Damage to internal organs due to a fall. Damage to internal organs due to chest injuries. Main characteristics of the ointments used

Injuries associated with mechanical impact on the human body are the most common in medical practice. The main reasons for their appearance:

• Impact with a blunt object.
• Colliding with a very hard object (usually found in road accidents).
• Fall from high altitude.

Symptoms of bruises internal organs

The nature of the damage resulting from bruises depends primarily on the degree of mechanical load and on the area of ​​the body to which this load was directed. For example, if we're talking about about a bruise chest, possible pathological changes in the lungs, heart, trachea, etc. If the main mechanical load falls on the abdominal area, the stomach, spleen, liver, kidneys, etc. may be significantly damaged. A head injury is often accompanied by a brain contusion, the consequences of which can be extremely serious. However, signs of a concussion are a topic for another discussion. How to recognize bruises of internal organs in other cases?

The main symptoms that allow us to draw conclusions about a bruise of internal organs:

• Severe pain in the damaged area.
• The presence of a hematoma in this area.
• Swelling of soft tissues in the damaged area. This condition is usually caused by internal hemorrhage.
• Impaired functionality of the organ that was affected.

Manifestations may vary depending on which organ was affected. Generally external signs In case of bruise of internal organs, it can be described as follows:

• Growing subcutaneous emphysema (excessive accumulation of air in the tissues, accompanied by severe pain).
• If the lungs are damaged, cyanosis is observed (bluish coloration skin), respiratory dysfunction.
• Decreased blood pressure, decreased heart rate.
• Injuries to organs that are in abdominal cavity, often manifested by a feeling of fullness in the stomach, nausea.
• Hemoptysis.

If the kidneys, liver, spleen are damaged - internal bleeding can be very strong. Any injury that causes injury to internal organs requires professional medical attention.

Basic methods of treating bruises of internal organs

First aid for suspected bruises of internal organs due to a fall is to ensure the victim’s rest. It is also necessary to take emergency measures:

• Ice or cold compress.
• To avoid anaphylactic shock, the patient needs to take a pain reliever.
• In some cases, a tight bandage is indicated (for example, with a closed chest injury).

Severe bruise of internal organs following an accident requires immediate hospitalization. In a hospital setting, a thorough diagnosis is carried out, which helps to identify the size and area of ​​​​distribution of damage to internal organs. The main diagnostic method is x-ray, and in case of a brain injury, computed tomography or magnetic resonance imaging (MRI) may be required. In this case, the doctor will prescribe an ECG, which will help to obtain a more objective picture of the disease.

Treatment usually involves surgical intervention which is carried out to stop internal bleeding and restore the integrity of the damaged organ. If the injury was not severe, to eliminate the hematoma 3-4 days after the injury, you can rub the damaged area with ointments that have an anti-inflammatory effect (without the warming effect).

By medical statistics injury to various internal organs is almost the most common type of injury, which also includes bruises. Quantity blunt trauma internal organs increases significantly due to the fact that the number of road accidents has increased significantly in recent years.

Doctors distinguish these injuries into 2 types: with the development of internal hemorrhage into the organ and with damage to the integrity of the organ itself. Each of these pathologies is dangerous and requires immediate medical intervention.

Causes

The most likely causes of injury are: various reasons, but most often the defeat occurs due to the following factors:

1. Hitting the body with a blunt object;
2. Falling from height;
3. Falling onto a hard object;
4. Colliding with a hard object (while running or in an accident).

Symptoms

The symptoms of the disease can vary significantly depending on which organ is affected. But the main signs of damage are:

• Severe pain in the area of ​​injury;
• The appearance of a hematoma (most often it is of impressive size);
• Edema. In most cases, it indicates the presence of internal hemorrhage;
• Deterioration in the functioning of the affected organ.

Very often, with such a lesion, patients also suffer from nausea and low blood pressure.

Consequences

Regardless of which internal organ was damaged, immediately after the injury it is necessary to see a doctor, who, after conducting a diagnosis, will identify what the patient is faced with.

In approximately 40% of cases of damage this kind require surgery. If hemorrhage or tissue rupture is not repaired in time, the consequences for the patient can be dire, even death.

From the anamnesis, the mechanism of injury, the position and condition of the body at the time of injury, the direction and force of the blow, the condition abdominal wall at the time of injury (muscle tension or relaxation), degree of filling gastrointestinal tract food and liquid preceding injury, and diseases of the abdominal organs. Subjectively, patients complain of pain, general weakness, nausea, and less commonly, vomiting. Pain sensations can be present in the first hours without a specific localization, throughout the abdomen or with a predominance in the upper or lower parts. Often the pain is associated with rib fractures with concomitant chest injuries (after intercostal blockade with novocaine, these pains disappear). The diffuse nature of the pain is typical for rupture of the intestines, mesentery, intracavitary or retroperitoneal bleeding. Localization of pain in the right or left hypochondrium with irradiation to the shoulder of the same name is characteristic of damage to the liver and spleen.

