Features of gunshot wounds of the musculoskeletal system
Gunshot wounds musculoskeletal system, pronounced blood loss, caused by extensive damage to the soft tissues, bones and major vessels. The high energy of the injuring projectile causes fractures, They are splintered and crushed, often with secondary damage to bone fragments of large vessels.
Mine blasting wounds Of shrapnel accompanied by limbs, glass fragments, tissue scraps of secondary bodies into sub organs of implantation of foreign bodies into the limb tissues. Increase and removal blood loss. Special care shouldn’t be blind or through wound. This is because the exit is not far from the entrance hole. Inadequate diagnostics can lead to an incomplete stop bleeding and aggravate the general condition of the wounded during transportation.
The volume of first aid at the prehospital stage
Doctrine on the treatment of the Great Patriotic War gunshot wounds. It includes the following provisions: all gunshot wounds are primarily infected; It is a surgical treatment of wounds; early affected surgery treatment of wounds; after treatment injured, provides the best prediction. The provisions of the law are not the same.
Temporary suspension bleeding; immobilization of the limb; blood loss replacement and anesthesia.
Temporary stop bleeding
Temporal stop bleeding It is achieved by the pressure bandage, the pressure bandage
At venous bleeding, aseptic dressing is shown. There is a tight wound tamponade with a tamponade of pressure.
Tamponade is absolutely contraindicated in wounds located in the armpit and popliteal fossa, since it can be limited to severe limb ischemia.
At arterial bleeding, It is a bright red color, it is shown, including, for example, a
Finger pressing injuries in the upper third of the shoulder and thigh, i.e. in areas where the application of hemostat is impossible.
Finger pressing is carried out until the victim is transported to the hospital.
Temporary stopping bleeding method hemostatic harness. This manipulation is shown only in case of massive arterial (not venous!) bleeding from the vessels of the limb. Harness impose above the place bleeding and as close as possible to the wound.
The rules for applying a hemostat are as follows:
- a place rope overlay wrap with soft material (clothes, napkins, bandage);
- tow stretch and make up 2-3
- limb must be tightened to full stop bleeding.
- right rope overlay determined by the absence of pulsation on peripheral vessels;
- wrong rope overlay may lead to increased venous bleeding;
- It is strictly forbidden to overlay harness dressings;
- time rope overlay the contingent of documents;
- tow may be on the lower limb no more than 2 hours, and at the top – no more than 1.5 hours. In the cold season, these periods are reduced by 30 minutes.
Application band harness It is not a condition that it leads to any pressure. Therefore, it is possible that it can be reduced to 10–20 mm Hg.
Immobilization Part of the body. Immobilization of the damaged limb it is not necessary for bone tissue injuries, but it is anti-shock event. Limbs include:
Main tire application rules It is necessary to ensure that it has an advantageous position to the limb; it is applied; Clothesline and fixed with bandages.
Emergency first aid for various localization of damage
The volume of rendering emergency first aid depends on the location of the damage.
Stopping bleeding – the position of the limb. These activities hemostat on the forearm or on the hand. When a hand is crushed – tire immobilization.
Stopping bleeding – imposition of a pressure aseptic dressing. Positional stop bleeding There is no damage to the use of the vehicle. A tourniquet may be applied to the forearm.
There are two limb lines (forearm and shoulder), A hemostat is placed on the lower third of the shoulder.
Stopping bleeding – aseptic dressing or hemostatic harness. Clamping the vessels over by applying tires. With continued bleeding It has been shown that it has been possible to pin it on.
Stopping bleeding – imposition of a pressure aseptic dressing. When crushing the foot – immobilization tire.
Damage to the lower leg
Stopping bleeding – imposition of a pressure aseptic dressing. Immobilization limbs tires.
Stopping bleeding – aseptic dressing or hemostatic harness.
- fixation to a healthy limb;
- tire overlap;
- due to significant blood loss this type of damage is shown anti-shock therapy.
Damage to the pelvic bones
Attitude towards rendering first aid This is a combination of damage to the internal organs.
Victim transport In the popliteal areas.
Diagnosis of spinal injury at the prehospital stage is a difficult task, accompanied by additional trauma and delayed.
It is necessary to immobilization position (on the back, on a hard stretcher).
Transportation of injured
Gunshot injury requires the most rapid delivery. It will be rendered first aid, depend on the course and outcome of the lesion.
It is necessary to take care of the patient; There is a provision for a multidisciplinary medical institution with a trauma department.
In the presence of the wounded shock and pronounced blood loss, caused by arterial bleeding, requiring imposition hemostatic harness, The victim should be transported directly to the operating unit. Availability shock It is an indication of the specific care.