Clunk-Click every trip (Warning: 9pm reader-watershed applies)!

Have you ever noticed how often the words “unrestrained passenger” turn up on TV in those hospital soaps like Casualty or Holby City - just before something really messy rolls in the door?

Slowly passing by a road traffic accident (or ‘RTA’ as it more commonly referred), the way I tell the difference between those who were wearing their seatbelts and those who were not is that the ones who were wearing them are standing around saying “This really sucks!” whereas the ones who weren’t are kinda just, well, lying there.

This is not to say that all unrestrained traffic accidents are fatals, nor that seat-belted peeps are invulnerable. My father didn’t believe in wearing a seatbelt, having lost a good friend in an RTA where the seatbelt failed to release leaving him trapped in his car. Trying to explain to my dad that his friend would’ve most likely died in any case from the injuries he sustained was pointless. Ironically, at only 51 years young, my poor dad also died in an RTA, though I doubt his insistence on not wearing a seatbelt wouldn't have made much difference to the outcome of his head-on collision with an articulated lorry. But, if you’re playing the odds….

Last year, Sir Alex Furguson’s 10-year old grandson Charlie was seriously injured in a car crash. Surgeons reported that Charlie had an initial 5-hour operation to reduce brain swelling having sustained serious head injuries. Then the boy had to undergo further surgery to repair his spine after shattering a neck vertebra. Little Charlie's mother and younger sister sustained more minor injuries than this. Bet you’ll never guess which two were wearing their seatbelts?

So, having considered both personal and family experiences, as well as dabbling in my usual not so scientific Google research, let me try to explain what physically happens to us when involved in a collision. Be warned though, some of this will be gruesome, and I make no apology for this.

Did you know that on impact you have three or four sub-collisions all taking place in sequence? First, the vehicle hits some object. The vehicle abruptly slows, but unrestrained passengers (and other objects) inside it continue at the same speed, in the same direction. Then the unrestrained body hits the interior of the vehicle, and starts to slow. That’s the second collision. And that body’s internal organs are still moving at speed until they hit the inside of the chest (or get cheese-sliced by their supporting ligaments). The fourth collision is when your mate who’s riding in the back seat lands on your head, and because they aren’t wearing their seatbelt either they keep moving at the same speed in the same direction.

In a nutshell, in a crash at 30mph, if unrestrained you will be thrown forward with a force of between 30-60 times your own bodyweight. Where most vehicles these days have split folding rear seats, items carried in the boot of your car now have more chance of travelling forward upon impact. This is why my partner Paul - who carries more equipment in his boot than I have in my office - always ensures he buckles up the rear seatbelts in his car regardless of whether he has passengers or not.

Newtonian physics: Learn it, live it, love it! As a side issue, upon tracing my family history some years ago I discovered that Sir Isaac Newton was actually some great, great, great, great, second cousin removed of mine…or something like that. So I know what I’m talking about - family blood lines an’ all that!

Now, for those of you who aren't that squeamish and are thus still reading this, there are two major routes that unrestrained persons take in a front-ended RTA. Up-and-over or down-and-under (‘submarining’). With up-and-over, the upper body launches forward and up. The head strikes the windscreen. Your injuries here include concussion, scalp laceration, and various brain bleeds. You can also suspect fractured cervical vertebrae - and if you have a fracture with compromise to the spinal cord at C-4 or higher, you’ve lost the nerves that control chest expansion and the diaphragm.

Go a little further through the windscreen, and it isn’t unexpected to leave some or all of your face behind stuck in the broken glass. You’d be surprised by how easily faces come off the facial bones! You can also expect fractured wrists, arms, and shoulders, from folks trying to brace themselves.

A little further through the windscreen, all the way out of the vehicle, and in addition to whatever damage you took on the way through, you get the damage from hitting the ground, trees, and metal poles at however-many-miles-an-hour.

Sure, like my late father’s philosophy, you hear people talking about wanting to be “thrown clear” in the event of an accident. However, if you want to simulate being thrown clear, just go to the fifth floor of a building and jump out the window!

Being thrown clear apparently happens more often than you’d think. Unrestrained driver: side impact. Vehicle spins. Driver goes out the window. One of my customers in our local police force recently recalled one incident to me where the driver was half-way out his window when the vehicle rolled over on top of him. That was the second-most grotesque scene they said they’d ever been to. And no, I didn’t ask what the first one was.

My police friend also said “Any time you see an accident and the windows aren’t rolled all the way up and unbroken, look 200ft in all directions for the other patients. It’s quite unpleasant finding them three days later when someone wonders why all those birds are over there, or when someone at the hospital wakes up enough to ask where Joe is."

With ‘submarining’ injuries however, the driver or passenger goes forward and down, and under the dashboard. Here’s where you’re going to find fractured femurs, broken knees, and compression fractures to the lower spine. Now I know you’re all asking “Is it possible for a human femur to be pushed through the floor of the pelvis?” Well, the answer according to my good friend Google is “Yes.” As the legs collapse accordion-style, the patient’s chest hits the dashboard. This can give you rib fractures, a fractured sternum, cardiac bruising, or that ruptured aorta that many will know only too well.

On the plus side, there usually isn’t any brain damage (unless you got clonked on the knob by that bowling ball you’re carrying in the back, and seatbelts won’t help with that). On the other hand, femur fractures can be, and frequently are, fatal.

I think I’ll leave Traumatic Asphyxia, Hemo/Pneumothorax, and Flail Chest for another time…..let’s just say that they’re associated with having your chest hit the dashboard or steering wheel, and they’re really pants!

Seatbelts stop you from going up-and-over or down-and-under, or out the window. Sure, seatbelts can hurt you too, but hey, you’re in the presence of large amounts of free-floating energy, you decide.

With the UK’s seat belt law having been introduced in 1983 (and amended to include all passengers in 1991 and child seats in 2006), the police can stop and issue a fixed penalty fine to drivers and/or passenger solely for not wearing their seat belt.

The current fine is £60 (up to £500 + costs if it goes to court).

The penalty can be death.