Injury is an injury, the main characteristic of which is the violation of the integrity of the skin, mucous membranes, and sometimes deep tissues. The wound is accompanied by pain, bleeding and gaping.
The cause of the pain that occurs at the time of injury is damage to receptors and nerve endings. How intense the pain syndrome is depends on a number of factors: the number of nerve cells in the damaged area; neuropsychic characteristics of the victim; the nature of the weapon with which the wound was inflicted (the sharper it is, the less cells and nerve elements are destroyed and the less pain).
The intensity of bleeding depends on the number of vessels that were damaged at the time of injury. The most significant bleeding develops when large arteries are damaged.
Gaping a wound is an indicator that determines its size, depth and violation of the elastic fibers of the skin, as well as the nature of the damaged tissues.
Types of wounds
Depending on the nature of the injuries, wounds are divided into gunshot, cut, stab, chopped, bruised, bitten, torn, etc.
Gunshot wounds occur as a result of bullet or shrapnel impact. Depending on the trajectory of the bullet, they can be through (there are entry and exit wound holes), blind (the bullet gets stuck in the tissues) and tangent (the bullet only slightly touches the skin and soft tissues without getting stuck in them).
Cut wounds appear due to the impact of a sharp cutting object. It can be a knife, glass, metal shavings. Such wounds have smooth edges and a relatively small affected area, however, at the same time, they are accompanied by heavy bleeding. The most dangerous are incised wounds in the neck and limbs in those areas where large arteries and veins are located.
Stab wounds are caused by piercing weapons. It can be a needle, an awl, a bayonet, etc. In this case, the zone of damage to the skin and mucous membrane is insignificant, but the depth of such wounds is very large. The main danger posed by such injuries is that internal organs can be affected. Internal bleeding is also likely.
Chopped Wounds capable of inflicting sharp objects. Such injuries differ in unequal depth, and they are also accompanied by bruising or crushing of soft tissues. They are extremely dangerous due to the fact that the injuring object penetrates deep into the body, resulting in significant damage.
Bruised Wounds are caused by blunt objects. As a rule, they are accompanied by a very extensive zone of tissue crushing, surrounded by bruises, and have uneven edges.
Such wounds are caused by animals. They are irregularly shaped, contaminated with animal saliva, as a result of which their healing is complicated.
Such injuries are called combined or multiple. In this case, the victim has a number of injuries, each of which can threaten his life.
Dangerous Complications of Injury
When providing first aid to an injured person, one should take into account the main dangerous consequences that such injuries are fraught with.
First of all, this is a serious blood loss, which poses a threat to the life of the victim. Damage to vital organs and the development of traumatic shock are also possible.
At the initial stage, a patient in a state of traumatic shock is in a state of extreme excitement, complains of severe pain. There may be manifestations of a panic attack or aggression. However, if help is not immediately provided, the second stage begins, characterized by an increase in heart rate, a gradual decrease in blood pressure and body temperature, and a lack of response to light and sounds. This condition is life-threatening for the patient.
Basic rules for first aid
First aid for various types of injury is different, but its general algorithm is unchanged. Therefore, before considering the features of first aid for various types of injuries, the general procedure should be mentioned.
First of all, the condition of the victim should be assessed and examined. After that, it is necessary to call an ambulance, and, while the doctors are on the way, perform all the necessary first aid measures: stop the bleeding, apply a bandage, help the victim take a position that will be optimal for this type of injury. After that, it is necessary to carefully monitor the condition of the victim until the ambulance arrives.
At the same time, during the provision of first aid, one should remember several important nuances:
- Under no circumstances should the wound be washed with water or any drug. It is also forbidden to use iodine or alcohol for this purpose.
- Blood clots or foreign bodies should not be removed from the wound as this may cause bleeding.
- It is forbidden to press protruding tissues or organs into the wound.
- In case of extensive injuries of the limbs, they should be fixed, completely immobilized.
First aid for head wounds
The first first aid that a person with a head wound needs is to stop the bleeding. Any surgeon knows that head wounds look very frightening precisely because of the fact that the blood literally “splashes”, causing the uninitiated person to feel that the victim will immediately die in his arms. In fact, such profuse bleeding with head injuries is caused by the fact that the vessels are located very close to the surface of the skin. Despite the fact that head wounds look very frightening, such wounds heal very quickly.
The best way to stop bleeding in a head wound is to apply a pressure bandage.
The algorithm of actions is as follows:
- Cover the wound with a sterile gauze pad.
- Fix it using bandages.
- In the event that the pressure of the bandage is insufficient, the edges of the wound should be squeezed by hand.
