Prospective audit of the pattern, severity and circumstances of injury sustained by vehicle occupants as a result of road traffic accidents.

The pattern and severity of injuries sustained by 174 vehicle occupants consecutively admitted to the Accident and Emergency Department of the Edinburgh Royal Infirmary were prospectively documented. Drivers (DR) accounted for 66% of the patients, 20% were front seat passengers (FSP) and 14% were rear seat passengers (RSP). Injured patients were more likely to be male, young, intoxicated and not wearing a seat-belt. The position of the patient within the vehicle at the time of the accident and point of impact significantly affected the pattern of injury sustained. The majority of injuries were sustained by the upper body and the pattern of injury is discussed. Most accidents occurred at low speeds and higher speeds were associated with an increased severity of injury. Seat-belts reduced the overall severity of injuries, in particular those to the face and chest, but may increase the risk of neck injury. Head-rests do not appear to influence the incidence of neck injury. Clinically apparent alcohol intoxication was associated with a markedly increased risk of severe injury.