The 2024 Car Accident Internal Injury Checklist

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Key Points:

  • Internal injuries are not always obvious following a car accident, but they can be very serious
  • Internal injuries, including soft tissue injuries like sprains, strains, and organ damage can be life threatening and require immediate medical help
  • Symptoms of internal injuries vary by the location of the injury, but any of the following symptoms should be considered serious: Abdominal or chest pain, nausea, vomiting, or dizziness, difficulty breathing, back or neck pain or numbness in the limbs
  • Even if you don’t think  you’re badly injured,  you should seek medical attention following an automobile accident to rule out any serious internal injuries

After a car accident, the most common question asked is, “Are you okay?” Sometimes it’s asked so often that you might feel tempted to say you are, just to stop the questioning. The reality is, you don’t know for sure. Injuries aren’t always visible. In fact, we often hear, “I thought I was okay, but as time went on, the pain got worse and worse.” This is a common theme with internal injuries. There’s no visible scar, blood, or scraping, but there might be a little internal pain that you shrug off, thinking there is no injury. Then, the following days tell you otherwise.

What is an Internal Injury?

The term internal injury refers to damage done to the inside of the body which cannot be seen with the naked eye. These injuries to organs and tissues can be caused by blunt-force trauma caused, for example, by a car accident or a fall.

Are Internal Injuries Silent Injuries?

We sometimes refer to internal injuries as ‘silent injuries’ because they so often go unnoticed right away. Internal injuries can be even more dangerous than other injuries because they cannot be seen and may go undiagnosed. In many cases, an internal injury can be life-threatening because the victim fails to seek medical attention in time to save his life.

Common symptoms of internal injuries to watch for are:

  • Severe pain in the abdomen or chest
  • Nausea and vomiting
  • Swelling or bruising of the abdomen
  • Difficulty breathing
  • Dizziness or lightheadedness
  • Weakness or fatigue

Traumatic Brain Injuries

If your head made contact with any objects inside the car, it’s highly possible that you suffered a brain injury.

What is a Concussion and How Do You Check for One?

A concussion is a mild traumatic brain injury (TBI) that disrupts normal brain function. It can occur from a hard bump or blow to the head, or from a sudden jolt to the body that makes the head move rapidly back and forth in a ‘whipping’ motion.

Concussions are common in car accidents due to the powerful forces involved in a collision. This violent movement causes the brain, which floats inside the skull in cerebral fluid, to hit against the skull’s interior. This impact can bruise or distort the brain, damaging brain tissue.

To check if you have a concussion, look for symptoms such as headaches, dizziness, confusion, nausea, vomiting, slurred speech, delayed response to questions, or changes in coordination. If you suspect a concussion, seek medical attention immediately.

What is a Contusion and How Do You Check for One After a Car Accident?

A contusion, also known as a bruise, occurs when an impact damages the blood vessels and capillaries under the skin without breaking the skin. To check for a contusion after a car accident, look for visible bruising, swelling, or discoloration, and assess any areas of tenderness or pain, especially where you might have made contact with the car’s interior. Gently press on painful areas to see if there’s swelling beneath the skin, and monitor your mobility for any stiffness or limitations. Keep an eye on the affected area, as bruising and swelling might develop hours or days later. If you suspect a contusion, seek medical attention. A doctor can perform a physical examination and possibly imaging tests like X-rays or MRIs to determine the extent of the injury. Follow your doctor’s advice for treatment, which may include rest, ice, compression, elevation (R.I.C.E), pain management, and physical therapy.

What is a Hematoma and How Do You Check for One After a Car Accident?

A hematoma is similar to a contusion but involves a deeper and larger pooling of blood under the skin. To check for a hematoma after a car accident, look for noticeable swelling, discoloration (red, blue, or purple skin), and warmth in the affected area. Assess pain levels, especially tenderness when pressing on the swollen area, and monitor your mobility for any stiffness or restricted movement. Be alert for severe symptoms like dizziness, headaches, confusion, or vision changes. If you suspect a hematoma, seek medical attention promptly for a physical examination and possible imaging tests like an ultrasound, CT scan, or MRI. Follow your doctor’s treatment recommendations, which may include rest, ice, compression, elevation (R.I.C.E), and pain management.

What is a Diffuse Axonal Injury and How Do You Check for it After a Car Accident?

Diffuse axonal injury (DAI) often results from high-speed car accidents, falls from a height, or violent assaults. It occurs when the brain rapidly shifts inside the skull, causing structural strain or tearing of axons (long nerve fibers). This injury disrupts brain communication and can lead to problems like coma, learning and memory issues, difficulty thinking and concentrating, speech and language problems, vision disturbances, balance and coordination issues, and emotional difficulties. To check for DAI, look for symptoms such as loss of consciousness, severe headaches, nausea, confusion, dizziness, difficulty speaking or understanding speech, vision problems, and balance issues. If DAI is suspected, seek immediate medical attention. A doctor will perform a neurological exam and may order imaging tests like a CT scan or MRI. Follow the prescribed treatment plan, which may include rest, cognitive and physical therapy, and medication to manage symptoms.