- Help the casualty lie on their back with their shoulders and head elevated.
- Call the medics.
First aid for penetrating chest injuries
The main danger of penetrating chest injuries is that internal organs can be damaged: the heart, lungs, etc. This is fraught with serious consequences, even death. In addition, due to a violation of the integrity of the pleura, the development of pneumothorax is possible, that is, the ingress of air into the pleural cavity. This leads to the fact that the lung is compressed, losing its functions.
With a penetrating wound of the chest, the victim is conscious for the first time, but gradually his condition worsens. The airways can be blocked by expectorated blood. Breathing is difficult, frequent, there may be expectoration of blood of a very bright shade, foaming. The breaths are shallow. Sometimes the sound of air sucked into the wound is heard. Pulse is frequent and weak. The skin of the victim becomes pale, the lips acquire a blue tint, the holes of the nails turn blue. Perspiration may appear on the face. Directly around the wound, the skin seems to “foam” due to the penetration of air into the subcutaneous tissues. In the event that a pneumothorax occurs, the blood in the wound bubbles, the patient's condition deteriorates sharply, squelching sounds are heard during inhalation and exhalation. When the victim exhales, bleeding from the wound increases.
First aid for a penetrating chest injury depends on whether the casualty is conscious or not.
If the casualty is conscious:
- Cover the wound with the palm of your hand and seat the casualty so that he is leaning towards the wound. Please note that this position of the body is extremely important. If the victim is tilted to the healthy side, then during bleeding, the blood will put pressure on the heart and healthy lung, as a result of which their work becomes more complicated.
- Ask the casualty to cover the wound with his hand while you put on a dressing, cover it with polyethylene or any other material that is impervious to air, then bandage or cover with plaster.
- Call the medics.
- Until the ambulance arrives, monitor the victim's condition so that if necessary, begin cardiopulmonary resuscitation.
If casualty is unconscious:
- Cover wound with palm of hand. Put on a dressing, and on top - polyethylene or other material that is impervious to air. After that, bandage or stick with a plaster.
- Place the casualty wound down and call an ambulance. Constantly monitor the patient's condition.
First aid for injuries to the abdomen
Injuries to the abdomen are considered the most dangerous. The thing is that they can provoke damage to the abdominal organs, which can cause internal bleeding and peritonitis, inflammation of the peritoneum. As a result, a person may die.
The goal of first aid for abdominal wounds is to stop bleeding, thus minimizing the risk of infection and shock. It is important to remember that the victim should not be allowed to drink or, of course, eat before the arrival of the doctors. It is also forbidden to administer any painkillers. You can wet a person's lips with water.
The first aid algorithm for abdominal wounds differs depending on whether there is a foreign body in the wound, and also on whether organ prolapse has occurred.
If there is a foreign body in the wound:
- If the person is unconscious, tilt their head back and turn to the side. It is in this position that air can freely pass into the lungs. If the wound is longitudinal, the victim should lie on his back with straightened legs. If the wound is transverse, then his legs should be bent at the knees.
- A wound on the abdomen should not be carefully palpated, and in no case should one try to determine its depth with a finger.
- A foreign object present in the wound (knife, nail, arrow, rebar, bullet, etc.) should never be touched. It should not be removed, attempted to loosen or perform any other actions. This can only increase the damage, which is fraught with the death of the victim. If possible, the object protruding from the wound should be cut off so that about ten centimeters of its length remain above the skin. If it is not possible to cut off a foreign body, it is necessary to leave it in the form in which it is located.
- The object in the wound must be immobilized. Any long dressing material should be used for this. A strip of dressing material is thrown over the object so that two long free ends are obtained. These ends are wrapped tightly around the foreign body and tied together. As a result, the object wrapped in this way is securely fixed.
- After the foreign body is fixed, the person is brought into a semi-sitting position, with legs bent at the knees. After that, wrapped in blankets, waiting for the arrival of doctors.
For organ prolapsed wounds:
- If the person is unconscious, tilt their head back and turn to the side to allow air to pass freely into the lungs.
- If any organs have fallen out of a wound in the abdomen, do not try to put them back into the abdominal cavity. Move them as close as possible to each other so that they occupy the minimum area. Collect all the fallen organs in a clean bag or cloth, and glue its ends to the skin with tape so that the fallen organs are isolated from the environment. In the event that such a method cannot be used for objective reasons, apply rolls of bandages or pieces of cloth around the fallen organs, then cover the organs with clean gauze over the rolls and fix with a bandage that is not too tight.
