Definition of injury. Classification of injuries

Traumatic brain injuries rank first among all injuries (40%) and most often occur in people aged 15–45 years. The mortality rate among men is 3 times higher than among women. IN major cities Every year, out of a thousand people, seven suffer traumatic brain injuries, while 10% die before reaching the hospital. In the case of a mild injury, 10% of people remain disabled, in the case of a moderate injury - 60%, severe - 100%.

Causes and types of traumatic brain injuries

A complex of injuries to the brain, its membranes, skull bones, soft tissues of the face and head is a traumatic brain injury (TBI).

Most often, participants in road accidents suffer from traumatic brain injuries: drivers, passengers of public transport, pedestrians hit by vehicles. In second place in terms of frequency of occurrence are household injuries: accidental falls, blows. Next come injuries sustained at work and sports.

Young people are most susceptible to injury in summer period- these are the so-called criminal injuries. Elderly people are more likely to get a TBI in the winter, and the leading cause is a fall from a height.

Statistics
Residents of Russia most often suffer a TBI while intoxicated (70% of cases) and as a result of fights (60%).

One of the first to classify traumatic brain injuries was the 18th century French surgeon and anatomist Jean-Louis Petit. Today there are several classifications of injuries.

• by severity: light(concussion, slight bruise), average(serious injury) heavy(severe brain contusion, acute compression of the brain). The Glasgow Coma Scale is used to determine severity. The victim's condition is assessed from 3 to 15 points depending on the level of confusion, ability to open eyes, speech and motor reactions;
• by type: open(there are wounds on the head) and closed(no damage to the scalp);
• by type of damage: isolated(damage affects only the skull), combined(the skull and other organs and systems are damaged), combined(the injury was not only mechanical, the body was also affected by radiation, chemical energy, etc.);
• according to the nature of the damage:
• shake(minor injury with reversible consequences, characterized by a short-term loss of consciousness - up to 15 minutes, most victims do not require hospitalization, after examination the doctor may prescribe a CT or MRI);
• injury(a disruption of brain tissue occurs due to an impact of the brain on the wall of the skull, often accompanied by hemorrhage);
• diffuse axonal brain injury(axons - the processes of nerve cells that conduct impulses - are damaged, the brain stem suffers, microscopic hemorrhages are noted in the corpus callosum of the brain; such damage most often occurs in an accident - at the time of sudden braking or acceleration);
• compression(hematomas form in the cranial cavity, the intracranial space is reduced, crush areas are observed; emergency surgical intervention is required to save a person’s life).

Important to know
Brain injury most often occurs at the site of impact, but damage often occurs at opposite side skulls - in the impact zone.

The classification is based on the diagnostic principle; on its basis, a detailed diagnosis is formulated, according to which treatment is prescribed.

Symptoms of TBI

The manifestations of traumatic brain injuries depend on the nature of the injury.

Diagnosis « concussion» diagnosed on the basis of anamnesis. Typically, the victim reports that there was a blow to the head, which was accompanied by a short-term loss of consciousness and a single vomiting. The severity of the concussion is determined by the duration of loss of consciousness - from 1 minute to 20 minutes. At the time of examination, the patient is in a clear state and may complain of a headache. No abnormalities other than pale skin are usually detected. In rare cases, the victim cannot remember the events that preceded the injury. If there was no loss of consciousness, the diagnosis is considered doubtful. Within two weeks after a concussion, weakness, increased fatigue, sweating, irritability, and sleep disturbances may occur. If these symptoms do not go away long time, which means it is worth reconsidering the diagnosis.

At mild brain contusionAnd the victim may lose consciousness for an hour, and then complain of headache, nausea, and vomiting. Eye twitching when looking to the side and asymmetry of reflexes are noted. An X-ray may show a fracture of the bones of the skull vault, and blood in the cerebrospinal fluid.

Dictionary
Liquor - liquid transparent color that surrounds the head and spinal cord and performs including protective functions.

Moderate brain contusion severity is accompanied by loss of consciousness for several hours, the patient does not remember the events preceding the injury, the injury itself and what happened after it, complains of headache and repeated vomiting. May experience: disturbances blood pressure and pulse, fever, chills, sore muscles and joints, convulsions, blurred vision, uneven pupil size, speech impairment. Instrumental studies show fractures of the vault or base of the skull, subarachnoid hemorrhage.

At severe brain contusion the victim may lose consciousness for 1–2 weeks. At the same time, he exhibits gross violations of his vital important functions(pulse rate, pressure level, breathing rate and rhythm, temperature). The movements of the eyeballs are uncoordinated, muscle tone is changed, the swallowing process is impaired, weakness in the arms and legs can reach convulsions or paralysis. As a rule, this condition is a consequence of fractures of the vault and base of the skull and intracranial hemorrhage.

