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Buckling so easy a child can do it

The Department of Transportation delivered some good news and bad news last week.

The good news: 84 percent of drivers wear seat belts.

The bad news: That means 45 million Americans still don't wear seat belts.

Who does that, you're wondering?

Possibly, these are the same people who still take up cigarette smoking despite all that is known about the dangers of tobacco. Or maybe these are the same people who leave kids in their cars while they shop, watch a movie, write a novel, undergo a colonoscopy and so forth while their kids roast to death.

To put it gently and diplomatically, these people are idiots.

But I digress.

Go figure. Seat belts cost nothing. They take two seconds to buckle up. It's so simple a child can do it. On a 10-point Effort Scale, buckling your seat belt ranks 1.2. Turning on the radio is 1.0. So is breathing.

It's illegal not to buckle your seat belt, but do we really need a law that tells us the obvious? If so, then we need a law against gouging yourself in the eye with a fork.

"You should spend a few days hanging out with me in the ER," says Dr. Eric Swanson. "You'd be a believer in seat belts."

Swanson is an associate professor of emergency medicine at the University of Utah and medical director of the university's AirMed division. He oversees four helicopters and two airplanes that are often used to ferry auto accident victims to the hospital. They serve the largest geographic area of any academic medical center in the U.S. — Montana, Idaho, Wyoming, Nevada and Utah.

All of which means Swanson has a front-row seat to significant auto carnage. You name it, he's seen it. Chest and abdominal injuries. Battered heads and faces. Collapsed lungs. He's had to open chests and massage hearts and plug up rivers of blood.

"We'll see people who were in the same accident, and the people who weren't wearing a seat belt were killed and the one who was is not injured," says Swanson.

Yet he still hears of people who believe that NOT wearing a seat belt is actually safer than wearing a seat belt. "Amazing," he says.

The problem is simple: When your car comes to an abrupt halt, you don't. Your head is still traveling at 70 miles per hour. Even if you are stopped by an airbag (or a windshield), your internal organs are still traveling at 70 mph inside your body. They slam into other body parts, and, well, it's a mess.

"I can't even fathom not wearing seat belts," says Swanson. "I see the results of this every day at work."

Who would know better than an ER doctor?

The government reports that 38 people die daily in car crashes from failing to wear seat belts — a total of 14,000 in 2008. It is estimated that half of them would have survived if they had worn seat belts.

Common sense hasn't kept pace with technology. For years, the U.'s emergency-response teams based their response on visual observations at the scene of the accident. If the car was demolished, it was given a Level 1 response — back at the hospital, a CT scan was placed on hold, the operating room was reserved, and anesthesiologists, X-ray techs, trauma surgeons, orthopedic surgeons, lab techs, neurosurgeons, etc., were readied and waiting.

Then they noticed with increasing frequency that the victims of such wrecks were showing up with no significant injuries and that they had gone to all that trouble and expense for nothing. They could no longer pre-judge injuries based on a description of the severity of the crash, because improved technology — cars that crumple (thus absorbing the energy of a crash), air bags and seat belts saved lives and prevented injuries.

"We had to change our trauma activation criterion," he says, "because the severity of the crash wasn't reliable. The cars look destroyed and that used to be an indication of serious injury. Now when they call from the scene they tell us if the victims were wearing seat belts and if the airbag deployed."

His point: These modern developments in the auto technology save lives — but some people still refuse to use seat belts, one of the critical components of that technology.

"For my family it's not even an option," says Swanson.

Doug Robinson's column runs on Tuesdays. Please send e-mail to