Important in diagnosis have duration, intensity of pain. If the intensity of pain subsides 2-3 hours after the injury and the victim’s condition improves (hemodynamics and breathing normalize), then with a high degree of probability damage to internal organs can be excluded (in the absence of objective signs of internal bleeding and peritonitis). If the pain progressively increases and becomes diffuse, indications for laparotomy should be given (even in the absence of objective signs of intra-abdominal pathology). It should be remembered that with local damage to the intestines, patients can walk for a long time, seek medical help on their own, and feel quite satisfactory. However, gradually, intensifying every hour, their signs of peritonitis increase.

Signs of severe shock in the first 1.5-2 hours after injury indicate massive internal bleeding, the source of which is often a rupture of the spleen or liver. In this case, the pulse becomes thread-like, 130-140 beats per minute, a sharp (deadly) pallor of the skin and mucous membranes is noted, a decrease in the temperature of the extremities, ears, nose, forehead, cold sweat. Psychomotor agitation (with low or uncertain pressure) confirms the diagnosis and serves as a formidable harbinger of the approaching death of the victim. Patients may complain of increasing tinnitus, dizziness, excruciating thirst, and lack of air. Their abdomen is swollen, moderately tense and painful. Only emergency surgery can save the patient.

One of the reliable signs of intra-abdominal damage is the absence abdominal type breathing (or, as they say, the stomach does not participate in the act of breathing). To others reliable sign is pronounced tension (rigidity) of the abdominal wall. The stronger this tension, the more likely the internal organ will rupture. With a sharp tension in the abdomen (“like a board”), an intra-abdominal catastrophe is beyond doubt. No noise intestinal peristalsis(auscultation) in the first hours after injury indicates more intra-abdominal bleeding, in late dates(2-3 days) “deathly silence” of the abdomen indicates diffuse peritonitis. Symptoms of peritoneal irritation (Shchetkin-Blumberg symptom, etc.) are not specific to abdominal injuries, but they always indicate an acute irritant in the abdominal cavity. The combination of these symptoms with other objective and subjective data significantly increases the reliability of the diagnosis.

A common symptom of intra-abdominal injury is vomiting; in the early period it is associated with irritation of the vagus nerve, in the later period - with intoxication of the body. You should always be wary of the “vanka-stand up” symptom - the patient’s desire to return to the previous position after turning over on his back, the other side, etc. This phenomenon is based on a sharp increase in pain from irritation of new areas of the peritoneum by the spilled contents of the gastrointestinal tract or blood (even in small quantities). The appearance of dullness in the sloping areas of the abdomen indicates the presence of fluid in the abdominal cavity. This sign becomes clear when about 1 liter of liquid accumulates. If blood accumulates, then objective signs of massive blood loss must be determined at the same time. The reliability of the sign increases if the fluid boundary moves when the patient's position changes.

A simple but very informative diagnostic technique is catheterization Bladder(especially with concomitant pelvic fractures). A full bladder may obscure clinical picture damage to the abdominal organs, lack of urine can be the cause of intra-abdominal rupture of the bladder, the presence of blood in the urine is a consequence of kidney damage.

A digital rectal examination can also be very informative. This the only method direct palpation of the peritoneum. Collection of blood or other fluid in the rectovesical recess in men or in the uterorectal recess in women can be directly palpated through the rectum and thereby definitively confirm the diagnosis.

Can be of great help in diagnosis X-ray examination, If general state allows the patient to be turned on his side or his torso vertical position. You can find in the X-ray picture of the abdomen shadows corresponding to fluid in the free abdominal cavity, and clearing in the form of a strip, crescent in the subdiaphragmatic spaces or along the lateral surface of the abdomen (with the patient positioned on his side).

At laboratory research blood, it is possible to establish a decrease in hemoglobin, hematocrit, number of red blood cells, and an increase in the number of leukocytes. IN early period these changes are not typical, however, determining these indicators over time will undoubtedly be useful to clarify the diagnosis. Additionally, you can determine the blood mass and use nomograms to calculate the approximate amount of blood loss.

The most reliable method for diagnosing damage to the abdominal organs is diagnostic laparotomy. Visually determine the nature and volume intra-abdominal injuries, stop bleeding, restore the integrity of internal organs.

Refusal of this method must be strictly justified, since wait-and-see tactics can be disastrous for the patient. The accuracy of diagnosis is significantly increased by laparoscopy and laparocentesis.

The causes of bruises can be rooted in normal human activities. You may accidentally trip, drop a heavy object, or bump into the corner of a hard object. People leading an active lifestyle and athletes are more susceptible to such injuries. During the icy season, you can get multiple bruises.

We are used to getting up if we fall, and, rubbing the bruise, continue doing what we did before the injury. After a fall, collision, push, we don’t think about how to treat bruises. But this is fundamentally wrong. This injury can be accompanied by quite serious damage, leading to severe complications. It is very important to recognize the severity of the injury and promptly seek medical help.