This is important!
If you or your loved ones suspect that you have suffered a traumatic brain injury, you need to see a traumatologist and neurologist within a few hours and carry out the necessary diagnostic procedures. Even if it seems that you are feeling fine. After all, some symptoms (cerebral edema, hematoma) may appear after a day or even more.

At diffuse axonal brain damage a prolonged moderate or deep coma occurs. Its duration ranges from 3 to 13 days. Most victims have a respiratory rhythm disorder, different horizontal positions of the pupils, involuntary movements of the pupils, and arms with hanging hands bent at the elbows.

At compression of the brain two may be observed clinical pictures. In the first case, there is a “light period”, during which the victim regains consciousness, and then slowly enters a state of stupor, which is generally similar to stupor and numbness. In another case, the patient immediately falls into a coma. Each condition is characterized by uncontrolled eye movements, strabismus, and cross-limb paralysis.

Long-term head compression accompanied by swelling of the soft tissues, reaching a maximum 2–3 days after its release. The victim is in psycho-emotional stress, sometimes - in a state of hysteria or amnesia. Swollen eyelids, impaired vision or blindness, asymmetrical swelling of the face, lack of sensitivity in the neck and back of the head. A computed tomography scan shows swelling, hematomas, skull fractures, areas of brain contusion and crush injuries.

Consequences and complications of TBI

After suffering a traumatic brain injury, many become disabled due to mental disorders, movements, speech, memory, post-traumatic epilepsy and other reasons.

TBI even mild degree affects cognitive functions- the victim experiences confusion and decreased mental abilities. More severe injuries may result in amnesia, impairment of vision, hearing, speech and swallowing skills. In severe cases, speech becomes slurred or even lost completely.

Disorders of motor skills and functions of the musculoskeletal system are expressed in paresis or paralysis of the limbs, loss of sensitivity of the body, and lack of coordination. In cases of severe and moderate injuries, there is failure to close the larynx, as a result of which food accumulates in the pharynx and enters the respiratory tract.

Some TBI survivors suffer from pain syndrome- acute or chronic. Spicy pain syndrome persists for a month after injury and is accompanied by dizziness, nausea, and vomiting. Chronic headache accompanies a person throughout his life after receiving a TBI. The pain can be sharp or dull, throbbing or pressing, localized or radiating, for example, to the eyes. Attacks of pain can last from several hours to several days, intensifying during moments of emotional or physical stress.

Patients have a hard time experiencing the deterioration and loss of body functions, partial or complete loss of performance, and therefore suffer from apathy, irritability, and depression.

Treatment of TBI

A person who has suffered a traumatic brain injury needs medical attention. Before the ambulance arrives, the patient must be placed on his back or on his side (if he is unconscious), and a bandage must be applied to the wounds. If the wound is open, cover the edges of the wound with bandages and then apply a bandage.

The ambulance team takes the victim to the trauma department or intensive care unit. There the patient is examined and, if necessary, an X-ray of the skull, neck, thoracic and lumbar spine is taken, chest, pelvis and limbs, perform an ultrasound of the chest and abdominal cavity, and take blood and urine for analysis. An ECG may also be ordered. In the absence of contraindications (state of shock), a CT scan of the brain is performed. Then the patient is examined by a traumatologist, surgeon and neurosurgeon and a diagnosis is made.

The neurologist examines the patient every 4 hours and assesses his condition using the Glasgow scale. If the patient's consciousness is impaired, tracheal intubation is indicated. A patient in a state of stupor or coma is prescribed artificial ventilation. Intracranial pressure is regularly measured in patients with hematomas and cerebral edema.

The victims are prescribed antiseptic and antibacterial therapy. If necessary, anticonvulsants, analgesics, magnesia, glucocorticoids, sedatives.

Patients with a hematoma require surgery. Delaying surgery within the first four hours increases the risk of death by up to 90%.

Prognosis of recovery for TBI of varying severity

In the case of a concussion, the prognosis is favorable provided that the victim follows the recommendations of the attending physician. Full recovery of ability to work is observed in 90% of patients with mild TBI. Cognitive function remains impaired in 10%, abrupt change moods. But these symptoms usually disappear within 6–12 months.

The prognosis for moderate and severe forms of TBI is based on the number of points on the Glasgow scale. An increase in scores indicates positive dynamics and a favorable outcome of the injury.

In victims with moderate TBI, it is also possible to achieve complete restoration of body functions. But often headaches, hydrocephalus, vegetative-vascular dysfunction, coordination problems and other neurological disorders remain.

