In a severe motor vehicle rollover, which situation could most easily lead to death?

Ejection of the patient from the vehicle is a critical scenario in a severe motor vehicle rollover that significantly increases the risk of fatal injuries. When a person is ejected from a vehicle, they are exposed to the full force of the external environment and the hazards associated with it, such as the ground and other potential obstacles. The impact of striking the ground or other objects can lead to severe trauma, including traumatic brain injuries, spinal injuries, and other critical injuries that often result in death.

Moreover, the dynamics of a rollover greatly increase the likelihood of ejection, especially if the occupant is unrestrained. Being thrown from the vehicle removes any protective measures that would typically mitigate injury, such as the vehicle's frame and safety features.

In contrast, other scenarios listed have serious risks, but they generally carry a lower immediate risk of fatal outcomes compared to ejection. Trauma from a seatbelt, while potentially serious, is often survivable with appropriate medical intervention. Crush injuries typically occur but can also be survivable depending on the nature and extent of the injury. An unrestrained passenger hitting various parts of the interior can result in significant injury, but the risks associated with ejection, especially in a rollover context, tend to be more pronounced.