Types of bruises

According to localization, the following bruises of internal organs are distinguished: associated symptoms:

• Liver bruise. Causes a feeling of sharp pain at the site of impact. The body experiences stress, the limbs cool down, the heartbeat quickens, and the blood pressure drops. The abdomen is depressed or protruded. Changing body position causes pain.
• Lung contusion. Symptoms: increased pain when inhaling, coughing up blood, tachycardia, pale skin, bruising in the area of ​​impact, swelling. A similar injury to internal organs can be caused by sharp drop on the back.
• When the spleen is bruised, the patient tries to take a certain position to relieve suffering: squat down, lie on his left side and bend his legs. The pulse is increased, blood pressure is decreased, strong pain, in the area of ​​the left hypochondrium, extending into the forearm and scapula. Internal bleeding is possible, accompanied by bloating.
• Kidney bruise. The injury causes paroxysmal pain in the lower back, spreading to the stomach and groin. Nausea or vomiting is present. Body temperature rises. Blood is detected in the urine. The number of clots indicates the severity of the condition. Injury to these paired internal organs can occur when falling from a height, as a result of unsuccessful sports activities, or accidents.
• Heart contusion is accompanied by tachycardia, pain in the area of ​​the organ, shortness of breath (suffocation), a gradual decrease in pressure, and pallor of the skin.
• A bladder bruise makes it impossible to urinate. The urge is frequent, but without results. Instead of urine, blood is released. In the lower abdomen there are painful sensations, swelling, blue discoloration of the skin.

A weak or severe bruise can be one of the following types based on the organ or part of the body affected by the injury:

• chest (can damage internal organs);
• brain (with possible severe consequences);
• shoulder (temporary joint dysfunction, likelihood of developing arthrosis);
• kidneys (probably internal bleeding);
• knee (rarely - hemarthrosis);
• ankle joint(causes arthrosis with age);
• elbow joint(followed by arthrosis or arthritis);
• hands or arms;
• heels;
• finger or toe;
• nose (with possible displacement of the septum);
• ribs (with the possibility of injury to internal organs);
• lung (with possible rupture or hemorrhage).

Bruises associated with internal organs are more serious than superficial wounds. According to the degree of severity, they are distinguished the following types bruises:

• first degree - a slight bruise with a scratch without a bruise or with a small bruise that passes quickly;
• the second degree is accompanied by the appearance of pain, tumor, hematoma;
• the third degree is associated with damage to soft tissues, as well as tendons and ligaments;
• fourth degree - with damage to internal organs.

How to treat a bruise depends on its severity. Minor injuries resolve without external intervention. The higher the degree, the more urgent the medical help. Brain injuries require the most rapid and serious attention from doctors.

1. Depending on the location of the damage, bruises are distinguished:

• brushes;
• finger;
• elbow;
• shoulder;
• forearms;
• brain;
• heads;
• backs;
• chest;
• abdominal cavity;
• coccyx;
• knee;
• hips;
• shins;
• feet.

• 1st degree – minor bruise – manifested by scratches and abrasions, practically painless; heals within a few days without care;
• 2nd degree - a rather painful bruise in which muscle tissue is damaged, accompanied by hematomas and swelling;
• 3rd degree – ligaments and tendons are damaged;
• 4th degree - severe injury that can threaten health; the functioning of damaged organs may be disrupted.

Tissue damage is divided into types depending on their location:

1. Chest contusion. Chest bruise can lead to malfunction of internal organs
2. Shoulder injury. Leads to temporary incapacity of the shoulder joint, and serious bruises of the shoulder can cause arthrosis
3. Knee bruise. Sometimes leads to the development of hemarthrosis
4. Bruised ankle joint. Severe bruises large joints lead to the development of arthrosis in old age
5. Bruised arm or hand. Has no serious consequences
6. Stubbed finger or bruised toe. Usually the little finger or thumb. Does not have serious and dangerous consequences, but can cause a fracture
7. Bruised ribs. If the ribs are bruised, internal organs can also be injured.
8. Bruised nose. The consequence is displacement of the septum
9. Bruised elbow joint. Causes arthritis and arthrosis as a consequence
10. Kidney bruise. May lead to internal bleeding
11. Brain contusion. Such an injury can be almost painless for the victim, but a slight swelling forms at the site of the impact. In the presence of additional symptoms such as nausea, vomiting and loss of consciousness, the injury should be treated immediately
12. Lung contusion. Very dangerous injury, can lead to lung rupture and internal hemorrhage
13. Bruised heel. A heel bruise is also always very painful, but there is no danger.

Contusions to the kidney, brain, and lung are more serious injuries than superficial contusions. And if the treatment of some external bruises can sometimes be carried out at home, then such injuries as a bruise of the lung or kidney, as well as other internal organs, require professional intervention.

31Question: Fractured ribs. Signs, first aid.

Sick
with fracture I cervical vertebra presents
complaints of pain in the back of the head, parietal
area and upper neck. In every
in the second case, fracture of the first cervical vertebra
accompanied by damage to the spinal cord,
less often – medulla oblongata or fracture
other vertebrae.