With severe TBI, the risk of death increases to 30–40%. Among survivors there is almost one hundred percent disability. Its causes are severe mental and speech disorders, epilepsy, meningitis, encephalitis, brain abscesses, etc.

Of great importance in returning the patient to active life plays a complex of rehabilitation measures provided to him after the acute phase is stopped.

Directions for rehabilitation after traumatic brain injury

World statistics show that 1 dollar invested in rehabilitation today will save 17 dollars to ensure the life of the victim tomorrow. Rehabilitation after TBI is carried out by a neurologist, rehabilitation specialist, physical therapist, occupational therapist, massage therapist, psychologist, neuropsychologist, speech therapist and other specialists. Their activities, as a rule, are aimed at returning the patient to a socially active life. The work to restore the patient’s body is largely determined by the severity of the injury. Thus, in case of severe injury, the efforts of doctors are aimed at restoring the functions of breathing and swallowing, and improving the functioning of the pelvic organs. Specialists are also working to restore higher mental functions (perception, imagination, memory, thinking, speech) that may have been lost.

Physical therapy:

• Bobath therapy involves stimulating the patient's movements by changing the positions of his body: short muscles are stretched, weak muscles are strengthened. People with mobility limitations get the opportunity to learn new movements and hone those they have learned.
• Vojta therapy helps connect brain activity and reflex movements. The physical therapist stimulates various areas of the patient's body, thereby encouraging him to perform certain movements.
• Mulligan therapy helps relieve muscle tension and pain-free movements.
• Installation "Exart" - suspension systems, with the help of which you can relieve pain and return atrophied muscles to work.
• Exercise classes. Shown are classes on cardio equipment, exercise machines with biological feedback, as well as on a stabiloplatform - for training coordination of movements.

Occupational therapy- a direction of rehabilitation that helps a person adapt to environmental conditions. The occupational therapist teaches the patient to take care of himself in everyday life, thereby improving his quality of life, allowing him to return not only to social life, but even to work.

Kinesio taping- applying special adhesive tapes to damaged muscles and joints. Kinesitherapy helps reduce painful sensations and relieve swelling, without limiting movement.

Psychotherapy- an integral component of high-quality recovery after TBI. The psychotherapist carries out neuropsychological correction, helps to cope with apathy and irritability characteristic of patients in the post-traumatic period.

Physiotherapy:

• Medicinal electrophoresis combines the introduction into the victim’s body medicines with exposure to direct current. The method allows you to normalize the state of the nervous system, improve blood supply to tissues, and relieve inflammation.
• Laser therapy effectively combats pain, swelling of tissues, and has an anti-inflammatory and reparative effect.
• Acupuncture can help reduce pain. This method is included in the complex of therapeutic measures in the treatment of paresis and has a general psychostimulating effect.

Drug therapy is aimed at preventing brain hypoxia, improving metabolic processes, restoring active mental activity, normalizing emotional background person.

After moderate and severe traumatic brain injuries, it is difficult for victims to return to to the usual way life or come to terms with forced changes. In order to reduce the risk of developing serious complications after a TBI, you need to follow simple rules: do not refuse hospitalization, even if it seems that you are feeling fine, and do not neglect various types of rehabilitation, which, with an integrated approach, can show significant results.

Which rehabilitation center after TBI can I go to?

“Unfortunately, there is no single rehabilitation program after traumatic brain injury that would allow the patient to return to his previous condition with a 100% guarantee,” says a rehabilitation center specialist. - The main thing to remember: with TBI, much depends on how quickly rehabilitation measures begin. For example, “Three Sisters” admits victims immediately after hospitalization; we even provide assistance to patients with ostomies, bedsores, and work with the youngest patients. We accept patients 24 hours a day, seven days a week, and not only from Moscow, but also from the regions. We devote 6 hours a day to rehabilitation sessions and continuously monitor the dynamics of recovery. Our center employs neurologists, cardiologists, neurourologists, physical therapists, occupational therapists, neuropsychologists, psychologists, speech therapists - all of them are experts in rehabilitation. Our task is to improve not only the physical condition of the victim, but also the psychological one. We help a person gain confidence that even after suffering a serious injury, he can be active and happy.”

Lecture No. 1.

Topic: “Nursing care for closed soft tissue trauma, dislocations, fractures and SDR.”

Lecture outline:

1. Definition of injury. Classification of injuries.
2. The concept of injury, its types.
3. System of organizing trauma care in Russia.
4. Closed mechanical injuries:

Stretching and tearing;

Shake;

Fracture.

