MVA history

Seeing a patient after a Motor Vehicle Accident?

Remember that it may be many months, or even years, before the details around the accident are needed for medicolegal reasons. And it may well be somebody else who is constructing the report. Better to get these details while they are fresh in the patient’s memory.

Questions to ask:

  • Assess the forces and velocities involved
    • How fast were they going? (notoriously inaccurate)
    • How fast was the other guy going? (even more inaccurate)
    • How far was your vehicle pushed if stationary? (much more accurate)
    • Which direction were you hit from?
    • Did the air bags go off? (usually)
    • Did the seat back collapse?
    • What were the relative sizes of the two vehicles?
  • Personal factors
    • Seat belt worn? Was it snug?
    • Driver or passenger?
    • KO’d? If so, how long?
    • Hit head on vehicle frame?
    • Did they see it coming? (were they braced?)
  • Symptoms at the time
    • Confused, black out?
    • Neurological symptoms at the time?

(We highlighted the most useful, but often forgotten, questions in bold.)

Just as with any orthopedic injury, it helps to determine what are the likely injuries if you understand the forces and directions of the injury.

Management

Once you have excluded serious c/spine injury, get them moving. Two days after the accident, their neck will be stiff and sore. The faster they get this moving, the less trouble they will have.