At
fractures of the second cervical vertebra II
degree, the tooth fragment moves anteriorly
or posteriorly. Anterior displacement of the fragment
may cause neurological disorders
varying degrees of severity: from local
disturbances of sensitivity to paresis
and paralysis. When a tooth moves posteriorly
neurological disorders are usually
less pronounced.

Usually
with rib fractures, a sharp sensation is felt
pain. It manifests itself especially clearly
when feeling the injured area,
and also at deep breath or cough.
It can be painful for a person to laugh, in
sometimes even talk. Victim
spares the damaged part of the chest;
breathing on this side is shallow.

Anesthetize
(non-narcotic analgesics; in severe
cases - narcotic drugs, except drugs
opium).

supraclavicular
the fossa is smoothed, it is palpable
proximal clavicle fragment.

omission
shoulder joint from the side of the fracture
and its inward displacement

limitation
active movements of the arm in the shoulder
joint

pain,
soft tissue swelling

head
the victim is tilted into the damaged area
side

often
displacement of bone fragments of the clavicle and
swelling in the area of ​​the fracture is caused
compression or damage to nerves
fibers and vessels. It leads to
impaired sensitivity and mobility
fingers

V
armpit from the fracture side
put a dense lump soft fabric, cotton wool,
a lump of plastic bags, etc.

hand
bend at the elbow so that the area from
hand to elbow (forearm) was parallel
semi

forearm
hung on a scarf or scarf. Can
fold the edge of the T-shirt and pin it
his pin.

The piece of matter must be
so wide that the forearm and
the brush was placed entirely in it. On
a thin rope or belt will not hold your hand
keep in a stable position.

This
will lead to its excessive mobility, and
means increased pain due to mobility
bone fragments. Reach,
dice cannot be compared.

preferably
arm, starting from the shoulder joint,
bandage completely to the body.

Fine
an immobilized limb will allow
for the victim to relax the sore arm,
which in turn will significantly reduce
painful sensations. Application
improvised tires and intricate
Deso type dressings are difficult to
extreme conditions.

First, the tires
you have to make something out of it. And not just
do it, but do it right.

Secondly,
they need to be bandaged with something. Third,
you need to know how to bandage correctly.

The most
simple and “economical” from the point of view
savings dressing material
the method would be immobilization by
tightly bandaging the arm to the body.

Traumatic
response is called shock
generalized to severe
mechanical injury.

erectile
(excitation phase). Always shorter than a phase
braking, characterizes the initial
manifestations of TS: motor and
psycho-emotional agitation, running
restless look, hyperesthesia,
pale skin, tachypnea,
tachycardia, increased blood pressure
pressure;

Symptoms of bruise

The main signs of a bruise are damage:

• muscle tissue;
• skin;
• fatty tissue under the skin.

Vessels with capillaries are often injured. The damaged area may swell due to hemorrhage and a hematoma appears on it. These are the most frequent symptoms bruises. If the joint is affected, the bruise may turn purple or even black. Then the shade changes to green, yellow-green. Also, when a joint is injured, the damaged area swells.

If a person has received serious bruises, then the main symptoms are serious pain.

When they become unbearable, there is every reason to fear a fracture. In this case, as well as if there is suspicion of damage to internal organs, it is necessary to undergo a control check with doctors. Doctors know all the morphological signs of a bruised wound. They will be able to conduct detailed diagnostics and diagnose accurate diagnosis.

How to determine a bruise of internal organs?

The task of doctors is to determine the degree of injury to internal organs based on symptoms and diagnostic test data:

• Electrocardiogram - shows a violation of cardiac impulses.
• Echocardiography is prescribed to detect hemodynamic disorders.
• Holter - measures pulse within 24 hours, heart rate, blood pressure.
• X-ray - allows you to detect associated injuries (fractures of the chest, ribs)

If there are symptoms of injury to internal organs, especially the genitourinary organs, blood and urine tests are prescribed to monitor changes in chemical reactions in the body.

The degree of damage and assessment of kidney performance are determined using the following methods:

• Chromocystoscopy - abnormalities are detected by staining urine. A special substance is used - contrast, which is injected into the urethra.
• An X-ray examination allows you to see the outline of the kidneys and examine the bruise of a contusion due to a bruise of an internal organ.

In case of liver contusion the results biochemical analysis blood there is a halving of total protein, a drop in albumin, an increase in ALT and AST. Instrumental methods organ studies include computed tomography and MRI they determine the degree and depth of damage, the amount of blood accumulated in the abdominal cavity.

A traumatologist diagnoses bruised ribs, bruised arms or bruised tailbones externally, but after examination he must check the integrity of the internal organs and the absence of fractures. This is especially important in case of brain contusion.

Often, a victim may mistake a fracture for a bruise, this especially often happens when the ribs or shoulder are bruised. In this case, the patient does not treat the fracture, which can lead to complications.