5. Fractures of ribs and collarbone.

6. Long-term crush syndrome.

Definition of injury. Classification of injuries.

Injury is a sudden, immediate effect on the human body external factors, leading to disruption of anatomical integrity and physiological functions in organs and tissues and accompanied by a general reaction of the body.

Injuries occupy third place in the structure of overall morbidity and overall mortality (12.7%), behind influenza, acute respiratory infections and CVD. In men, injuries occur 2 times more often than in women. In recent years, there has been an increase in mortality from injuries.

Classification of injuries:

I. According to the mechanism of occurrence(taking into account the point of application of force):

Straight lines (in the area where force is applied);

Indirect (for example, falling on an outstretched arm, breaking the collarbone).

II. By location of damage:

- isolated (damage to one organ or segment of the musculoskeletal system of the musculoskeletal system);

- multiple (several similar injuries to the musculoskeletal system or organs);

- combined (damage to two or more anatomical and functional areas), for example, a fracture of the musculoskeletal system with damage to internal organs (skull, chest, abdomen);

- combined (this is damage caused by exposure to a mechanical factor with some other thermal, chemical, etc. agent)

III. By type of damaging factor:

Mechanical injuries (fractures, ruptures, dislocations, bruises);

Thermal injuries (burns, frostbite);

Chemical injuries;

Electrical injuries (electric current);

Radiation injuries (effects of radiant energy);

Psychological (receiving sudden news).

IV. According to the nature of the damage:

- closed - without damage to the skin and mucous membranes (dislocations, bruises, sprains, ruptures, SDR, cavitary injuries, etc.);

- open - damage to the skin and mucous membranes (wounds, burns, frostbite, electrical trauma);

- penetrating cavities - with damage to the barrier septum

(parietal layer of the peritoneum, pleura, synovial membranes of the joint, dura mater);

- penetrating with damage to internal organs and without damage to internal organs;

- non-penetrating in the cavity (without damaging the barrier septum).

V. By time of occurrence:

- spicy (immediately after exposure);

- chronic (due to repeated exposure, eg dry callus).

VI. By penetration depth:

Superficial;

Subcutaneous; - cavitary

1. The concept of injury, its types. System of organizing trauma care in Russia.

Injuries is a set of injuries that are repeated in a certain area or among a certain group of people over a certain period of time.

Classification of injuries:

Depending on the conditions of occurrence, the following are distinguished:

1. Occupational injuries (industrial, agricultural, military).

2. Non-occupational injuries (transport, pedestrian, household, children, etc.).

Injury prevention:

Proper organization labor and safety;

Improving the personal safety of workers;

Compliance with traffic rules, etc.

Traumatology is the science of damage to human organs and tissues. She studies traumatism, its prevention, the organization of trauma care and the treatment of injuries of the musculoskeletal system.

Trauma, or damage, is a sudden impact of factors external environment(mechanical, thermal, chemical, etc.) on tissues, organs or the body as a whole, leading to anatomical and physiological changes, accompanied by a local and general reaction of the body.

Damage, depending on the application of force, is divided into direct and indirect. They can be isolated - with damage to one anatomical and functional formation of the musculoskeletal system; multiple - with damage to two or more anatomical and functional formations or damage to blood vessels and nerves in different segments of the limbs; combined - damage to internal organs in various cavities with trauma to the musculoskeletal system - and combined - the simultaneous presence of two etiologically dissimilar injuries in the victim (for example, a fracture of the humerus and burns of the body).

The mechanical factor can manifest itself in the form of pressure, stretching, rupture, twisting moment of force or shock. In this case, the force of influence of the external factor on tissues and organs is directly proportional to the direction (directly or at an angle), speed and duration of exposure, which leads to varying degrees of injury severity. The most common injuries include bruises, wounds, dislocations, bone fractures, limb separations, burns, frostbite, electrical injuries, etc.

TO bruises(contusio) include mechanical damage to tissues or organs, often without compromising the integrity of the skin. In this case, subcutaneous fatty tissue is destroyed, and hemorrhages occur with disruption of arterial, venous circulation and lymph flow. Swelling of soft tissues, increased local temperature, and redness of the skin (reactive hyperemia) occur. With bruises in the area of ​​the extremities involving muscles, tendon-ligamentous apparatus, joints, musculoskeletal function is disrupted; with bruises of organs (heart, lung, brain, etc.), functions specific to these organs are disrupted. The severity of the bruise depends on the strength of the external influence and the location of the damaged tissues and organs.

