Wear Your Seat Belt!

Teresa Nielsen Hayden writes:

Making Light: Seatbelts Save Lives: There's one further reason I always wear my seatbelt: I know that if I'm an unsecured victim in an MVA, injured but not killed, I will never, ever hear the end of it from Jim.

Because Jim McDonald has written:

Do you know how we can tell the difference between people who were wearing their seatbelts and those who weren’t, at the scene of an automobile accident? The ones who were wearing their seatbelts are standing around saying “This really sucks,” and the ones who weren’t are kinda just lying there. This is not to say that all unrestrained traffic accidents are fatals, or that seatbelted folks are invulnerable. But if you’re playing the odds....

The proximate cause of this post is the recent automobile accident involving Jon S. Corzine, governor of New Jersey.

Dr. Robert Ostrum said that Corzine’s surgery was successful but noted that the governor would need two more operations on his leg in the coming days. Doctors also inserted a breathing tube that would remain “for days to weeks, until [Corzine] is able to breathe on his own again,” Ostrum said. Corzine had a broken sternum, a broken collarbone, a slight fracture of his lower vertebrae, a broken left leg, six broken ribs on each side and a laceration on his head, said Dr. Steven Ross, head of trauma for the hospital.

The two other persons in the vehicle sustained minor injuries. Bet you’ll never guess which two were wearing their seatbelts.

(Or—-from a few years back—beautiful young princess, millionaire boyfriend, drunk driver, bodyguard—hit an abutment at a Whole Bunch of Miles Per Hour. Who lived? Answer: the guy who was wearing a seatbelt.)

Did you ever notice how often the words “unrestrained passenger” turn up in Trauma: Life in the ER just before something Really Messy rolls in the door? In a collision, you have three or four sub-collisions all taking place in sequence. First, the vehicle hits some object. The vehicle abruptly slows, but unrestrained objects inside it continue at the same speed, in the same direction. Then the unrestrained body hits the interior of the vehicle, and starts to slow. That’s the second collision. That body’s internal organs are still moving at speed until they hit the inside of the chest (or get cheese-sliced by their supporting ligaments—and that’s where you get things like bisected livers or aortas). The fourth collision is when the bowling ball you left on the rear deck hits you in the back of the head, because that continued at the same speed in the same direction. Newtonian physics: Learn it, live it, love it.

There are two major routes that unrestrained persons take in a front-end MVA (Motor Vehicle Accident). Up-and-over or down-and-under (AKA “submarining”). With up-and-over, the upper body launches forward and up. The head strikes the windshield. (This produces the classic “windshield star”) Your injuries here include concussion, scalp laceration, and various brain bleeds. You can suspect fractured cervical vertebrae (and if you have a fracture with compromise to the spinal cord at C-4 or higher, you’ve lost the nerves that control chest expansion and the diaphragm. “C-4, breathe no more,” as the saying goes).

Go a little farther through the windshield, and it isn’t unexpected to leave some or all of your face behind stuck in the broken glass. You’d be surprised by how easily faces come off the facial bones. You can also expect fractured wrists, arms, and shoulders, from folks trying to brace themselves. A little farther through the windshield, all the way out of the vehicle (a situation we call “pre-extracted for your convenience”), and in addition to whatever damage you took on the way through, you get the damage from hitting the ground, trees, and metal poles at however-many-miles-an-hour.

Sure, you hear people talking about wanting to be “thrown clear” in the event of an accident. If you want to simulate being “thrown clear,” go to the fifth floor of a building and jump out the window. Let’s talk briefly about being thrown clear, because it happens more often than you’d think. Unrestrained driver: side impact. Vehicle spins. Driver goes out the window. In one case I recall, the driver was half-way out his window when the vehicle rolled over on top of him. That was the second-most grotesque scene I’ve ever been to. Another scene, the driver went out the window when it spun. The vehicle went into a snow bank and was drivable from the scene. The driver went into a river and drowned. Any time you go to an accident and the windows aren’t rolled all the way up and unbroken, look 200 feet in all directions for the other patients. It’s pure heck finding them three days later when someone wonders why all those birds are over there, or when someone at the hospital wakes up enough to ask “Where’s Joey?”

