April 21, 2016

Warm weather heralds beginning of “trauma season”; Vanderbilt physicians urge pedestrians and drivers to use extra caution

Vanderbilt University Medical Center trauma physicians are warning pedestrians and drivers to be attentive, alert and cautious as the weather warms up and the likelihood of auto-pedestrian accidents increases.

In 2015, 18 pedestrians died after being struck by vehicles in Davidson County. In 2016, there have been two pedestrian deaths so far, according to Nashville Metro Police.

Auto-pedestrian wrecks are largely attributed to distracted drivers and pedestrians who are not alert to their surroundings, and while it only takes a second to make a bad decision, the resulting injuries can be debilitating and life altering, according to Oscar Guillamondegui, M.D., associate professor of Surgery and medical director of the Trauma Intensive Care Unit.

“Auto-pedestrian injuries typically result from pedestrians stepping into the street without identifying a vehicle traveling toward them,” Guillamondegui said. “This occurs commonly when the pedestrian is distracted by inebriation or some other means—talking with friends on the phone, texting, or walking with earbuds and not being aware of their surroundings.”

Bicyclists, intoxicated pedestrians walking at night and children are the three most common types of auto-pedestrian patients treated at VUMC’s Emergency Department.

Many pedestrians hit by a vehicle face traumatic pelvic, femur and wrist fractures as well as damage to internal organs.

“When a person is typically hit by a car, it is from the side as they step off a curb,” Guillamondegui said. “The mechanism starts with the car identifying the pedestrian and slamming on the brakes, which drives the bumper down.  This effectively makes the initial contact point the lower leg in adults and the upper leg, or femur, in children.”

Pedestrians may face further internal injuries as they are thrown onto the hood of the car, or their head strikes the vehicle or ground.  The injuries are commonly called the Waddell’s triad: leg fracture, internal organ injury and head injury.

A few precautionary measures could prevent critical injuries and even death.

“The most important tip for both drivers and pedestrians is vigilance,” Guillamondegui said. “Be ever aware of where one is driving and playing. If driving through a neighborhood, respect the speed limits and keep an eye out for children playing in the area. 

“For pedestrians, always look both ways before crossing the street.  For cyclists and joggers, utilize protective high-visibility clothing and flashing lights to make your presence known to traffic, and remain vigilant in high-traffic areas.”

Ten commandments of safe walking and driving:

  •  Avoid distractions: Drivers who are texting, talking on the phone or eating are taking attention away from the road. Pedestrians who are texting, talking on the phone, or listening to loud music through earbuds are not as aware of surroundings. Bad things can ensue.
  • Obey all traffic signals: Pedestrians, cyclists and motorists are all responsible for obeying laws and keeping themselves safe.
  • Beware the twilight zone: Visibility is much reduced in the times just before sunup and just after sundown. Drivers should be extra cautious, and pedestrians should wear light or reflective clothing. 
  • Know the rules for intersections and crosswalks: Pedestrians should always cross the street at a crosswalk or an intersection. Drivers should always stop before crosswalk markings and remember that pedestrians have the right of way at intersections.
  • Look both ways: Drivers, look both ways before pulling into an intersection. Pedestrians, look both ways before crossing the street –just like your parents taught you.
  • Always walk against traffic if no sidewalk is available: And walk to the side of the street. Avoid walking out in the street, even if it looks as though no vehicles are around.
  • Remember that bicyclists have the same rights and responsibilities as motorists: A driver should maintain at least three feet between his or her vehicle and a bicycle. By law, you cannot pass a cyclist unless you have three feet of space between you and the cyclist. Wait until there is a safe opportunity to pass.
  • Open doors with care: Look for pedestrians and cyclists when opening your car door. It is the driver’s responsibility should any collision occur.
  • Caution, children at play: Be especially alert on neighborhood streets and take extra time to look for children at intersections, on medians and on curbs.
  • Slow down a little: Speeding greatly increases your chance of a crash with a cyclist or pedestrian; and just a 5 mile-per-hour decrease in speed can be the difference between life or death.

(Tips adapted from Nashville.gov, NashVitality program)