Training intensity and consultant support: the Canadian experience.

particularly at the level of the hyoid bone, but no fractures were seen. On completion of the orthopaedic procedure, direct laryngoscopy was performed showing complete regression of the oedema and the patient’s trachea was extubated. During postoperative interview the patient agreed to have felt somewhat hoarse on the evening following the traffic accident. Seatbelts save lives and are effective in reducing the severity of non-fatal injuries but new patterns of injury, including subclavian artery laceration and carotid artery dissection, have been recognized. 5 Linear ecchymosis of the abdominal wall (a positive ‘seatbelt sign’) as a result of wearing a lap belt increases the risk of intestinal and other occult injury. In the present case, the restraining effect of the lap-shoulder belt prevented severe direct laryngeal trauma by contact with the steering wheel or dash board. However, ironically, it led to the linear ecchymosis across the right shoulder and laryngeal oedema was observed.