Okay, let’s look at down-and-under. In this one the patient goes forward and down, under the dashboard. Here’s where you’re going to find fractured femurs, broken knees, and compression fractures to the lower spine. If you’re asking “Is it possible for a human femur to be pushed through the floor of the pelvis?” the answer is “Yes.” If you ask me how I know that, the answer is: “Seen it done.” Unrestrained driver, 40 MPH impact. As the legs collapse accordion-style, the patient’s chest hits the dashboard. This can give you rib fractures, a fractured sternum, cardiac bruising, or that ruptured aorta that we all love so well. The nice thing about going submarining is that there usually isn’t any brain damage (unless you got clonked on the knob by that bowling ball, and seatbelts won’t help with that). On the other hand, femur fractures can be, and frequently are, fatal.

I think I’ll leave Traumatic Asphyxia, Hemo/Pneumothorax, and Flail Chest for the Trauma and You post that I’m going to do one of these days. Let’s just say that they’re associated with having your chest hit the dashboard or steering wheel, and they Really Suck (and not in a good way).

Seatbelts stop you from going up-and-over or down-and-under, or out the window. Sure, seatbelts can hurt you too, but hey, you’re in the presence of large amounts of free-floating energy. So. Effective May 1, 2000 New Jersey’s seat belt law is being upgraded. Police officers will be able to stop and issue summons to drivers and front seat passengers solely for not wearing their seat belts. The fine is $20 and $26 court costs. The penalty can be death.

Comments

[Ben]

You are roughly 5 times more likely to die in a MVA if you aren't wearing your seat belt. Since this is the number one cause of death for folks ages 3-33, this is not a trivial statement.

This is also (an off message) reason so many people die in drunk-driving accidents ... not only are they more likely to be in the accident, the intoxicated are far less likely to be wearing their seatbelt.

That said, I do anecdotally know several people who didn't die because they weren't wearing a seatbelt. One of these was driving a heavy truck on a transmission line patrol road and was able to jump from the vehicle as it left the road and rolled 400ft down a hill before bursting into flame. Another was a passenger in a light vehicle stopped at a traffic light which was crushed from behind by a semi. He had time to get into the floorboard. The vehicle driver (wearing seatbelt) died.

Anecdote is such a convenient tool in the face of overwhelming statistical evidence, eh?

[stewart]

I work in rehabilitation. It's easy to tell the people who wore seatbelts. Usually, we call them visitors. When they do stay with us, they have a lot less injury (just a head injury without the broken legs, don't have all the chest and stomacj scars, etc), and go home a lot sooner.When you're thrown clear and the car lands on you, it's not good.
And what is this thrown clear bit; Do people expect the roadside to be covered with mattresses?

[Steve]

Math is difficult, but physics is scares me.

[D-Slam]

As a kid growing up in Canada, we had sessions on the Importance of Wearing Your Seat Belt in school. (And the fines for not wearing one are a lot stiffer than $25 AFAIK). Socialist Brainwashing? Nanny State social engineering? Yeah, probably. But NOBODY fails to wear their seatbelt here. I don't think I've ever been in a car with somebody who wasn't buckled up. It just isn't done.

I knew a guy who was a paramedic first responder to road accidents (in the US). Their saying was "we don't unbuckle corpses".

[John Emerson]

I think that refusal to use seatbelts would be a good quick diagnostic test for various other sorts of irrationalities and psychological problems.

[otto]

I get really irritated when I get into a taxi and the seatbelts aren't functioning.

[Ginger Yellow]

Why only front seatbelts? If you're going to legislate it, make it compulsory for everyone.

[save_the-rustbelt]

During my first driving lesson my father said something tactful like "if I ever catch you driving without a seatbelt I will beat you with an axe handle, because you must enjoy pain." Something tactful like that. Lesson learned.

VIsit a junk yard and you will see windshield spiders, the point at which the face intersects the windshield, and the face loses.

Physics is very unforgiving.

[baileyman]

These should be "Nader belts", and breathable air "Nader air", and swimmable water "Nader water", and recoveries on consumer products injuries "Nader justice".

[Sonia]

Unrestrained objects and unrestrained animal companions don't belong in the passenger compartment either. Perhaps unbelted passengers should be subject to an automatic high deductible on their health insurance, particularly if the passenger is high net worth. What happened to the air bags in the Corizinecrash?