Treatment of bruise

The obtained results of hardware studies and analyzes are taken by doctors as a basis in choosing a method of treating bruised internal organs.

UHF therapy expands capillaries, enhances lymph flow and the flow of leukocytes to the site of injury. The procedure resolves accumulated fluid and stimulates regeneration processes. Microwave expands capillaries and increases their permeability. Magnetotherapy enhances the phagocytic activity of leukocytes. Manual massage is very effective in resolving hematomas.

IN home therapy Several groups of medications are used:

• Troxevasin, Rescuer, Lyoton - a group of heparin-based drugs that resolve hematomas.
• Capsicam or Arpisatron are ointments that allow you to dilate blood vessels.
• Wobenzym or Flogenzym - enzyme preparations that relieve swelling and pain syndrome.
• Fastum or Indovazin are non-steroidal anti-inflammatory drugs.

Application herbal decoctions resolves fluid accumulated from the impact of internal organs, restores injured vessels, enhances tissue regeneration.

After a bruise, with the exception of the mildest cases, the help of a doctor is necessary, otherwise complications can be serious. Treatment of bruises and hematomas starts with an examination. It is mandatory to check for fractures and other associated injuries. They are treated additionally.

Treatment of bruises of soft tissues and joints is carried out using gels and ointments containing NSAIDs (non-steroidal anti-inflammatory drugs). They are applied to the damaged area four times a day.

The number of treatments depends on the degree of damage. You can also make a compress to help with bruises.

If there are abrasions or scratches, NSAIDs are contraindicated. In case of serious pain, the same drugs are taken orally.

If the pain does not subside, urgent consultation with a specialist is necessary.

The bruise usually heals within a week and a half or less. If recovery is delayed, you can undergo physical therapy as prescribed by your therapist. To cure a bruise, prescribe:

• electrophoresis with drugs;
• magnetic therapy with high-frequency fields;

Traditional methods

Treatment is also possible at home. For this there are many folk remedies. For example, you can grind flax into fine powder and mix it with vegetable oil(1 to 4). The mixture is applied to the injured area for an hour and covered with film.

First aid for bruises consists of examining the damaged area. If a limb is damaged, its functions (extension, flexion and other movements) must be checked.

If there are only signs of a bruise, and not more significant damage, cold should be applied to the injured area. As a result of this procedure, the microcirculatory vessels spasm and internal hemorrhage stops.

It is better not to use painkillers, as this can only worsen the victim’s condition. But if you are sure that the internal organs are not damaged, you can give one of the painkillers. Do not use aspirin for bruises - it will only increase bleeding.

In the event that a head injury occurs and a person loses consciousness, a severe injury to the chest, lower back or abdomen, in addition to applying cold, it is necessary to maintain rest, immobilize the site of the injury as much as possible and take the patient to the emergency room.

Cold is effective only for half an hour. 2-3 days after the injury, the damaged area needs gentle warmth. Warm compress during this period, it will ensure blood flow to the bruised area, as a result of which the resorption of the hematoma is accelerated without the possible risk of resumption of bleeding.

If a limb is bruised, a pressure bandage is applied to the affected area. In case of extensive bruises of the extremities, it is necessary to carry out differential diagnosis with dislocations and fractures.

In such cases it is imposed transport tire, and the victim is hospitalized in a hospital. After the hemorrhage resolves, it is prescribed physiotherapy and massage to prevent the formation of contractures.

This is especially important for bruises of large joints or periarticular areas. In case of hemarthrosis, a puncture is performed and the blood is removed.

Hospital treatment indicated for significant bruises, as well as bruises of the head, chest, lower back and abdomen. In severe cases, carry out surgery.

Prevention

Only a doctor should treat blows and injuries, with the exception of rare, mild forms. Even with such simple injuries as a bruised chest, a bruised tailbone and a bruised knee, hand or shoulder, neglect of the problem can lead to serious consequences. A fracture is often confused with a regular bruised toe, which can result in complications for the victim.

Treatment begins with an examination. If an elbow, hand or little finger is bruised, as well as other limbs, the absence of a fracture is checked, that is, the function of the limb.

After the signs of injury have been eliminated, the bruise has resolved, the consequences need to be treated special ointments, compresses and gymnastics. A bruised heel, a bruised nose, and even a bruised tailbone or hand will not lead to serious consequences, however, they must be treated as carefully as eye and brain injuries.

You need to be prepared that the treatment of bruises and sprains will take an average of 2-3 weeks. During this period, it is very important to give up any stress in order to ensure maximum fast healing damaged tissues.

Important! Before treating bruises at home, it is necessary to take an x-ray to confirm the diagnosis, and also make sure that there are no contraindications to each specific remedy.

Physiotherapy for those diagnosed with a bruise

Under the guidance of a physiotherapist, you can also exercise physical therapy. Necessary exercises are selected individually for each patient, based on where the bruise is located and how strong it is.

Knowing what a bruise is and how to treat it, you can forget about the pain for several days. Regular use of home remedies will eliminate cosmetic defects literally in one week.

