Symptom >> Surgical >> General Surgery

Trauma

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Mechanical factors cause damage to human tissues or organs. Analysis was based on location, injury site, injured tissue, injury factors, and skin integrity. Severe trauma can cause systemic reactions, local manifestations of pain, swelling, tenderness in the wounded area; deformity and dysfunction in fracture dislocation. Severe trauma can also have fatal bleeding, shock, suffocation, and disturbance of consciousness. First aid should prevent and treat shock, keep the respiratory tract unobstructed, bandage the wound to stop bleeding, and fix the injured limb, transfer the wounded to the hospital safely, smoothly and quickly, and open wounds should be debrided in time. The prevention of trauma is to conduct safety education and take safety measures.

Cause

Cause

Diseases caused by physical and chemical factors and physical and chemical factors.

Examine

an examination

According to the history of injury, local symptoms and systemic reactions, medical staff must further identify the damage of different tissues and organs caused by these traumas, first determine and eliminate the existence of life-threatening emergencies (insufficient ventilation function, insufficient circulation function) And major bleeding).

1 Ask the medical staff to have an overall view, not to be attracted by the local injury and neglect the systematic and careful examination of other parts of the body.

2 According to the anatomy of each injured part, find or eliminate the destruction of various tissues and organs that may exist locally, so as to make an accurate diagnosis, determine the severity of the injury, and provide a basis for first aid and treatment.

3 closely observe the changes and development of the injury.

4 Apply various tests, X-rays, computed tomography, etc. to increase the correctness of the diagnosis.

Diagnosis

Differential diagnosis

Trauma can be classified according to the location, the injured site, the injured tissue, the injury factor, and the integrity of the skin.

According to the location, it is divided into war wounds, industrial injuries, agricultural injuries, traffic injuries, sports injuries, life injuries, etc.; according to the injured parts, it is divided into craniocerebral trauma, chest trauma, abdominal trauma, fractures of various parts and joint dislocation, hand injuries. According to the type of injury, it is divided into fracture, dislocation, concussion, organ rupture, etc.; those who are injured at the same time are called joint injuries (such as combined chest and abdomen); when they are classified according to the injured tissue or organ, they can also press the injured tissue. The depth of the skin is divided into soft tissue trauma, bone and joint trauma and visceral trauma. Soft tissue trauma refers to damage to the skin, subcutaneous tissue, and muscles, as well as blood vessels and nerves that are involved. Simple soft tissue trauma is generally mild, but a wide range of crush injuries can cause crush syndrome. Major bleeding from blood vessel rupture can also be fatal. Osteoarticular trauma includes fractures and dislocations, and is further classified and named according to the injured bone or joint. Such as femoral fractures, shoulder dislocation and so on. Visceral wounds can be classified and named according to the specific internal organs of the injury. Such as brain contusion, lung contusion, liver rupture and so on. The same cause of injury causes trauma to more than two parts or organs, called multiple injuries or multiple injuries. According to the injury factor, it is divided into firearm wound, cut, stab wound, laceration, crush injury, sprain, contusion and so on. According to the degree of skin integrity, it is divided into closed trauma, open trauma and so on.

In all kinds of trauma, life injury and sports injuries are mostly single tissue or organ injuries, and the injury is relatively simple and clear. In war wounds, industrial injuries, agricultural injuries and traffic injuries, the wounds are guns and guns. ,bomb. The cumbersome machines and cars driving at high speeds are often caused by open wounds and complex wounds. The injuries are more serious and complicated. Taking the current common traffic accident as an example, the injured person can have craniocerebral injury, maxillofacial injury, cervical vertebrae fracture and dislocation, chest injury, abdominal injury or limb fracture and dislocation. The injury is very complicated and critical, and even died before the first aid.

Closed trauma: the skin remains intact, sometimes with scars, but without skin rupture and external bleeding, there may be skin bruising (subcutaneous hemorrhage, also known as ecchymosis or subcutaneous blood stasis). If the injury is deep, the wound is several days after the injury. See the blue and purple.

