Positive Seat Belt Sign


Let’s talk about a + seatbelt sign and what that could mean when taking care of your trauma patients. Always anticipate the types of injuries that you will see such as:

1. Hemothorax, pneumothorax or hemopneumothorax 
2. Clavicular fx’s
3. Blunt abdominal injury with active internal bleeds such as small bowel rupture or mesenteric artery tears. Initial FAST may or may not see so emphasis on pt presentation and repeat FAST exams are key especially in the case of fluctuating patient stability. 
4. Traumatic kyphosis with paraparesis
5. Teardrop fx’s L-S spine
6. Chance fx’s-usually related to lap seatbelt use, this mechanism can result in complete ligamentous injury or a combination of bony, ligament, and disk involvement.

Lap belt ecchymosis or “positive seatbelt sign” accounts for approx. 20% of mesenteric, bowel and lumbar spine injuries. 


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