Pedestrian injuries, as seen in the ER

Almost every morning, there is another story in this newspaper about a pedestrian who has been hit by a driver. After the initial burst of attention, the crash typically fades from the news. Then the next day, or the day after that, there’s another story.

Understandably, we pay more attention to the fatalities (173 in 2013) than to the “lucky” ones who survive (more than 10,000 in any given year). As an emergency room doctor who has attended to thousands of pedestrian victims, I have seen the damage of injuries up close — both those who were killed and the “lucky” ones.

It is absolutely harrowing. Each patient I have treated has suffered the worst day of his or her life. One minute they are walking to work, or home, or to the grocery store; the next moment, they are in the hospital, and their life has changed irrevocably.

Suppose an adult is struck head-on by a sedan while in the crosswalk. This is a typical scenario; about half of pedestrians injured by automobiles in the city are either walking with the signal in the crosswalk or on the sidewalk. This victim will suffer a series of serious injuries.

First, the car bumper hits the pedestrian’s pelvis and legs, shattering these bones. The driver’s car then “scoops” the person off the ground and onto the hood and windshield.

The impact with the windshield causes traumatic brain injury — the brain actually slams against the inside of the skull. The smashed windshield will also cause dicing cuts to the face.

The driver at this point typically stomps on the brake, which throws the pedestrian to the ground at a great speed, causing a second set of brain, skull, neck and pelvic injuries.

With children, short people or people hit by SUVs and trucks, the crash is different, but at least as brutal. Instead of being thrown up onto the hood, the victim will typically end up being pushed forward and under the vehicle, whereupon they get entangled with the car and dragged some distance, leading to traumatic brain and chest injuries.

Traffic accidents, of course, are terrible all around. But automo- bile drivers and passengers have the benefit of seat belts and air bags, not to mention crumpling steel to absorb impact. Not so for pedestrians.

And all the scenarios I have outlined, as horrible as they are, assume a driver is traveling at or below the 30-mph speed limit. A pedestrian hit by a speeding driver tends to be thrown up over the hood and roof of the car, setting off a chain of impacts that cause much deadlier outcomes.

Indeed, pedestrians struck by speeding drivers are much likelier to die at the scene.

In short, being struck by a car or truck is a horrific way to end up in the emergency room. Hopefully, the patient arrives quickly, because he or she may be suffering ruptured organs, brain bleeding or another life-threatening crisis.

An ER doctor at a level one trauma center will treat at least two or three crash victims during a typical 12-hour shift. At least one of those patients, on average, enters the hospital very likely to need an inpatient stay to prevent loss of life or limb.

We have gotten better over the years at treating pedestrian crash patients, but lately we have had more of them to treat.

Once these patients leave my care, they have a long road of recovery ahead of them. It can take weeks before they can leave the hospital, months for their bones to heal, and years of physical therapy to be able to restore their ability to live a “normal” life.

My experience leads me to believe that Mayor de Blasio’s push for Vision Zero, which aims to eliminate traffic fatalities within 10 years through better enforcement and street design, is a moral necessity.

So many of the patients I attend to are in the ER because they misjudged how long it would take to cross a wide street, or because a driver wasn’t paying attention. I don’t believe that a small, preventable mistake should end in an emergency room visit. Thankfully, the city’s leaders agree.

Vision Zero is a moral imperative