getting worse. Imaging showed that she was bleeding in her brain which cut off blood flow, caused the pressure to increase and additional damage to her brain even after the accident. Neurosurgeons needed to place a needle and tube in her brain (called a shunt) to drain off fluid and decrease the pressure. After several days, her seizures were controlled with medication, the pressure in her brain was reduced, and she was breathing with the help of a machine. Finally, surgeons were able to repair her broken pelvis after which she was placed in an intensive care unit to recover.

Brain-Imaging-Scan-Injury-Trauma-Blue

A traumatic brain injury (TBI) is any injury to the head that causes abnormal brain functioning, which can include cognitive difficulties, physical maladies, and emotional or behavioral disorders. TBI and motor vehicle accidents go hand-in-hand. Of the 2.5 million TBIs per year, 14 percent (or 350,000) are caused by motor vehicle collisions. TBIs are responsible for 50,000 deaths per year, but many more are left with permanent disabilities. 5.3 million Americans (or 1 in 60 people) live with some disability related to a previous TBI.

I met Jenny during her recovery on the inpatient rehabilitation service. In the next Little Big Fighters post I will discuss details of her process and share some good news!

Please take a few minutes to check out the video below for more information about how we can help keep our Little Big Fighters stay safe on the road. It’s great information for everyone, not just parents!

 

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More about Danny Clark

Little Big Fighters is a blog that aims to inform the public about both the well-known and lesser known issues surrounding pediatric medicine. We hope to find and provide practical ways where we can become active participants of change.