- After the prolapsed organs are fixed, place the person in a sitting position. The legs should be bent. Put cold on the wound and wrap the victim with blankets or warm clothing.
- Constantly moisten the prolapsed organs with water to keep them moist. This hydration is necessary for the organs to survive. If they dry out, then necrosis will occur, as a result of which the organs will actually become dead.
For wounds without prolapsed internal organs:
- his head back and turn to the side so that the air passes freely into the lungs.
- Do not try to feel the wound on the stomach. If there are small foreign objects in it, such as a bullet or shrapnel, do not try to get them.
- For a gunshot wound, check if there is an exit hole. If present, both holes are machined according to the algorithm described below.
- First of all, the wound is cleaned of blood and dirt with a few pieces of cloth, gauze or bandage. The fabric is abundantly moistened with water or any agent with antiseptic properties. With a wet piece of cloth, blood and dirt are very carefully removed by movements from the edge of the wound to the side, moving in a circle around the entire perimeter of the wound. In the event that one circle was not enough, the used piece of fabric is thrown away, another one is taken and the procedure is repeated.
- After the blood and dirt have been removed, smear the skin around the wound with brilliant green or iodine. Please note: no antiseptics can be poured into the wound! All treatment should be to remove contamination from the outside, from the skin that is adjacent to the wound.
- After the wound is treated, bandage it. Ideally, sterile bandages should be used for this. If they are not at hand, then you can take pieces of fabric. First, cover the wound with a small piece of gauze or cloth, folding it into eight to ten layers. After that, tightly wrap the gauze to the body of the victim or glue it with adhesive tape or adhesive tape.
- Ice should be applied to the dressing. It can be ice in a bag or a heating pad with cold water. After applying a bandage, help the victim to take a sitting position. The legs should be bent at the knees. Wrap the person in blankets or clothing.
Please note that until a person with a stomach wound is taken to the hospital, he should not be given anything to drink or eat, nor should he be given pain medication.
First aid for eye injuries
Even a minor injury to the eye can have disastrous consequences - visual impairment up to complete blindness. Therefore, proper first aid for eye injuries is of great importance.
All eye injuries are divided into blunt and penetrating. The algorithm of actions for damage of each type is somewhat different.
In case of blunt trauma to the eye, the damaged organ of vision should never be rubbed. This will only provoke additional irritation, and can also cause infection.
The foreign body causing the injury should be removed using a sterile dry swab or the corner of a clean handkerchief. To do this, pull down the lower eyelid or turn the upper one, remove the foreign object and rinse the eye with boiled water. After that, 2-3 drops of albucid should be instilled into the eye, after washing your hands thoroughly. After instillation, lie down with your eyes closed for about five minutes, and remove the remaining drops from the eyelid with a clean napkin or cotton pad.
Penetrating injuries to the eyeball are much more dangerous than blunt injuries to the eye. Particularly severe consequences are those injuries, as a result of which a foreign body (splinter, ice, etc.) is introduced deep into the eye. Such injuries are difficult to treat and are fraught with very serious complications.
The first thing to remember is that you should not try to remove the foreign body that caused the bleeding on your own. A sterile pressure bandage should be applied to the injured eye. It will reduce bleeding and prevent infection from entering the wound. In the event that a sterile bandage and cotton wool are not at hand, you can use any cotton fabric that has been previously ironed. One piece is rolled up and placed in the center of the eye, and another piece is placed on top, which completely covers the area of injury.
After this, the victim should be immediately taken to an ophthalmologist.
Bleeding from injury: first aid
Bleeding is a complication that accompanies most injuries. Bleeding is the escaping of blood from damaged blood vessels. Depending on the nature of the damaged vessels, bleeding during injuries is divided into venous, capillary, parenchymal and arterial bleeding.
Venous bleeding is characterized by the continuous flow of blood of a dark color. The cause of capillary bleeding is damage to small vessels of the skin, muscles and subcutaneous tissue. In this case, the entire surface of the wound bleeds. Parenchymal bleeding occurs if the internal organs are damaged: the liver, kidneys, lungs, etc. However, the most serious is the injury to the artery, which provokes arterial bleeding.
First aid for injured arteries
Wounded arteries are extremely serious injuries. In the event that medical care is not provided in a timely manner, arterial bleeding can be fatal.
Arterial bleeding is considered the most dangerous of all types of bleeding. When the arteries are injured, blood flows out of them in a gushing stream of bright scarlet color. Each heartbeat provokes new blood loss. Injury to an artery is an injury that can cause death even if qualified medical care is provided, since it is extremely difficult to stop bleeding in this case.