1 crush injury. Severe trauma caused by heavy objects being squeezed for a longer period of time. Such as the collapse of houses, the mud and soil of tunnels, and the collision of vehicles. Can cause a large number of muscle ischemic necrosis in the compression site, often accompanied by severe shock, and can lead to acute renal failure (see crush syndrome). Traumatic asphyxia: A special type of chest crush injury, less common. It is characterized by subcutaneous tissue in the upper chest, shoulders, head and neck, and small bleeding spots (freckles) that are widely distributed in the conjunctiva and oral mucosa. This is because at the moment when the chest is squeezed, the injured person's glottis is closed, so that the air in the trachea and the lungs cannot be discharged, causing the pressure in the chest to rise sharply, forcing the blood in the heart and the large vein to flow back, causing the upper body to squat. The result of blood or even rupture of small veins and capillaries. Traumatic asphyxia itself has no serious consequences, and its outcome depends on the accompanying rib fracture and the injury to the internal organs.

2 bruises. Trauma of the skin or subcutaneous tissue caused by blunt or blunt violence. There is often a breakdown of subcutaneous fat, small blood vessels, and sometimes rupture of deep organs.

3 sprains. It is the trauma of ligaments, muscles, and tendons caused by violence in one direction of the joint. Under normal circumstances, a sprain does not cause dislocation of the joint, but it can cause bone fragments of the bone near the joint to avulsion.

4 impact injuries. Also known as blast injury, a strong explosion (such as heavy bombs, torpedoes, nuclear weapons and other explosions) caused by the shock caused by strong shock waves. The body surface is free of scars, but the organs in the body suffer severe damage. Shock waves on the ground and in the air cause damage to the ear and chest, manifested as hearing loss, ear pain, dizziness, balance disorder (due to tympanic membrane perforation, tympanic hemorrhage), or pneumothorax, hemothorax. In the water, the person who suffered from the explosion was injured and the internal organs of the abdomen showed abdominal pain, abdominal tenderness and peritonitis. In patients with severe rupture of the organ in the abdominal cavity, shock may occur. When the chest is injured, symptoms of increased intracranial pressure may occur.

5 closed fractures. Direct or indirect external violence causes the continuity of the bone to be interrupted, but the skin is not broken. At the same time as the fracture occurs, it is accompanied by damage to nearby muscles, blood vessels and nerves.

6 dislocation. It is the direct or indirect external violence of the joint that causes the two bones that make up the joint to lose their anatomical relationship. At the same time, the joint capsule is ruptured, and the bone piece can also be avulsed.

Open trauma: accompanied by skin and mucous membrane rupture and external bleeding. Bacteria easily invade from the wound and cause infection. Therefore, open wounds must be debrided in time.

1 firearm injury. Trauma caused by bullets, shrapnel, etc. Not only bullets and shrapnel can cause direct destruction of various tissues and organs in the ballistics, high-speed shock can also cause trauma to tissues and organs around the ballistics. Shrapnel can bring dirt and pieces into the wound, causing serious pollution and causing purulent infection. , tetanus or gas gangrene.

2 lacerations. Blunts can cause skin and soft tissue cracking while causing contusions. The edges of the wounds are not neat, and the surrounding tissues are extensively damaged. The running machine and vehicle avulsion the skin and subcutaneous tissue to cause laceration, and sometimes avulsion of muscles, tendons, blood vessels and nerves. A laceration often causes skin necrosis and infection. Wrist lacerations are most common in the clinic.

3 stab wounds. Caused by slender, sharp injuries. Although the wound is not large, the deep tissues and organs can be destroyed and not easily detected, but are ignored. Stab wounds can cause deep infections.

4 cut injuries. Caused by sharp wounds (such as blades, glass). The edges of the wound are neat. The depth of the cut varies depending on the amount of external force. The deep elbow of the wrist is accompanied by a fracture of the tendon, blood vessels and nerves.

5 bruises. Superficial trauma caused by friction of the skin with rough wounds. There was only a small amount of bleeding and exudation in the injured area, so the injury was mild.