Face for Impact

I was on call Thursday night and got called into the Emergency Department for an 8 year old vs. Motor Vehicle. Talking to the Emergency Resident I asked if the kid was cleared medically, because dental is totally low priority when your kid gets kit my a car going 25 mph. "Yep," she says, "actually, all his injuries are dental."

"Huh?" I thought, "No way you get hit by a car and only mess up your teeth."

Sure enough, somehow this kid managed to hit this car with only his face, and do it hard enough to leave a dent. He had some scrapes on his face and forehead, but no other bruises, broken bones, or anything, just a really, really jacked up mouth. He knocked out his top front teeth and slammed another up into his gums, and knocked out one of his lowers. His two middle lower teeth were still in the alveolus (ridge of bone your teeth sit in) but that ridge, along with the teeth had been punched right out, and they were laying back on his tongue. These are all permanent teeth. He had vomited a couple times because he swallowed so much blood, so we couldn't sedate him, so we put him on the list for OR in the morning. As I'm about to leave for home, another resident walks up and says, "Are you dental? I have a kid vs. Motor vehicle with some dental trauma."

"I've already seen him," I say.

"Nope, this is a different kid."

"Seriously?! Is she cleared medically," I ask?

"Yeah, we're going to x-ray her hand, but mostly it's just her face."

I look at the chart, this car was reported to be going 30 mph. As I look at the kid, she's got abrasions on her knees, arms, and face, and one teeny tiny fracture on one tooth. Nobody in the room could describe what happened beyond that "she just flipped." She's pretty dang lucky.

Both these kids have broken what I thought were hard and fast laws of physics. Either that, or apparently, kids in upstate NY have been trained to brace for impacts using only there face. We do it differently where I'm from, but I try to be accepting of different cultures. Maybe we'll have to get out to the schools and do some community education on the reflex movements the rest of us take for granted.

Incidentally, we patched the first kid up pretty well, considering. I'm seeing him Tuesday and we'll see how things look.