Falls
From TraumaWiki.com
Contents |
Background
Fall is a relatively common mechanism of injury. The lethality of injuries sustained as a result of falling increases with the height of fall. Of interest, one of the most amazing stories of survival has been described after a flight attendant, Vesna Vulovic survived a fall from approximately 33,000 feet [1].
Epidemiology
In terms of mortality, the overall figures relating to the height of fall are as follows. For adult patients, the LD-50 is approximately 48 feet (4 stories) and LD-90 is approximately 84 feet (7 stories) [2].
Injury Patterns
The approximate terminal velocity (the velocity resulting from the balance between the downward force due to the gravity and the drag provided by the surface area of the falling patient) is approximately 130 miles per hour. However, the fastest recorded fall velocity by a human was 714 miles per hour, performed by Capt. J. W. Kittinger from a height of 102,000 feet (31,090 meters) using a multi-stage chute [4].
Certain injury patterns may be seen following falls. If the patient falls on their feet, calcaneal fractures, pelvic fractures, and spinal injuries should be highly suspected [3].
Special considerations
Patients who are classified as being high risk for frequent mechanical or non-mechanical falls also represent a high-risk group for the use of anticoagulants. This group of patients may be a greater than usual risk of superficial bleeding, bruising, internal bleeding, as well as intracranial hemorrhage.
Notes & References
[1] Wikipedia: Vesna Vulovic. Available online at: http://en.wikipedia.org/wiki/Vesna_Vulovic. Last accessed on April 3, 2008.
[2] Rosen P, Ed. Emergency Medicine: Concepts and Clinical Practice. 4th ed. Mosby-Year Book, Inc; 1998:352.
[3] eMedicine Image Case: Fall from 25 feet. Available online at: http://knowledge.emedicine.com/splash/shared/pub/cotw/0012answer.html. Last accessed on April 3, 2008.
[4] Balloons as Forerunners of Spaceflight and Exploration. Available online at: http://www.centennialofflight.gov/essay/Lighter_than_air/Balloons_and_Space/LTA17.htm. Last accessed on April 3, 2008.
Credits & Notices
Authors-contributors to this page (listed alphabetically, last name, first & middle initial only, no institutional affiliations, no scientific titles):
Stawicki SP
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