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First aid for bruises

Impacts from a blunt object or a blow from a fall from a height often cause bruises to internal organs. Symptoms may not appear immediately. If the consequence is internal bleeding, then pallor, cold sweat, dizziness and weakness appear after 10-30 minutes as blood accumulates in the abdominal cavity or chest.

It is impossible to stop internal bleeding without medical help. Before the arrival of a team of specialists, the victim is provided with first aid aimed at stopping the bleeding.

The person must be placed on his back so that the head and shoulders are higher than the back, and a cold compress must be applied to the stomach.

After bruising your ankle, elbow, heel, knee, or tailbone, you can apply a cold compress to relieve swelling and pain. This assistance is undesirable for injuries to the eye or brain and is completely prohibited if the chest is injured. If joints or limbs are injured, a pressure bandage is applied to the affected area.

If the injury is severe, it is better to apply a splint, as in this case a fracture is possible. Also, with such an injury, it is necessary to provide the person with peace and immobility, and take him to a medical facility as quickly as possible. Doctors will advise how to treat a bruise. It is forbidden:

• massage the damaged area;
• drink alcohol;
• warm a bruise;
• move a lot.

A person can hurt himself anywhere: at home, on the street, on an expedition, etc. There is not always a doctor nearby, so everyone should be able to help the victim. Often the victim himself can provide this help.

First aid for bruises and sprains should be aimed at eliminating pain.

When there is a bruise, the first step is to cool the injured area. To do this, wrap a small amount of dry ice in natural fabric and press it onto the injured area for 10-15 minutes.

If the damaged area is quite large, then you can repeat the procedure no more than once an hour. But in the case of spot cooling of the elbow or shoulder, it is better to apply a second compress no earlier than after 3-4 hours.

Important! In the first few days after injury, heating the bruise is strictly prohibited.

If possible, you need to take a position so that the bruise is above the level of the heart (raise your arm, leg). This will help prevent the development of tumors and edema.

For quick fix painful symptoms, it is recommended to take a paracetamol-based drug. But it’s better to avoid Ibuprofen, because it can provoke new subcutaneous bleeding. In consultation with your doctor, drug treatment can be supplemented with stronger painkillers.

The above actions are all that can be done in case of a bruise. Further treatment must be coordinated with a traumatologist. If your head has been injured, self-medication is generally prohibited.

Prevention

The best prevention bruises are neatness in everyday life. Most injuries people get are due to inattention. Recommended:

• do not hurry;
• look around;
• walk along icy paths with a shuffling “ski” gait;
• handle heavy things carefully.

Attention and caution can protect everyone from the vast majority of injuries that lead to bruises.

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are

megan92 13 days ago

Daria 12 days ago

megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a scam? Why do they sell on the Internet?

Yulek26 10 days ago

Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars

Editor's response 10 days ago

Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!

Sonya 10 days ago

I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...

Andrey A week ago

No matter what folk remedies I tried, nothing helped, it only got worse...

Ekaterina A week ago

I tried drinking a decoction from bay leaf, no use, I just ruined my stomach!! I no longer believe in these folk methods - complete nonsense!!

Maria 5 days ago

I recently watched a program on Channel One, it was also about this Federal program to combat joint diseases talked. It is also headed by some famous Chinese professor. They say that they have found a way to permanently cure joints and back, and the state fully finances the treatment for each patient

4.3. Internal organ injuries

Strong blows to the abdomen, chest, lumbar region, perineum, especially if they are accompanied by fractures of the ribs, sternum, pelvic bones, can lead to damage to the heart, lungs, liver, spleen, intestines, kidneys, and bladder.

Heart damage. Several factors are involved in the mechanism of heart damage in blunt chest injuries:

1) direct physical impact on an organ with hemorrhage in its parts - myocardium, subendocardium or epicardium;

2) the influence of the central nervous system on the endocrine-vegetative regulation of heart activity (stress);

3) various metabolic disorders in the myocardium (redistribution of catecholamines, potassium, sodium, etc.), which lead to hypoxia and hypotension;

4) hyperfunction of the sympathoadrenal system, as a result of which the cardiotoxic effect of catecholamines increases.

There are four degrees (forms) closed injury hearts:

- shake;

Bruise (concussion);

Heartbreak;

Traumatic heart attack.

Shake - the mildest form of closed heart injury. It is characterized by the rapid development of short-term and mild clinical-cardiographic changes. Victims complain of aching, quickly passing pain in the heart area

The main symptom is arrhythmias (paroxysms of tachycardia, atrial fibrillation, atrial or ventricular extrasystoles), as well as conduction disturbances up to complete, albeit transient, transverse block of the heart or one of the legs of the atrioventricular bundle (bundle of His) Characteristic dizziness, fainting, short-term

hypotension.

