Citation

Lillehei KO, Robinson MN. J. Trauma 1994; 37(5): 826-830.

Affiliation

Department of Surgery, University of Colorado Health Sciences Center, Denver 80262.

Copyright

(Copyright © 1994, Lippincott Williams and Wilkins)

DOI

unavailable

PMID

7966484

Abstract

OBJECTIVE: To examine the mechanisms of injury and death in a commercial airline disaster and to propose preventative safety measures based on this analysis. DATA SOURCE: Denver County Coroner's Office and the National Transportation Safety Board. STUDY SELECTION: Those patients suffering fatal injuries as a result of the Continental Flight 1713 Airline crash. DATA EXTRACTION: Autopsy records from the Denver County Coroner's Office were reviewed with the causes of death determined. In many instances there was significant injury to more than one anatomic region in a single individual, each analyzed independently. DATA SYNTHESIS: There were 28 fatalities: nine died of mechanical asphyxiation, one of a penetrating cranial injury, and 18 of blunt trauma. The blunt injuries were remarkably similar to the deceleration injuries seen in high-speed motor vehicle crashes. Head trauma was the most common fatal blunt injury, followed by injuries to the chest and the abdomen. Thirty-six percent of the head injuries and 27% of the chest injuries had associated cervical and thoracic spine fractures, respectively. Analysis revealed a marked similarity in injury pattern sustained by seatmates, with a high incidence of fatal and serious injuries suffered by those passengers sitting in the front half of the airplane. CONCLUSIONS: Fatal blunt injury secondary to deceleration forces was the most common cause of death seen in this analysis. The use of a lap belt restraint system alone is not adequate to protect passengers against these forces as shown convincingly in the automotive industry literature. What impact a better passenger restraint system may have had on survival in this disaster is unknown, however, at a minimum, it would have significantly improved survival for 6 of 28 passengers dying of isolated blunt head trauma. Minor alterations in aircraft design (secure bolting of passenger seats to the airplane superstructure) and passenger restraints (3-point lap and shoulder harness system) is proposed to positively influence survival during an airplane crash at negligible increased airline expense or passenger inconvenience.