Compression(compressio)- damage to organs or tissues caused by pressure from the outside or from neighboring organs or tissues. Compression of the brain (hematoma, edema, tumor), heart (hemopericardium), and lungs (hemothorax, pneumothorax) poses a serious danger to life. A separate nosological group includes long-term compression of the soft tissues of the extremities, and, less commonly, the torso, which results in long-term compression (crushing) syndrome, or crash syndrome. In its development, the main role is played by traumatic toxicosis caused by the products of decay and impaired metabolism of compressed or crushed soft tissues.

The severity of the condition of the victims is aggravated by the development of acute renal failure.

Wound(vulnus)- any violation of the integrity of the skin or mucous membranes under the influence of external mechanical influence or internal influence - a bone fragment. There are superficial wounds and deep ones - with damage to large vessels, nerves, and internal organs.

Dislocation(luxatio)- complete separation of the articular ends of the bones; with subluxation, partial contact of the articular surfaces is maintained, but with deformation of the contours of the joint and joint space (excessive expansion, uneven narrowing, etc.). A distinction is made between fracture-dislocation (intra-articular fracture of the dislocated end of the bone) and bone dislocation with extra-articular fracture. The dislocated bone is considered to be dislocated. A dislocation is considered fresh up to 3 days from the moment of injury, stale - up to 3 weeks, old - more than 3 weeks. Based on etiology, dislocations are divided into traumatic, habitual, congenital and pathological. Traumatic dislocations occur more often with indirect trauma with forced violent movement in the joint, exceeding the amplitude of its normal movements. Habitual dislocation occurs mainly in the shoulder joint after an untreated or improperly treated primary traumatic dislocation. Repeated dislocations can occur with varying frequency due to minimal external force and even normal movements in the joint with a large amplitude. Congenital dislocation is formed as a result of dysplasia (underdevelopment) of the joint. Predominant involvement of the hip joint has been and remains a serious orthopedic problem. Pathological dislocation is the result of destruction of the joint by some pathological process (arthrosis, tuberculosis, osteomyelitis, tumor).

Fracture(fracture ossis) called bone damage with a violation of its integrity. Most fractures occur due to impact mechanical force exceeding the strength of normal bone. Less commonly, a fracture occurs from minor forces (from the weight of a limb or body) and is considered pathological (in the area of ​​a tumor, cyst, inflammatory process). More often, fractures are closed, less often (1:10) - open (the fracture area communicates with the wound). If the wound was caused by external violence, then the fracture is considered primary open. If the skin is perforated by a fragment (shard) of bone from the inside, then the fracture is considered secondary open. This division is of fundamental importance, since in a primary open fracture, soft tissue destruction and microbial aggression can significantly affect the surgical tactics and method of treating the fracture.

Injuries— social phenomenon, as a result of which certain groups of residents who are in the same working and living conditions are injured. The following types of injuries are distinguished.

I. Occupational injuries.

1. Industrial.

2. Agricultural.

II. Non-occupational injuries.

1. Household.

2. Street:

a) transport;

b) non-transport.

3. Sports.

III. Intentional injury (murder, suicide, self-harm).

IV. Military injuries.

V. Childhood traumatism.

1. Generic.

2. Household.

3. Street.

4. School.

5. Sports.

6. Other accidents.

Work injury arises as a result industrial accident when workers are exposed to various production factors. All employees are subject to compulsory social insurance against accidents and occupational diseases.

The causes of accidents at work are divided into objective and subjective. TO objective reasons conditionally include technical and sanitary-hygienic, subjective - organizational and psychophysiological.

TO technical reasons include equipment malfunction; uncoordinated switching on of electricity and other energy sources; lack of fencing danger zone etc.

TO for sanitary and hygienic reasons include poor lighting; air pollution; increased radiation, etc.

Organizational reasons are improper organization of labor; poor quality training on labor safety issues; admission of unskilled workers to high-risk work.

Psychological reasons are fatigue and inattention during monotonous work; weakening of self-control; self-confidence; unjustified, unlawful risk.

Up to 80% of accidents occur due to erroneous or delayed actions of workers. The main cause of accidents and injuries is the risk factor. Risk can be legal (acceptable) and illegal (unacceptable).

Investigation and recording of accidents. All accidents that occurred at work are subject to investigation:

• during execution labor responsibilities, as well as actions in the interests of the enterprise without instructions from the employer;
• at the workplace, on the territory of an enterprise or at another place of work during working hours, including prescribed breaks;
• while putting production tools and clothing in order before starting or after finishing work, as well as for personal hygiene;
• while traveling to or from work, including on your own transport used for production purposes;
• during accidents (fire, explosion, collapse) and their elimination at production facilities.

About an accident as a result of which the employee, according to a medical report, lost his ability to work for one day or more or there was a need to transfer him to another, more light work for a period of at least one day, an act is drawn up in form N-1.