Vascular Injuries

The human vascular system, also known as the circulatory system, is a network of blood vessels which transport blood throughout the body. In a car accident, vascular injuries are common as the result of blunt force trauma. Such trauma can happen as a result of:

Shearing: Shearing happens when organs or tissues are rapidly twisted or stretched causing the tearing of blood vessels. This is an especially dangerous risk if it affects the aorta, the major artery leaving the heart, and the vena cava, the major vein returning blood to the heart.

Crushing: The impacts and forces at play during a crash can cause organs and tissues to be crushed which damages blood vessels.

Sudden deceleration: The rapid stopping motion in an accident can cause crushing injuries when organs are banged violently around inside the body potentially injuring blood vessels.

Embolism – One common vascular injury seen in car accidents is an embolism. An embolism is a blockage within a blood vessel that is caused by a foreign object. The object, which can be a blood clot, a fat globule, or other debris introduced to the bloodstream from a wound, travels through the bloodstream and becomes lodged somewhere. This foreign object, called an embolus, can be especially dangerous if the emboli happens in the lungs creating a pulmonary embolism.

Pelvic Injuries

Pelvic injuries can range from minor fractures to severe trauma and may require extensive medical treatment and rehabilitation. Common internal pelvic injuries include bladder ruptures and urethral injuries which can happen particularly if there is a pelvic fracture. Pelvic injuries can happen because of several factors in a car accident including these:

Seatbelt use: Seatbelts do save lives, however they can also be responsible for pelvic injuries when the lap belt portion applies sudden excessive force to the pelvic area during a collision.

Vehicle intrusion: In high-speed accidents or rollovers, the vehicle may bend, crumple or deform, causing the dashboard, door, or steering wheel to be thrust into the passenger compartment, injuring the people inside.

Airbag deployment: When airbags deploy, they do so with explosive force. They can sometimes cause injuries to the pelvis, especially if the occupant is too close to the airbag when it deploys.

Ejection: If a person is ejected from a vehicle during an accident, they may suffer pelvic injuries when they hit the ground or other objects.

Abdominal Injuries

The abdomen can be injured in a car accident in several ways, including blunt force trauma caused by impact with the steering wheel, dashboard, or seatbelt. Additionally, sudden deceleration, ejection from the vehicle, and/or airbag deployment circumstances can lead to abdominal injuries:

Abdominal injuries can range from minor bruising to severe internal injuries, such as lacerations to the organs, ruptured spleens, or ruptured intestines.

Damage to Internal Organs:

Some of the possible internal injuries and their symptoms are listed below:

Ruptured Spleen:  Symptoms of a ruptured spleen can include severe abdominal pain, tenderness, and swelling. The victim might also experience dizziness, lightheadedness, and confusion. A ruptured spleen can lead to life-threatening bleeding and other complications – seek medical care immediately if you’ve been in an accident and have these symptoms.

Liver Laceration:  Common symptoms of a lacerated liver can include severe abdominal pain, tenderness, and swelling. Additionally there may also be fatigue, nausea, vomiting, as well as yellowing of the skin and eyes called jaundice. A lacerated liver can lead to life-threatening bleeding and other complications so immediate medical care is critical.

Kidney Damage: Damage to the kidneys can cause pain in the back or abdomen, blood in the urine, fatigue, and swelling of the legs or ankles. It is possible that kidney damage can lead to kidney failure, which would require dialysis or a kidney transplant to treat.

Pancreatic Injuries: Injuries to the pancreas may present with symptoms that can include severe abdominal pain, nausea, vomiting, and fever. Treatment for pancreatic injury can, in severe cases, require surgery to repair the damage

Perforated Bowel: Symptoms of an intestinal tear or perforated bowel include severe abdominal pain, nausea, vomiting, fever, and tenderness in the abdomen. A perforated bowel is a medical emergency that requires immediate treatment, including surgery, to repair the damaged tissue and prevent serious complications, such as infection or peritonitis.

Internal Bleeding

Internal bleeding can occur in several ways during an automobile accident.

During a car collision, the force of the impact can cause internal organs and blood vessels to be damaged, resulting in bleeding. Blunt force trauma including that caused by seatbelt and airbags is common. Seatbelts and airbags may be essential for safety, they can also cause injuries, such as bruising or internal bleeding, during a collision.

Bone fractures, especially those which involve the ribs or pelvis, can also cause internal bleeding which can be serious and life-threatening.

Internal bleeding in the chest, abdomen, or brain can refer to several different serious medical conditions, including:

  • Hemothorax: This is bleeding inside the chest cavity, usually caused by trauma to the chest wall or ribs.
  • Hemoperitoneum: This is bleeding inside the abdominal cavity, commonly caused by trauma to the abdomen or pelvis.
  • Intracerebral hemorrhage: This is bleeding within the brain tissue, often caused by high blood pressure, trauma to the head, or a rupture of a blood vessel in the brain.

