On the basis of information that a 6-year-old is in the front seat wearing a lap belt and the air bag deployed, which injury is most suspicious?

• A. Blunt trauma to the head
• B. Open abdominal trauma
• C. Neck and facial injuries
• D. Lower extremity fractures

Answer: (C)

When a child sits in the front seat with only a lap belt and the air bag deploys, the most at-risk area is the face and neck. The air bag inflates rapidly with substantial force and can strike a small child’s facial structures directly, causing facial fractures, eye injuries, nose/mouth injuries, or significant facial lacerations. The neck can also suffer from the sudden deceleration and whiplash-like forces transmitted during rapid air bag deployment. A shoulder belt helps distribute these forces across the chest and reduces direct impact to the face and neck, so lacking that restraint makes facial and neck injuries most suspicious.

Open abdominal injuries and lower extremity fractures are important concerns in crashes, but the immediate, distinctive risk of air bag deployment in a front-seat child wearing only a lap belt is facial and neck trauma.