Crash takes seconds, impact is forever

BROKEN bodies with multiple fractures arrive at the Royal Brisbane and Women’s Hospital almost every day within minutes or hours of major traffic crashes.

And for one team, the severe injuries don’t raise an eyebrow when they are briefed. “Here is a typical patient,” Dr Michael Rudd, RBWH head of burns, trauma and critical care says.

“Fractured right side of ribs, fractured body of spine so thoracic spine, fractured left radius so this arm, fractured humerus on this side.

“Four fractures of the pelvis, fractured femur.

“That was an unrestrained patient.”

Despite the frequent carnage on the road, Dr Rudd said he feels people have become conditioned or desensitised to the road toll and most information was getting lost as “noise”.

He said when he attended some ambulance service morbidity and mortality conferences he wondered how patients survived because the vehicle was unrecognisable.

“They look like pieces of scrap,” he said.

Women were more riskaverse, he said.

He add that there was a disproportionate number of people in the 17–30 age group.

Trauma teams were seeing more people intoxicated with drugs, not just alcohol.

He said there was a trend of food delivery and ride-share people presenting with serious injuries, sometimes after crashing into the back of another vehicle.

In other cases people were jogging with headphones. One was hit by a truck. Another did not hear a traffic accident – and that resulted in them being hit.

Dr Rudd said trauma systems and pre-hospital paramedic care were so good people were surviving more than in the past.

Hopes and aspirations were turned on their heads for patients and they had to start their life again.

There was a “golden hour” slogan in which doctors could make corrections to patients, but in reality it wasn’t a predefined amount of time.

“They might be dying of blood loss or they might have injured their nervous system or some other vital organ,” Dr Rudd said.

“Whether or not they survive sort of depends partly on the system that brings them to us, partly on the severity of the injury and partly on the expertise of the clinicians looking after them.”

“We have to do that every day and every week,” he said.

“It’s a life-changing event that occurs very quickly with trauma.”

Dr Rudd said if Fatal Five factors were eliminated, most

of the road trauma would be non-existent.

“You’re driving at the right speed, wearing a seatbelt, not drunk, not under the influence, not distracted, not looking at your mobile phone, it pretty much eliminates all road traffic accidents,” he said.

“It’s not rocket science.” He said the hospital was involved in a program called PARTY – Prevent Alcohol and Risk-related Trauma in Youth – in which schoolchildren were taken to emergency departments where critical injury scenarios were run.

“And they have people who have been injured who give their time to explain how they were injured. And I think that’s a very powerful way of getting the message to young people about how just an instant of lack of situational awareness or poor judgment can change your life forever,” he said.