trauma

1. Trauma. Burns
Schwartz’s Principles of Surgery (Chapter 7, 8)

2. Types traumatic injury
Abrasions are superficial injuries of the skin and visceral linings in the body, resulting in a break in the continuity of tissue.
These are the simplest of injuries in terms of healing, with most injuries being confined to the epidermis and resulting in
minimal bleeding at most
avulsion is a partial or complete tearing away of skin and the tissue beneath. Avulsions usually occur during violent accidents,
such as body-crushing accidents, explosions, and gunshots. They bleed heavily and rapidly.
bruise, or contusion, is skin discoloration from a skin or tissue injury. This injury damages blood vessels underneath the skin,
causing them to leak.
Lacerations are made when a surface, such as the skin of the hand seen here, is cut in an irregular fashion down to the
underlying tissue. An incision is defined as a very regular cut made by a sharp object such as a knife. Lacerations typically
occur by contact with an irregular object.
Puncture wound: An injury that is caused by a pointed object that pierces or penetrates the skin
A gunshot wound is a puncture wound. Puncture wounds do not bleed much unless a blood vessel has been injured.
However, an object that goes into the soft tissues beneath the skin can carry germs deep into the body. Gun shot wound ,
entry: smooth edge and thermal damage borne , exit like alcuration
Treat: not suture : inflamation (anerobic bacteria)! Not damage cavities, how many gun shot was there because patients has
andernalin find another gun shot
⁃ cut entey and exit wound to clean- between this 2 wound cannal amerobic bacteria wash and clean (use drain age and
antibiotic) -stop bleeding-
sound waves injuries : trauma, physiological changes in the body caused by sound waves. Sound waves cause variations in
pressure, the intensity of which depends upon the range of oscillation, the force exerting the sound, and the distribution of
waves. Related Topics: barotrauma.

3. 1.Blust injury : can be so strong damage leg ,
finger,
Damage finger and ligaments
Unpleasant
2. ⁃ 2. Resilens: if mosht bzanim b hard object we
can do cell death and damage our tissue
⁃ 3.trauma : bleeding (tornike)

4. Burning

5. Trauma Definition, Phases
Trauma, or injury, is defined
as cellular disruption caused by an
exchange with environmental
energy that is beyond the body’s
resilience which is compounded
by cell death due to
ischemia/reperfusion.
• Primary Survey
(Resuscitation)
• Secondary Survey
(Evaluation, Definitive Care)
• Tertiary Survey

6. Primary Survey

7. ⁃ 4.:1 danger: your safety is first $:look around what happened (victim of some shooting , dogs , victim of electric
layer you will be second victim - identify environment )2:call emergency by speaker and say location 3:go to patient
(call person hello do you hear me (give exact identities of his t shirt ) woman in blue jaket call 112 -4:go close to
him not shake and beat him (beat on shoulder!!) 5: no answer chek breathing chek breast movement / hear noise
of breathing/ feel air breathing by chin (not breathing!!!)
⁃ 6:pharmacy (fibrolator) no heart beat start heart beat - :///chin up damage spinal cord /// put patient to slite
right (patient without spinal trauma) ask somebody to know what happend to this guy!?- 7: cpr : re alive the
person - breathing first (give o2 and co2 ) and compresion to o2 move - maybe o2 drop down and patient can not
breathe with out compression- then compression (where horizontal line in nipple ,: dastto mese telefon kon .:first
finger jungular and small finger down we reach sefoid prosess
How deep compress : more than 5 cm straight arms ( not elbows )
-$4-7 min to restate patient how long we can to compression? Heart beat and oxygen ( 45 min) patient not have
dnr (do not resatitae) wait some time to patient die (called blue do cpr)

8. , Tracheotomy
Intubation
an opening surgically created through the neck into the trachea
(windpipe) to allow direct access to the breathing tube and is
commonly done in an operating room under general
anesthesia_A tracheostomy is an opening created at the front
of the neck so a tube can be inserted into the windpipe
(trachea) to help you breathe. If necessary, the tube can be
connected to an oxygen supply and a breathing machine called
a ventilator
Intubation is the process of
inserting a tube into the mouth
or nose and then into the airway
to help move air in and out of
the lungs. There are several
reasons why it may be
performed, but it is mainly used
to support breathing during
surgery or an emergency

9. When the tube is inserted through the mouth, it is referred to as endotracheal intubation.1
When it is inserted through the nose, it is known as nasotracheal intubation.2
Endotracheal intubation may be used to:1
Keep the airway open to provide oxygen, medicine, or general anesthesia
Support breathing in people with pneumonia, emphysema, heart failure, collapsed lung, or severe
trauma
Remove a blockage from the airway
Prevent fluid from entering the lungs due to stroke, overdose, or massive bleeding from the
stomach or esophagus (feeding tube)
Nasotracheal (through the nose) intubation is used to:2
Protect the airway if there is an impending threat of obstruction
Deliver anesthesia for surgeries involving the mouth, head, or neck (including dental surgery)
Intubation
Endotracheal intubation is typically used in emergencies. It also supports breathing in people with severe
breathing problems due to disease or trauma. Nasotracheal intubation is more commonly used to deliver
anesthesia, but it can also protect the airways if there is a risk of obstruction.

10. Hemopneumothorax —-stereoscope one part
right some breating hear
better some problem and Ct
scan(time ) => no time x ray
(l,s) (r,d) mediastiom more
deviate in left side ,stomach
with air )’
$$place drainage lower age
lower rib not damage
vessels (blood and air come
out) tube connect vacuum
machine (blood less 500ml),
blood more than 500ml do
thoracotomy-under local
anastesia
Hemopneumothorax is a combination of two medical
conditions: pneumothorax and hemothorax. Pneumothorax,
which is also known as a collapsed lung, happens when there is
air outside the lung, in the space between the lung and the
chest cavity. Hemothorax occurs when there is blood in that
same space

11. thoracostomy
It's typically an emergency procedure. It may also
be done after surgery on organs or tissues in your
chest cavity. During chest tube insertion, a hollow
plastic tube is inserted between your ribs into the
pleural space to drain air, blood, bile, pus, or other
fluids.

12. —Glasgow coma : less score difficult conditions, person's level of consciousness after a brain injury. The minimum score is a 3
which indicates deep coma or a brain-dead state. The maximum is 15 which indicates a fully awake patient .

15. Burns
,
—pantenol spray for burning
—with chemical is toxic and you will
be contaminated
-electical burn you can get it
(Identity what is reason of burn)