Air bags influence the pattern of injury in severe thoracic trauma

Severe intrathoracic cardiovascular injuries were found in three patients who were drivers of cars involved in head on collisions causing air bags to be released. A 32 year old male had not worn a seat belt, while a 39 year old female was restrained by a seat belt. The male patient suffered an intimal lesion of the brachiocephalic artery. Extensive soft tissue haematomas were seen subcutaneously and retrosternally. The female suffered a rupture of the aortic isthmus and a dislocated pelvic fracture. Vascular repair was performed in both patients. The female died after two months without having regained consciousness. The third patient, a 47 year old male, had not worn a seat belt. He lost his pulse within minutes. Midline emergency thoracotomy showed a complete rupture of the right atrium. An air bag protects against injuries caused by hitting internal parts of the vehicle. It does not necessarily protect against deceleration trauma in high speed collisions.