The head of the enterprise, having received a message about the accident, by order appoints an investigation commission in next lineup: head (specialist) of the labor protection service (chairman of the commission), head of a structural unit or chief specialist, representative of a trade union organization, sanitary and epidemiological supervision specialist (acute poisoning), representative of the labor collective on labor protection issues.

The owner of the enterprise approves five copies of the act in form N-1 within 24 hours. One copy of Act N-1, together with the investigation materials, is stored for 45 years at the enterprise where the accident was registered. Copies of the report are kept until all measures are taken to eliminate and prevent the hazardous production factor.

The fight against injuries is usually carried out in three areas:

1) prevention;

2) organization of trauma care;

3) qualified and specialized treatment.

This problem still remains one of the most acute problems in traumatology, since injuries annually claim a significant number of human lives, transform even larger number victims into disabled people and thereby causing enormous moral and material damage to the state.

Traumatology and orthopedics. N.V. Kornilov

Injuries occur in people at different ages and situations. The risk group includes people leading an active lifestyle, the elderly, and children. Injuries are fraught with serious complications, it is important to provide first aid to the victim in a timely and correct manner, consult a doctor as quickly as possible, and follow all recommendations.

In case of serious injury, be sure to consult a doctor

Classification of injuries by severity

Trauma is a violation of the integrity of the skin, damage and deterioration of the functions of various tissues, organs, and blood vessels under the influence of external factors. There are many causes of injury, so pathologies are divided into different groups and types.

Injury severity:

1. Extremely severe - incompatible with life, immediately or within a short period of time leads to death.
2. Severe – characterized by pronounced signs of impairment of general well-being, requiring immediate medical attention, hospitalization, the person loses ability to work for at least 1 month.
3. Moderate severity - cause some changes in the functioning of internal organs and systems, treatment is carried out in a hospital or at home, the period of incapacity is 10-30 days.
4. Lungs - a person experiences only minor discomfort, which does not affect his ability to work. Treatment can be carried out independently; the duration of therapy for acute forms is about 10 days.

Serious injuries must be treated in hospital

Injuries – statistical concept, it refers to mass injuries that occur in certain conditions among people of the same type in any time period. These indicators have great value to compile the right plan preventive measures. There are industrial, household, sports, children's, and household forms of pathology.

Types of injuries and characteristics

Depending on the nature of the injuries, injuries are divided into open and closed.

With open injuries, the integrity of the skin is compromised, they are accompanied by severe bleeding, and infection often penetrates into the wounds, which causes the development of a purulent process. Such injuries are the result of mechanical damage; they also occur with open fractures. Self-medication is unacceptable; medical assistance is required.

Closed injuries are more common; there are no wounds or deep scratches on the skin, but hematomas and swelling may appear, and sometimes internal bleeding may develop. The most common are sprains, dislocations, soft tissue bruises, and closed fractures.

Closed injuries are characterized by the appearance of bruises and hematomas

Main classification of wounds:

• mechanical - a sharp mechanical effect on tissue, this includes surgical and birth injuries;
• thermal - occur when the skin is exposed to low or high temperatures, this includes burns and frostbite varying degrees heaviness;
• electrical – the effect on the body of household or natural electric current;
• chemical – manifested by contact or inhalation of aggressive substances, which can affect the skin or internal organs;
• radiation – develop against the background of prolonged exposure to radiation;
• biological – develop under the influence of pathogenic microorganisms, toxic substances, insect poisons on the body;
• psychological - the cause is stress, experienced shocks, against their background psychosomatic problems also form.

Additionally, when classifying, their nature of impact is taken into account. With isolated injuries, only one organ or department is damaged. In case of multiple injuries, several injuries of the extremities, head, and soft tissues with similar parameters are diagnosed. Combined – there is deterioration of several organs, parts of the musculoskeletal system, and brain injuries.

Damage can affect various parts - limbs, spine, abdomen and other internal organs, brain, eyes, soft tissues, skin and mucous membranes.

Mechanical

Such injuries occur quite often in everyday life - hitting the corner of furniture, falling on a slippery floor, asphalt, ice, soft tissues, joints, bones, tendons, and muscles suffer. Most often they are acute, sudden, but sometimes chronic injuries and microtraumas are also diagnosed, which occur with minor but regular exposure to mechanical factors.