[D-Slam]

sonia, AFAIK airbags these days are designed to function for a BELTED passenger. If you aren't wearing your belt it is unlikely to be of much help. They used to deploy with a lot more force, in order to protect unbelted 200 pound males (who deserved to die anyway, being unbelted), but that had a side effect of occasionally ripping off the head of a belted ten year old who dropped his ice cream cone and bent down to pick it up .2 seconds before Mommy had a tiny fender bender. Auto manufacturers now understand that people who don't wear their seatbelts do not deserve any consideration (having signalled their unfitness for the gene pool already) and design their airbags accordingly. That's progress.

[rea]

"These should be 'Nader belts', and breathable air 'Nader air', and swimmable water 'Nader water', and recoveries on consumer products injuries 'Nader justice'."

Too bad we get to read about these doubtless worthy things during the "Nadar presidency"

[BoonyaExperience]

I wear my seatbelt. I think it is dumb not to wear a seatbelt.

However, I have a major problem with seatbelt laws. Children under 18 should be required by law to wear a seatbelt. By law a car should be required to have functioning seatbelts. But if an adult opts to not wear their seatbelt I do not think they should be fined.

Taking chances with your own life is socially irresponsible and stupid but it should not be illegal. Unless of course people are force to pay fines for skydiving, bungy jumping, white water rafting, skiing, riding a motorcycle, etc.

We are a society of risk takers. Laws which protect children and bystanders are great but laws protecting the individual from him or herself are, in my opinion, wrong.

[Roger Albin]

A few years ago, Scientific American had a short piece on the invention of the modern seat belt (really seat-shoulder harness). It was developed in Sweden by Volvo or Saab in the 1950s. They quoted the engineer who led the design team as saying it took only a few weeks from start to the final design, including on road testing. In terms of cost/benefit ratio, this may be the most efficient use of time and effort in modern history.

[C]

You gonna post a bond, Boonya, for the cost of scraping you off the pavement? And to compensate me for sitting in stopped-up traffic while they do that?

If you want to enjoy the special thrill of seatbeltless driving you can buy your own land, build your own road on it, and drive around on it any way you like. If you use public roads and avail yourself of public emergency facilities you are gonna be hemmed in in all kinds of ways.

Society of risk-takers, right. Any more specious generalizations this morning?

[BoonyaExperience]

C,

First of all let me restate that I do wear my seatbelt and I think it is dumb not to.

Great that is out of the way.

Ok... let's say that we do want to create fines for individual behaviour that may create additional costs for the government and taxpayers.

I think we need to start with fines for being overweight. Then maybe we can move to fines for not properly exercising (I can't wait to get my own telescreen). Once we figure out how much money we are saving we can pinpoint other fineable offenses. I would like to suggest fines for not getting enough sleep and not wearing sunscreen.

I pay income tax. I pay car insurance and the insurance company pays tax. I pay to have my vehichle registered and I pay tax on gas. At what point have I paid the government enough for cleaning up my bloody corpse?

[D-Slam]

Boonya: "Unless of course people are force to pay fines for skydiving, bungy jumping, white water rafting, skiing, riding a motorcycle, etc. We are a society of risk takers."

I think we don't fine sking because you could argue that skiing, by encouraging fitness and mental well-being in general (sliding down a hill is fun!), saves society enough to pay for patching up the occasional busted-up skier.

Calling driving unbelted "risk taking" is not quite right. I think of "risk taking" as risk in pursuit of some reward (even if it just be the fun of skiing). Where's the reward of driving unbelted? There isn't one, it's just dumb and lazy. There is no positive benefit to the activity, it is costly, ergo there is no reason not to discourage it (aside from the libertarian one of "freedom", but in Canada, at least, with universal health care, that doesn't fly... if I have to pay to fix you up I get some say over how you behave).

We fine unbelted drivers but not skiers because we want to encourage responsible behaviour but we don't want to be killjoys.

[C. L. Ball]

Thanks for posting the whole McDonald post. I think I'm going to post it on my class sites.

I was dumbfounded that Corzine did not wear a seatbelt regularly. He's the chief executive of the state's laws and he's sitting *right next to a state trooper*. What the hell? No one said, "Buckle up, governor"?