Blood loss from an arterial injury is so rapid and extensive that emergency measures should be taken within the first two to three minutes after injury. In the event that large arteries are affected, the time that the person providing first aid has in stock is reduced to one or two minutes. With every second, the pressure of the victim will fall, as a result of which he will quickly lose consciousness and may die.
In case of arterial bleeding, first of all, the injury site should be clamped to stop the flowing bleeding. You can do this with your fingers or your fist.
Note that there are a number of rules for pressing and squeezing certain blood vessels:
- The common carotid artery is pressed against the transverse processes of the cervical vertebrae with the fingers. Pressure must be applied to the inner edge of the sternocleidomastoid muscle, approximately in the middle part.
- The external maxillary artery is pressed with fingers against the anterior edge of the masseter muscle.
- The temporal artery should be pressed with the fingers at a point slightly anterior to the upper edge of the ear.
- The subclavian artery is pressed with fingers or a fist. The necessary point is located behind the outer edge of the clavicular part of the sternocleidomastoid muscle. It should be pressed against the first rib.
- Compress the brachial artery with the fingers along the inner edge of the biceps muscle.
- Compress the femoral artery with a fist, pressing it against the pubic bone. In thinner people, this vessel can be pressed against the thigh.
- The popliteal artery is compressed with a fist at a point located in the center of the popliteal cavity.
After an injured large artery is occluded, a tourniquet should be applied without delay. In conditions where it is not at hand, the tourniquet can be replaced with a belt, scarf, thick twine and other similar means. A sterile dressing must be applied to the wound itself, which will protect the wound from infection.
In some cases, when the artery on the limbs is damaged, but there is no fracture of the bones, instead of a tourniquet, forced flexion of the injured limb and its fixation using a bandage or other available means can be used.
Application of a tourniquet in case of arterial injury
Already at the moment when a person injured in an artery is being assisted in squeezing the vessels, someone from the nearby people should prepare a tourniquet, which will be used to stop bleeding. You should also prepare cotton wool or gauze.
Cloth or gauze is applied to the damaged area, which, however, should not cover the bleeding site. In this case, if the limb is damaged, it should be in an elevated position. After that, the rubber tourniquet or what will replace it is slightly stretched and a limb is tied around it in two or three turns. It is necessary that the tourniquet be applied tightly and tightly enough to stop arterial bleeding, but at the same time it is impossible to strongly squeeze the limb. The ends of the harness are tied and fixed. Most often, a tourniquet or pressure bandage is placed two to three centimeters above the wound.
It is also necessary to take into account some features of applying a tourniquet for different types of damage to the arteries.
So, if the upper limbs are damaged, it is applied to the upper third of the shoulder. Please note that a tourniquet is not applied in the middle of the shoulder, because this is fraught with damage to the radial nerve. If the femoral artery is damaged, then two tourniquets are applied, one of which is located just above the second. For injuries to the carotid artery and other arteries of the head and face, a soft bandage should be placed under the tourniquet to help prevent further injury. Please note that in this case, the tourniquet should not be tightened very tightly in order to prevent suffocation and deterioration of the blood supply to the brain.
If the tourniquet is applied correctly, the bleeding will stop completely. Under the tourniquet, you must put a note in which you indicate the data on the causes of damage and note the exact time when the pressure bandage was applied. The area on the body where the tourniquet is applied should not be completely covered with clothing so that doctors do not waste time looking for the injury site.
After the tourniquet is applied, the victim should be immediately sent to a medical facility where he will be provided with qualified medical care. When transporting a patient with a wound of large arteries, he should be completely immobilized.
In order to prevent severe negative consequences associated with insufficient nutrition of tissues (including their necrosis and paralysis due to compression of nerve fibers), the tourniquet should not remain on the patient's body for more than one and a half hours. In the event that, for a number of reasons, the tourniquet must remain on the damaged artery longer than this time, it is slightly loosened for several minutes, after which it is tightened again.
Mention should also be made of the main mistakes that ignorant people who sincerely want to help the victim make when applying a tourniquet.
First of all, a tourniquet should not be used without sufficient evidence. This is, indeed, an extreme measure, which is used exclusively in case of severe arterial bleeding, which there is no way to stop in other ways.
In no case should a tourniquet be applied to bare skin without first protecting it with a layer of cloth or gauze. In this case, infringement and even necrosis of the skin is possible.
The correct location for the tourniquet is important. It must be placed above the site of bleeding.
Finally, consider that a tourniquet that is too loose will not stop the bleeding, but rather increase it. At the same time, if the tourniquet is tightened too much, nerve compression will occur, which is also fraught with a number of unpleasant consequences.