At heart bruise subtle, non-penetrating myocardial ruptures are observed (the atria are affected more often than the ventricles), which can be accompanied by extensive hemorrhages involving subepicardial areas and the thickness of the myocardium. Sometimes they compress small branches of the coronary arteries, which leads to the formation of subsequent

common scar-altered areas. Often all the membranes of the heart become saturated with blood. In this case, the myocardium becomes flabby and unevenly saturated.

Characteristic constant or paroxysmal pain in the heart area, arrhythmias, expansion of the heart in diameter, shortness of breath, various changes on the ECG. In severe cases, heart failure develops.

Traumatic heart rupture - the most severe form of its closed injury Traumatic myocardial ruptures are a common cause deaths: they are observed in 10-15% of all those killed in car accidents

Ruptures of the right ventricle of the heart occur less frequently than the left; in 30% of the damage they are multi-chamber in nature; in UZ patients, pericardial ruptures simultaneously occur; in the rest, the pericardium remains unaffected, but there is a threat of cardiac tamponade with blood, and subsequently, with a favorable outcome, - development of pericarditis.

Cases of ruptures of traumatic aortic aneurysms, characterized by high mortality, have been described.

The consequence of a closed heart injury can also be pericarditis (inflammation of the pericardium) , coronary thrombosis and traumatic myocardial infarction, “dislocation of the heart” and its “compression”, traumatic heart hole, arrhythmias, myocardial dystrophy.

Damage to the pleura and lungs occur with bruises of the chest, its compression, fractures of the ribs and sternum, wounds from fencing weapons and athletics spears. In closed pleural injuries (without breaking the skin), the main role usually belongs to the end of the broken rib.

Lung contusion. In case of a lung contusion caused by a closed chest injury, characteristic clinical picture of hemorrhage in the lung, which is usually asymptomatic: hemoptysis, especially in the first 3-5 days, chest pain, apparently associated with damage to the pleura, shortness of breath and decreased breathing in the corresponding area of ​​the lung, short-term fever, moderate increase in the number of leukocytes in blood and a slight acceleration of sedimentation

red blood cells

Due to the short duration of the changes (5-7 days), the most informative is an X-ray examination performed on the first day after the injury.

When pneumonia is added, there is an increase in symptoms, as well as a longer and higher increase in temperature, a pronounced increase in the number of leukocytes in the blood and the appearance of young forms.

When a lung is contused, hemothorax often develops - blood entering the pleural cavity, the clinical manifestations of which depend on the degree of blood loss, displacement of the mediastinum and compression of the lung by accumulated blood, the degree of destruction lung tissue and decreased pulmonary ventilation. The development of hemothorax may be accompanied by acute pulmonary heart failure.

At severe injury with multiple rib fractures There is a progressive development of respiratory failure caused by limited respiratory excursions and ineffective cough.

One of the most difficult and early complications thoracic injury is traumatic pleurisy. As a rule, it occurs within the first three days after injury. The effusion usually corresponds to the side of the injury, but may be bilateral or contralateral. Characteristic complaints of pain when breathing in the chest and shortness of breath.

Pneumothorax - presence of air or gas in pleural cavity. The entry of air into the pleural cavity inevitably leads to partial or complete collapse of the lung.

Depending on the cause of occurrence, traumatic, spontaneous (spontaneous) and artificial (therapeutic) pneumothorax are distinguished.

At open pneumothorax the pleural cavity communicates with external environment through a gaping defect in the chest wall or bronchus.

The pressure in the pleural cavity is equal to atmospheric pressure (for small defects, it decreases slightly when inhaling and increases when exhaling). The lung completely collapses and is switched off from the act of breathing. The most severe phenomena arise due to the fact that the opposite lung, which in that case provides all gas exchange, begins to function under abnormal conditions. The negative pressure in the healthy pleural cavity cannot be balanced by the pliable and easily displaceable mediastinum, which is under

influenced by atmospheric pressure shifts towards healthy lung, as a result of which the functional ability of the latter is significantly reduced. Since the pressure in the intact pleural cavity fluctuates significantly during the respiratory phases, and on the side where the open pneumothorax occurred remains approximately constant, with each inspiration the displacement of the mediastinum increases, and with exhalation it decreases. As a result, the mediastinum

together with the vital organs contained in it, abundantly supplied with nerve receptors, undergoes more or less sharp fluctuations, “runs”. This leads to difficulty in blood flow through the vessels of the mediastinum and primarily through the vena cava, disruption of the heart and the occurrence of severe shockogenic reactions

At closed pneumothorax there is no communication between the air in the pleural cavity and the external environment.

In the pleural cavity, one or another level of negative pressure is usually maintained, at least at the moment of inspiration. In connection with this, the collapse of the lung on the damaged side is often incomplete. It partially takes part in gas exchange. The mediastinum shifts slightly and its fluctuations are expressed to a small extent. Respiratory and circulatory disorders with closed pneumothorax are much less pronounced than with open pneumothorax, and are quickly compensated after a short period of disturbances that are largely reflexive in nature (irritation of the pleura by infiltrated air)

Severe disturbances occur with valvular pneumothorax, usually observed with small defects chest wall, lung tissue or bronchus. With this type of pneumothorax, atmospheric air is sucked into the pleural cavity at the moment of inhalation, and during exhalation, when the pressure in the pleural cavity increases, the defect is covered and does not allow air to pass through reverse direction In some cases, air enters the pleural cavity during the exhalation phase.