[Tangurena]

I used to work up in the mountains west of Denver. I called the highway (US-285) I took to the office "blood alley" as there fatalies at least every month along the roadway. Some were car vs elk (elk weigh more than 1000 pounds, and even trucks lose), but the worst were at a corner called "windy point" for the sign. One side had a 300 foot drop, and in icy weather, vehicles would go over the edge. The last one that went over the edge (before I got a job in the city) had 3 people in the car. The driver was unbelted: he died. The two passengers were belted and they survived the 300 foot drop down the hillside. Other fatalities include typical criminal stupidity: driver going 90mph downhill, gets a blowout and the truck rolls. She was belted and survived, the baby seat wasn't buckled in at all and the kid ended up a red smear on the pavement.

[AS]

C.L. Ball: the initial news reports had quotes from the troopers, who said that they do ask him to wear the seatbelt but he refuses...

[bigTom]

The two times for me when someone checked to see if I was wearing a belt, I had already unbuckled. It seems my brain is preprogrammed to unbuckle at the same time I turn off the ignition. Fortunately both times I was believed. In the first instance, my employer was giving a dollar to every employee found wearing their belt ;)

Of course the real problem is the movies. We've seen hundreds of wrecks where the unbelted hero jumped out of the vehicle just before it went over the cliff, or burst into flames. For many people the extensive visual evidence from their movie-watching experience trumps logic and statistics.

[anatol]

"These should be 'Nader belts', and breathable air 'Nader air', and swimmable water 'Nader water', and recoveries on consumer products injuries 'Nader justice'."

Actually there was an interesting (as usual) article in the New Yorker magazine a few years back regarding the history of restraining devices in cars. Turns out that Nader and Naderites were not hot about the seat belts - they thought Americans would never wear them, so they pushed hard for the airbags restraining people willy-nilly. That of course had some bad side effects, discussed in this thread, and according to the article Naderites actually delayed the universal acceptance and enforcement of seatbelts, which they considered an easy copout for the gready auto industry.

I see interesting public policy lessons in this little story...

[JonF]

Re: We've seen hundreds of wrecks where the unbelted hero jumped out of the vehicle just before it went over the cliff, or burst into flames.

While vehicles may catch fire, they almost never explode. Hollywood has to rig cars with dynamite to produce that unrealistic effect.

A further note of seatbelts: they must also be worn properly (and people who are unusally short, tall or obese may have problems with this). They are designed to grab the hip, sternum and shoulder, and may bruise or (in extreme cases) fracture those bones. But the organs underneath are protected. However if the belt grabs soft body areas it can rupture livers, strangle the wearer or (in very extreme crashes) even decapitate. So adjust the belt to fit where it belongs.

[anon]

This is typical socialism at work. If these unrestrained passengers had guns they'd be better able to protect themselves in the event of an unforeseen accident. America needs fewer seatbelts and more handguns to keep road fatalities in check. Then everyone will be safe.

[Walt]

anon says the only sensible thing I've heard all day.

[Kenneth Almquist]

1) The accident occurred when a driver, attempting to clear the road to let the police vehicles through, went off the shoulder and then came back onto the road. It would not have occurred if the police had not been using their emergency lights, and somehow I don't think that the governor's desire not to be late for a meeting between Imus and the Rutger's basketball team qualifies as an emergency.

2) BoonyaExperience suggests that we shouldn't create fines for individual behaviour just because the behavior may create additional costs for the government and taxpayers. If someone get into an accident, is seriously injured or killed because you weren't wearing a seat belt, and then sues the driver of the other vehicle, this costs the driver of the other vehicle significant time and expense regardless of the outcome of the lawsuit. So not wearing a seat belt can impose costs on specific individuals as well as taxpayers generally.

[D-Slam]

Reportedly, Corzone's SUV was going 91mph when the accident happened (again, driven by a State Trooper), so I guess this meeting must have been a Big Emergency.

Is there anything more galling than authority figures flouting the rules they expect YOU to obey? "Do as I say, not as I do" lost its appeal for me after I was twelve.

[Ronald Brak]

In Australia it is compulsary for all people in a vehicle to wear seat belts. Our per capita road fatality rate is more than 40% lower than the United States. If the figures were adusted to to show deaths per kilometer driven then the United States would probably appear worse.