Injuries Sustained from High Velocity Impact with Water

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Abstract
Over 720 persons are reported to have died jumping from the Golden Gate Bridge [California, USA]. A review of 100 consecutive autopsies showed that, in the majority of cases, massive pulmonary contusion, pneumothorax, laceration or perforation of the heart, great vessels or lungs by displaced ribs were the causes of immediate death. Irreparable fractures of the liver or spleen were the most common abdominal injuries. The persons fatally injured apparently entered the water in a horizontal position, experiencing maximal deceleration. Six survivors entered the water feet first with more gradual deceleration. These survivors remained conscious but sustained similar injuries of lesser degree; only 1 sustained rib fractures, 50% had fractures of the liver or spleen requiring operative therapy, and 50% sustained lung contusions and subsequent pneumothoraces. Suspicion of underlying injuries to the liver, spleen and lungs is essential during resuscitation of those who survive impact with water.

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