The amount of air in the pleural cavity gradually increases, the lung collapses and is switched off from the act of breathing, and the mediastinum shifts to the healthy side, as a result of which severe respiratory and circulatory disorders can occur.

Urgent Care. At open pneumothorax(chest injury) first aid is to apply an airtight bandage, at least temporarily turning open pneumothorax into closed and reducing mediastinal fluctuations. Without such a bandage it is fatal the outcome may occur even before the ambulance arrives. The simplest airtight dressing consists of several layers gauze heavily soaked in Vaseline, on top of which compress paper or oilcloth is applied. After application an airtight bandage is urgently needed delivery of the victim to a special medical facility.

Closed pneumothorax, as a rule, does not require the use of urgent medical manipulations if there is no significant displacement of the mediastinum. However, even with a closed pneumothorax, the patient must be taken to the hospital.

At valvular pneumothorax it is necessary to transport the patient to the hospital as quickly as possible medical institution, where he will receive emergency care (unloading the pleural cavity from excess air using puncture, i.e. inserting a special needle into the pleural cavity in order to convert the valve pneumothorax into an open one).

Damage to abdominal organs can occur at the moment of impact in the hypochondrium area (with a football boot, a throwing projectile, when hitting surrounding objects, etc.), a fall from a great height (during diving) and through the mechanism of counter-impact on the spine and ribs (when skiing ). They are accompanied by symptoms of shock, expressed to varying degrees. Characteristic rapidly increasing internal bleeding (especially with ruptures of the parenchyma and capsule of the liver and spleen), pallor of the skin and mucous membranes, thread-like pulse, darkness or loss of consciousness, sudden tension in the muscles of the abdominal wall. When the intestines are damaged, inflammation of the peritoneum develops - peritonitis.

Urgent Care.

Traumatic injuries to the spleen account for 20 to 30% of all parenchymal organ injuries.

There are one-stage and two-stage ruptures of the spleen.

With single-stage ruptures, simultaneous damage to the parenchyma and capsule occurs. In these cases, bleeding into the free abdominal cavity from the ruptured spleen occurs immediately after the injury.

With a two-stage rupture, usually at the first moment only one parenchyma of the spleen is injured with the formation of a subcapsular hematoma. When repeated, often under the influence of a minor visible cause, the capsule ruptures and the hematoma breaks into the free abdominal cavity. Between the moment of injury and the breakthrough of blood into the free abdominal cavity, a certain period of time passes, calculated from several hours to several weeks and even months.

The clinical picture of splenic injury varies depending on the severity of the injury, the time elapsed since the injury, and the presence of concomitant injuries to other organs. The leading symptoms are acute blood loss and shock, which are accompanied by signs of peritoneal irritation.

Typically, victims complain of pain in the left hypochondrium, less often in the upper abdomen or throughout the entire abdominal cavity. The pain often radiates to the left shoulder and left shoulder blade.

Irritation of the peritoneum by engorged blood leads to tension in the abdominal wall and severe pain on palpation.

Massive bleeding, in addition to local symptoms, characteristic of intra-abdominal bleeding, leads to development common manifestations acute blood loss: rapidly progressing weakness of the victim, the appearance of tinnitus, dizziness, nausea, vomiting, cold sweat, pale skin, visible mucous membranes, etc. In severe cases, the patient may develop agitation, impaired consciousness, and a sharp drop in blood pressure.

With the formation of an extensive subcapsular hematoma, stretching of the capsule with gushing blood causes significant pain and a feeling of fullness in the left hypochondrium.

The prognosis depends on the severity of the spleen injury, the amount of blood loss and the nature of concomitant damage to other organs. The timeliness of surgical intervention is of decisive importance for the outcome of the disease.

Urgent Care. Apply cold to the affected areas, rest and urgent hospitalization (usually surgery is necessary).

Damage to the kidneys and bladder possible with a blow to the lumbar region, stomach (suprapubic region), or a fall from a height onto the buttocks. In the latter case, the kidneys suffer due to a blow to the spine and lower ribs.

Direct damage to the kidneys, which is accompanied by a bruise, is characterized by hemorrhages into the renal parenchyma, its edema and ischemia, vascular thrombosis and infarction, hematuria, and acute renal failure.

Kidney damage is accompanied by a state of shock, the appearance of blood in the urine or the formation of a perinephric hematoma. In this case, acute renal failure may develop.

Bladder rupture is accompanied by urinary retention, which quickly flows into the peri-vesical tissue. State of shock deepens by the phenomenon of intoxication.

Urgent Care. Apply cold to the affected areas, rest and urgent hospitalization (usually surgery is necessary).