Of all the wrecks I’ve worked in the past 5 years, nobody who survived has cut loose, so far. Knock on wood, and all that other stuff…
That’s interesting. Although, from the expression on the actor’s face, he’s either a really good actor or it might have actually happened.
Based on my personal experience handling thousands of patients from car wrecks and other assorted anxiety-producing situations, urinary incontinence is rare and fecal incontinence, like the bungee guy, even rarer. I am guessing he had a vagal reaction and actually passed out, but perhaps not. I will admit that a little self-dribbling might go unnoticed by me, and on average very severely injured patients are disrobed with scissors fairly early on; perhaps I missed a few. We do rectal exams on nearly every severe trauma that comes to the ED, though, so I have had occasion to do a lot of checking.
I have seen urinary incontinence associated with various things–including ordinary vagal reactions–that cause unconsciousness, but even then it does not strike me as very common. And some anxiety situations for a kid–say, one that’s about to get a shot–might cause a little dribble.
Severe blunt abdominal trauma will not force urine out of an intact sphincter in the young. As mentioned above, it will rupture the bladder instead. Those kinds of patients would typically have gross blood at the urethral meatus and I doubt a little urinary sprinkle would even get noticed if a tiny dribble did come out. For the elderly, of course–especially women–even the mild valsalva of a cough could do it, and certainly a seat-belted elderly woman might have some urinary incontinence just from a rapid deceleration.
I’m aware that anxiety makes some people pee pee. Also some dogs. I’m also aware of even fecal incontinence being described with real scary things like just before execution. I just haven’t seen it much in the situation you describe. Maybe car wreck victims don’t have time to process enough to lose sphincter control before the wreck is over. FWIW, I calculate I’ve seen somewhere around 100,000 patients (all comers) over a long career in emergency medicine. But maybe there are some actual studies out there which would prove my memory incorrect.
I got the “always wear clean underwear in case you’re in an accident” lime from Mom. Grandma told me it wouldn’t make any difference since the nurses would just cut them off anyway and they probally wouldn’t still be clean by that point either. The one bad car accident were I ended up in hospital they did cut them off (along with my pants), but I didn’t mess myself. I didn’t even need to pee until hours later after my x-ray when I was waiting for the results in the ER. Mom had to threaten the ladies at the nurses’s station before they got around to giving her a urinal (they’d been trying to decide were to order dinner from and she interupted them).
“I must have lost twenty pounds that day, most of it brown.” - George C. Scott, Taps
Been involved in EMS for over 30 years and one comes to mind more so because it is still the worst I was ever on.
2 vehicle head on, one going wrong way on express way at apex of hill, family of 5 and other was single occupant. neither had even let off throttle from all indications.
4 dead on scene and one died upon arrival at ER. One lone 8 year old survivor.
Anyway the 4 dead on scene all were fecal incontinent.
Note; This was discovered in the morgue.
I remember a surgeon stopped at the scene and checked in to see if he could be of any help and after a quick glance he answered his own question and left us to the grizzly task of extricating the DOA’s.
I had already made a 20 mile round trip from the ER to do a morgue run.
It might just be a coincidence of anatomy. There are two sphincters. One is controlled subconsciously and the other consciously. If you’re scared enough, you’re definitely not consciously controlling the one and stress causes most of the digestive system to stop working so the body can use energy elsewhere.
I suspect that any injury bad enough to worry about feces in an injured bowel is going to be lethal anyway in a pre-technological period of history. And I doubt those injuries were common enough to be a driving force in natural selection.
The real reason to ignore this bit of motherly mis-information is that we don’t care, and, unless your wearing something that looks like it’s been on for a month, or is commonly associated with a different age group or gender we won’t even notice.
You know, it took me over 24 hours to remember the Cos’s followup line, which was one of his finest…