Types of damage:

1. Bruise – occurs when struck by a blunt object due to a fall. Symptoms – the integrity of the skin is not compromised, the damaged area swells, pain occurs on palpation, and a hematoma quickly develops. The most dangerous are joint bruises.
2. Subcutaneous hematoma– the result of pinching or strong compression of soft tissues, a fall, an impact. Under the influence of mechanical factors, small vessels burst, blood penetrates into the subcutaneous tissue. The bruise is initially red or blue, gradually acquires a yellow, green tint, and pain occurs when pressed.
3. Abrasions are shallow but numerous damage to the epidermis or mucous membranes. Injuries are accompanied by minor pain, burning, slight bleeding, the surrounding skin swells and becomes red.
4. A wound is a violation of the integrity of the skin or mucous membranes of varying degrees of intensity. Signs: severe bleeding, severe pain, the person turns pale, and may lose consciousness.
5. Compression - injuries to tissues, bones and internal organs that occur during prolonged exposure to heavy objects; they are often diagnosed during earthquakes, mountain collapses, and mines. In damaged areas, toxins begin to accumulate, which can penetrate into the general bloodstream, and necrosis begins.
6. Rupture of tendons, ligaments, can be complete or partial– a common sports injury. Symptoms are pain, swelling, bruising, dysfunction of the joint or the entire limb as a whole.
7. Dislocation is a displacement of bones at the joint, accompanied by sharp, sudden severe pain, the joint completely or partially loses mobility, swells, and its appearance is disturbed. Such injuries can be intrauterine, birth, or pathological.
8. – complete or partial violation of the integrity of the bone, characterized by severe pain, swelling, which quickly increases, and sometimes the temperature rises. With an open fracture, bleeding occurs, the appearance of the limb changes, moving fragments can be seen, and a crunching sound is heard on palpation. The pathological form is diagnosed in older people; it occurs against the background of osteoporosis.

Fracture is a type of mechanical injury

Severe mechanical injuries, especially brain and internal organs, pose a threat to human life. The functioning of the nervous, cardiovascular, endocrine system, general reaction manifests itself in the form of shock, collapse, fainting, anemia.

Physical

This group includes thermal burns, frostbite, heat stroke, electrical injuries at home or at work.

Chemical and biological

Chemical burns occur when the skin or mucous membranes come into contact with alkalis, acids, and other toxic, aggressive, and toxic substances. At the initial stage, a film appears on the damaged area, or top layer the epidermis is rejected, the surface becomes pink. In grades III and IV, a dry or wet scab appears.

Development of a chemical burn

Symptoms of biological injuries depend on the type of pathogenic microorganism. After an animal or insect bite, the injured area swells, turns red, and anaphylactic shock may develop. The venom of some snakes affects blood clotting and the functioning of the nervous system; confusion and hallucinations may occur.

Complex forms of lesions

Many injuries are accompanied by many dangerous symptoms; irreversible processes begin to develop in tissues, which can lead to disability and death.

In road accidents, injuries to the cervical spine most often occur; women are more susceptible to such injuries than men due to underdeveloped muscles in this area. Symptoms: headache, dizziness, numbness of limbs, memory loss.

Which doctor should I contact?

Depending on the location of the injuries, treatment is carried out by a surgeon, traumatologist, ophthalmologist, neurologist, or orthopedist. Sometimes you may need to consult an infectious disease specialist, toxicologist, dermatologist, or psychotherapist. During recovery period a physiotherapist, a specialist in physical therapy, and a massage therapist are involved in the therapy.

Diagnostics

The initial collection of anamnesis, questioning of the victim or eyewitnesses is carried out by ambulance doctors, on-duty traumatologists - they assess the type of injury, the degree of damage, their location, measure blood pressure, heart rate. Then the treatment is carried out by a specialist who prescribes the necessary types of studies.

Main types of diagnostics:

• MRI, CT – allows you to assess the degree of damage to bones, soft tissues, the presence of internal hematomas and pathological processes;
• Ultrasound of damaged organs, soft tissues, tendons, cartilage;
• X-ray - necessary to create clear picture damage.

To determine the exact size of the damaged areas, the presence of hidden edema and hematomas in complex and combined injuries, endoscopy is prescribed.

X-rays are important to determine the exact extent of damage

Treatment of injuries

Any injuries, even minor ones, require medical supervision, since often hidden processes occur during injuries, which are impossible to determine on your own. Used in therapy medicines, various fixing devices, during the recovery stage physical therapy, massage, and physiotherapy are included.

First aid

General actions for any type of injury are that the victim should be placed in a comfortable position, ensure complete rest, calm down, and call an ambulance. If there is bleeding, it must be stopped by applying a tourniquet, tight bandage, cold compress - be sure to note the time when the manipulation was performed. For arterial bleeding, clamp the area above the wound; for venous bleeding, apply pressure below.

