Lillehei K O, Robinson M N
Department of Surgery, University of Colorado Health Sciences Center, Denver 80262.
J Trauma. 1994 Nov;37(5):826-30. doi: 10.1097/00005373-199411000-00020.
To examine the mechanisms of injury and death in a commercial airline disaster and to propose preventative safety measures based on this analysis.
Denver County Coroner's Office and the National Transportation Safety Board.
Those patients suffering fatal injuries as a result of the Continental Flight 1713 Airline crash.
Autopsy records from the Denver County Coroner's Office were reviewed with the causes of death determined. In many instances there was significant injury to more than one anatomic region in a single individual, each analyzed independently.
There were 28 fatalities: nine died of mechanical asphyxiation, one of a penetrating cranial injury, and 18 of blunt trauma. The blunt injuries were remarkably similar to the deceleration injuries seen in high-speed motor vehicle crashes. Head trauma was the most common fatal blunt injury, followed by injuries to the chest and the abdomen. Thirty-six percent of the head injuries and 27% of the chest injuries had associated cervical and thoracic spine fractures, respectively. Analysis revealed a marked similarity in injury pattern sustained by seatmates, with a high incidence of fatal and serious injuries suffered by those passengers sitting in the front half of the airplane.
Fatal blunt injury secondary to deceleration forces was the most common cause of death seen in this analysis. The use of a lap belt restraint system alone is not adequate to protect passengers against these forces as shown convincingly in the automotive industry literature. What impact a better passenger restraint system may have had on survival in this disaster is unknown, however, at a minimum, it would have significantly improved survival for 6 of 28 passengers dying of isolated blunt head trauma. Minor alterations in aircraft design (secure bolting of passenger seats to the airplane superstructure) and passenger restraints (3-point lap and shoulder harness system) is proposed to positively influence survival during an airplane crash at negligible increased airline expense or passenger inconvenience.
研究一起商业航班灾难中的伤亡机制，并基于此分析提出预防性安全措施。
丹佛县验尸官办公室和美国国家运输安全委员会。
因大陆航空1713号航班坠毁而遭受致命伤的患者。
查阅丹佛县验尸官办公室的尸检记录，确定死亡原因。在许多情况下，单个个体的多个解剖区域都受到了严重损伤，每个区域都进行了独立分析。
共有28人死亡：9人死于机械性窒息，1人死于颅脑穿透伤，18人死于钝器伤。钝器伤与高速机动车碰撞中所见的减速伤非常相似。头部创伤是最常见的致命钝器伤，其次是胸部和腹部损伤。分别有36%的头部损伤和27%的胸部损伤伴有颈椎和胸椎骨折。分析显示，邻座乘客的损伤模式有明显相似性，坐在飞机前半部分的乘客遭受致命和重伤的发生率很高。
在本分析中，减速力导致的致命钝器伤是最常见的死亡原因。正如汽车行业文献令人信服地表明的那样，仅使用腰部安全带约束系统不足以保护乘客免受这些力量的伤害。然而，更好的乘客约束系统在这场灾难中可能对生存产生何种影响尚不清楚，不过，至少它会显著提高28名死于单纯钝器头部创伤的乘客中6人的生存率。建议对飞机设计（将乘客座椅牢固地螺栓固定在飞机上层结构上）和乘客约束装置（三点式腰部和肩部安全带系统）进行微小改动，以在航空公司费用增加可忽略不计或乘客不便最小的情况下，对飞机坠毁时的生存产生积极影响。
