Adelaide Medical School, The University of Adelaide, Australia.
Forensic Science South Australia, Australia.
Med Sci Law. 2021 Jul;61(3):227-231. doi: 10.1177/0025802421993990. Epub 2021 Feb 14.
A retrospective review of autopsy files at Forensic Science South Australia in Adelaide, Australia, was undertaken over a five-year period from January 2014 to December 2018 for all motor vehicle crashes with rollovers ending with the vehicle inverted and the occupants suspended by the lap component of their seat belts. There were five cases, all male drivers (aged 18-67 years; = 32 years). Acute neck flexion or head wedging was noted in four cases, with facial petechiae in four and facial congestion in one. Deaths were due to positional asphyxia in four cases, with the combined effects of positional asphyxia and head trauma accounting for the remaining case. Although all drivers had evidence of head impact which may have caused incapacitation, in only one case was this considered severe enough to have contributed to death. A blood alcohol level above the legal limit for driving was detected in two cases, but no other drugs were detected. This series demonstrates another subset of cases of seat belt-associated deaths where suspension upside down by the lap component of a seat belt had occurred after vehicle rollovers. Predisposing factors include incapacitation of the victim and delay in rescue. The postulated lethal mechanism involved respiratory compromise from the weight of abdominal viscera on the diaphragm, as well as upper airway compromise due to kinking of the neck and wedging of the head.
对澳大利亚阿德莱德南澳大利亚法医科学中心的尸检档案进行了为期五年的回顾性研究，时间为 2014 年 1 月至 2018 年 12 月，研究对象为所有翻车事故中车辆翻倒后呈倒置状态且乘客被安全带的腰部固定部分悬挂的事故。共有 5 起案例，均为男性驾驶员（年龄 18-67 岁；平均年龄 32 岁）。有 4 例出现急性颈部弯曲或头部楔入，4 例出现面部瘀点，1 例出现面部充血。4 例死亡是由于位置性窒息，另 1 例是位置性窒息和头部创伤共同导致的。尽管所有驾驶员都有头部撞击的证据，这可能导致意识丧失，但只有 1 例被认为严重到足以导致死亡。2 例驾驶员血液中的酒精含量超过法定驾驶限制，但未检测到其他药物。该系列案例展示了另一个与安全带相关的死亡案例子集，在这些案例中，安全带的腰部固定部分在车辆翻车后将乘客倒置悬挂。易患因素包括受害者意识丧失和救援延迟。推测的致死机制涉及腹部内脏的重量压迫膈肌导致呼吸受限，以及颈部弯曲和头部楔入导致上呼吸道受限。