What to do when various types injuries:

1. Traumatic brain injuries - place the victim in a room with dim lighting, raise the head slightly and turn it to the side so that the person does not choke on vomit. Apply a cold compress and monitor the person’s consciousness until the ambulance arrives.
2. In case of injuries to the arms and legs, the injured limb should be placed on a small cushion, ice should be applied, and then a fixing bandage should be applied.
3. If the spine is damaged, you should not try to sit the person down; the victim must be carefully laid on a hard surface, with bolsters placed under the knees and neck. Although doctors do not recommend performing any manipulations for such injuries.
4. The presence of a foreign body in the eye - do not rub the damaged organ, wash it carefully. You can remove small particles with a clean handkerchief - pull the lower eyelid down a little, or turn the upper eyelid out a little. For more serious injuries, it is only permissible to apply cold to the site of the blow or bruise and call a doctor.
5. If an animal is bitten, it is necessary to wash the wound with a soapy solution - dissolve a third of a piece of laundry soap in 400 ml of water, and carry out the procedure for at least 5 minutes. Apply antibacterial ointment or streptocide powder and apply a sterile bandage.
6. If you are bitten by an insect, apply a piece of refined sugar to the damaged area; if you are prone to allergies, take an antihistamine.
7. In case of frostbite, remove all cold clothing, place the person in a warm room, give him warm tea; if there are no blisters, you can rub the skin with alcohol.
8. For minor burns, the affected area should be freed from clothing, a cold compress should be applied for 20 minutes, Panthenol should be applied, and a loose bandage made of sterile material should be applied. These measures can also be carried out for chemical burns, if they are not caused by lime or sulfuric acid. The burned area should not be treated with iodine or greasy ointments.
9. Sulfuric acid burns should be treated with a solution of 200 ml of water and 5 g of soda, if the injury is caused by alkali - diluted vinegar. If damaged by alkali, oil or fat must be applied to the skin.
10. For severe burns, it is cold and no local medicines can be used; a bandage must be made, the person must be given warm tea, and the burned part of the body must be placed at the same level as the heart.
11. In case of electrical injury, it is necessary to check the pulse and breathing; if they are absent, begin resuscitation - chest compressions, artificial respiration.

You should not try to straighten a limb on your own, remove bone fragments, or abuse painkillers and sedatives.

Drugs

The choice of a group of medications depends on the severity of the injuries, their location, the age of the patient, the presence of additional symptoms and chronic diseases.

How injuries are treated:

• anti-inflammatory drugs – Ketorol, Ibuprofen;
• antispasmodics - Papaverine, No-shpa, improve blood flow to the affected area;
• means to prevent blood clotting in the form of tablets and ointments - Heparin, Aspirin, Troxevasin;
• for traumatic brain injuries - Piracetam, Nootropil;
• for eye damage - Diklo-F, Tobrex, Mezaton, drops eliminate inflammation and have an antibacterial effect;
• microcirculation correctors – Actovegin, restore damaged vascular walls, accelerate the regeneration process;
• cooling ointments – Menovazin, Efkamon, used during the first 24–36 hours after injury;
• external agents with anti-inflammatory, analgesic effects - Fastum gel, Deep Relief, prescribed on the second day after injury;
• warming ointments - Myoton, Finalgon, improve blood circulation and the regeneration process, can be used 28 hours after injury.

Fastum gel has anti-inflammatory properties

Burnt areas must be treated with Panthenol several times a day and lubricated with sea buckthorn oil during the healing stage. When treating any type of injury, you must follow drinking regime– drink at least 2 liters of water, herbal or green tea per day.

Possible complications and consequences

Any injury without proper and timely treatment is dangerous with various complications; in order to avoid negative consequences, it is necessary to undergo an examination and listen to all the recommendations of the attending physician.

Possible complications:

• In case of injury to the cervical spine, the spinal cord may be damaged, which will lead to disruption of the breathing process and death;
• bedsores due to prolonged immobility;
• sepsis – due to untimely treatment of wounds;
• partial or complete loss of vision, memory;
• gangrene, disruption of internal organs;
• deformation of the skin, scars, cicatrices, dermatoses;
• if the bones do not heal properly, the length of the limbs may decrease, which is fraught with decreased functionality and constant attacks of pain.

Scars often remain after skin damage

With burns and frostbite, necrotic processes develop quickly; without timely treatment, amputation may be required.

The consequences of injuries can affect even after 10–15 years, this manifests itself in the form of arthrosis, hernias, pinching nerve endings, chronic bursitis.

No one is immune from injuries; you can get them at home, at work, or on the street. Timely medical care, proper treatment will help avoid complications and sometimes death.