First emergency aid for abdominal and abdominal injuries
Jun 07, 2018
Damage to the abdomen and abdominal organs are among the life-threatening and in many cases require emergency surgery. The delay in the operation due to late detection of these injuries or any other causes sharply worsens the prognosis.
Contusion of the abdominal wall. Occurs as a result of direct injury. Abdominal wall abrasions and bruises can be detected. The pain increases when the position of the body changes, when the head is raised. Symptoms of irritation of the peritoneum are absent. Nevertheless, one should always keep in mind the possibility of damage to the internal organs.
The injured person should be brought to a surgical hospital in a supine position for dynamic observation. Anesthetics and antispasmodics are not injected, it is also contraindicated to heat on the stomach.
Abdominal injuries, accompanied by internal bleeding. Occur due to severe impacts on the abdomen with injuries, various accidents. The source of bleeding are ruptures of the liver, spleen, and mesentery of the intestine. As a rule, the victim is in serious condition. There are signs of hemorrhagic shock: pallor, cold sweat, lower blood pressure, sometimes to critical values. The victim spares the abdomen during breathing due to pain, it is moderately swollen, evenly painful on palpation, but a greater soreness is detected in the place of application of the traumatic force. Because of the accumulation of blood in the abdominal cavity, percussion is determined by dullness of sound in the sloping parts of the abdomen. A positive symptom of Shchetkin. Peristalsis is weakened, and with the growth of peritonitis may be absent.
First aid. The fastest delivery of the victim to the surgical hospital, with the phenomena of shock of the third degree - bypassing the admission department. Infusion of solutions of polyglucin, rheopolyglucin with hormones, as in shock, cold on the stomach is mandatory. Contraindicated in the introduction of adrenaline, mezaton, ephedrine, which, although slightly increase blood pressure, but will increase bleeding and complicate further drug treatment of shock. Transport lying, as gentle as possible.
Closed abdominal injuries, accompanied by rupture of the hollow organ. The mechanism of damage is the same as for injuries with bleeding, especially since the rupture of the hollow organ - the stomach, intestine, bladder - is often accompanied by bleeding, shock. The exit of the contents of the hollow organs into the abdominal cavity, the irritation of the peritoneum give a very strong pain syndrome. Every hour the process of inflammation of the peritoneum increases, spreads, the phenomena of peritonitis, at first local, then diffuse( less than two floors of the abdominal cavity), and then spilled( more than two floors) increase. The victim is pale, groans with pain, tries to lie motionless. Dry tongue. The abdomen is sharply strained and painful in all departments, the symptom of Shchetkin-Blumberg is positive, in the first 1-2 hours - at the site of the injury, and then, but as far as the spread of peritonitis - throughout the abdomen. When percussion of the abdomen may be absent hepatic dullness due to exit into the abdominal cavity of air and its accumulation above the liver.
Diagnosis in typical cases is not difficult, it is more difficult to determine the abdominal trauma in the victim in the unconscious state, in severe degree of alcoholic intoxication. In these cases, the diagnosis will be presumed based on the tension of the abdominal muscles, the general severe condition with unstable hemodynamics.
Hospitalization in a surgical hospital, lying down. With the fall of AD - polyglukin, rheopolyglucin, hormones.
Wounding of the abdomen. Subdivided into non-penetrating, when the peritoneum is not damaged, and penetrating( with its damage).Absolute signs of penetrating injury will be:
• prolapse of the bowel loops, omentum;
• expiration of urine, bile.
All other signs are relative, and the final diagnosis is put only in the hospital.
Abdominal wounds can be stabbed, cut, stabbed, cut, gunshot. The clinical picture will depend on whether bleeding prevails in the abdominal cavity or the hollow organ is damaged.
First aid .On the wound, a sterile bandage is applied, it is strengthened with a band-aid. It is impossible to set the organs that have fallen into the wound, as this can cause their rupture or bleeding. They should be covered with cotton napkins( with solutions of furacilin, novocaine, isotonic sodium chloride solution).If there are absolute signs of a penetrating injury, drugs should be introduced, if there are no such signs, it is better to refrain from introducing them. If necessary, carry out anti-shock therapy. In all the cases described above, never give a drink to a victim.
Hospitalization in the surgical department, lying down.
Trauma, or damage, is called anatomical and functional disorders of tissues and organs that result from exposure to environmental factors. Impacts can be mechanical( impact, compression, stretching), physical( heat, cold, electricity), chemical( the effect of acids, alkalis, poisons), mental( fear, fear).The severity of damage depends on the strength and time of exposure to these factors.
The most frequent damage is caused by direct action of mechanical force( impact, compression, stretching) on the body tissues. Mechanical damage can be closed and open.
Closed injuries are those with which there is no violation of the integrity of the skin and mucous membranes. These include bruises, sprains, subcutaneous ruptures of organs and soft tissues( muscles, tendons, vessels, nerves).
Open injuries( injuries) are accompanied by mandatory violation of the integrity of the skin or mucous membranes( wounds, open fractures of bones).
Damage resulting from a one-time, sudden, severe impact on body tissues is called acute trauma. Damage arising from permanent and repeated low-impact forces that are incapable of causing a trauma during a one-time operation is called a chronic injury( occupational diseases).Any trauma, in addition to local tissue disorders, causes some or other general changes in the body: a violation of the cardiovascular system, breathing, metabolism, etc.
The aggregate of injuries in certain population groups that occur within a limited period of time is called traumatism.
There are industrial injuries, domestic, sports, children's, road and military. Combating injuries is one of the main tasks of the health and safety authorities.