The symptoms of internal bleeding in the chest, abdomen, or brain can vary depending on the severity and location of the bleeding, but may include pain, swelling, dizziness, confusion, and changes in heart rate or blood pressure.

Internal bleeding in these areas of the body can be life-threatening and requires immediate medical attention to prevent further complications.

Chest Injuries

Of all the parts of your body, the organs of the chest have the best built-in protection – the rib cage. Unfortunately, the ribs can and do break often leading to serious chest injuries such as pneumothorax (collapsed lung,) hemothorax (blood in the chest cavity.) Other serious chest injuries include the following conditions:

Flail chest is a serious injury to the chest wall caused when there are multiple broken ribs in at least two places. These breaks to the rib cage can cause a section of the chest wall to become detached from the rest of the chest. This detached section of the chest moves independently and causes instability and difficulty breathing.

Flail chest injuries are commonly caused by severe trauma or direct blows to the chest caused by falls or motor vehicle accidents. They can also result from certain medical procedures, such as chest compressions during CPR.

It’s important to seek immediate medical attention if you suspect you or someone else has a flail chest injury, as it can be life-threatening if not treated promptly.

Cardiac Contusion: As the name might indicate, a cardiac contusion is actually a bruised heart. This injury to the heart muscle can be caused by blunt force trauma to the chest as is typical during a severe accident or impact. The force of a violent impact can cause the heart to collide with the chest wall, leading to bruising or swelling of the heart muscle.

Diagnosis of cardiac contusion usually involves an electrocardiogram (ECG), blood tests, and/or cardiac imaging to evaluate the extent of the injury.

Aortic Rupture: An aortic rupture is a life-threatening medical emergency that requires immediate treatment. It occurs when there is a tear in the aorta, the largest artery in the body, which can lead to severe internal bleeding and, if left untreated, death.

Treatment for an aortic rupture usually involves emergency surgery to repair the damaged artery and stop the bleeding. The specific surgical procedure will depend on the location and severity of the rupture, but is likely to include either open chest surgery or a more minimally invasive procedure called endovascular surgery.The prognosis for an aortic rupture depends on the severity of the injury, the speed of diagnosis, and the success of the surgical repair.

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Spinal Cord Injuries

Car accidents are one of the leading causes of spinal injuries. The forces involved in a crash or collision can cause damage to the vertebrae, discs, and spinal cord causing even permanent damage like paralysis. Some of the more common spinal injuries are listed below.

Spinal Cord Compression is a serious medical condition that requires prompt diagnosis and treatment. It happens when the spinal cord  becomes pinched or bunched-up within the spinal canal. Early intervention can help prevent permanent nerve damage. Any of the several conditions listed below can lead to spinal cord compression.

Whiplash is a soft tissue injury of the neck that occurs when the head is jerked back and forth in a whip-like motion. Symptoms of whiplash can include pain, stiffness, and headaches.

Sprained or strained ligaments or muscles often happen when the ligaments and muscles that support the spine are stretched or overextended in a car accident. This can cause pain and stiffness in the back or neck.

Vertebral fractures involve break(s) to one or more of the bones or vertebra of the spine. Symptoms of a vertebral fracture can include pain, swelling, and bruising in the area of the fracture. More serious fractures can damage the spinal cord which is usually protected by the vertebrae which form the spinal canal, a “tunnel” which runs the length of the spine

Herniated discs occur when the soft inner material of the discs that act as cushions between the vertebrae bulges out through a tear in the outer wall. This can put pressure on the nerves in the spine, causing pain, numbness, and weakness.

Spinal cord injury refers to damage to the spinal cord itself. Spinal cord injuries are very serious and can be life-changing since they can result in paralysis, loss of sensation, and other problems.

Following a car accident it’s extremely important to seek medical attention right away, especially if you are experiencing any pain or other symptoms in your back or neck.

Soft Tissue Injuries

As mentioned previously soft tissue injuries can happen anywhere inside the body and are not always immediately obvious. Sprains, strains, contusions, bruising, internal bleeding, and organ damage can happen as a result of the tremendous forces that happen in collisions.

Diaphragm Injuries

The diaphragm is a dome-shaped muscle separating the chest cavity (thorax) from the abdominal cavity. If this muscle sustains a tear or hole, usually as the result of blunt-force trauma, the tear can allow abdominal organs, like the stomach, intestines, or spleen, to push up into the chest cavity, which can interfere with lung function and breathing.

Car accidents are a leading cause of ruptured diaphragms, particularly following a high-speed crash where there is blunt-force trauma. The impact from such a collision can cause the diaphragm to tear from the sudden and intense pressure increase in the abdomen.

Symptoms of a ruptured diaphragm include severe chest or abdominal pain, shortness of breath or difficulty breathing, shoulder pain, coughing up blood or hiccups that won’t go away.

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