Multiple injuries are common in major traffic accidents, accidental injuries, falling from a height, etc. It means that under the impact of the same inju
Multiple injuries are common in major traffic accidents, accidental injuries, falling from a height, etc. It means that under the impact of the same injury, two or more tissues and organs are seriously damaged at the same time or successively. The following is what I arranged for you for your reference.
What are the rescue measures for multiple injuries?
The first is to keep the respiratory tract unobstructed. Respiratory obstruction caused by foreign bodies or secretions is the most common problem in multiple injuries, which can cause asphyxia, cyanosis and dyspnea. In on-site first aid, we must first find out whether there is airway obstruction. Remove foreign bodies or secretions blocking the mouth and throat, and conduct tracheal intubation or tracheotomy when necessary, so as to lay the foundation for further treatment.
The second is cardiopulmonary cerebral resuscitation. No matter on-site first aid or during transportation, once the injured person has cardiac arrest, he should immediately put the patient flat on a wooden bed or flat ground, and take emergency measures such as artificial respiration, precordial beating, chest compressions and intracardiac injection of 0. 1% adrenaline to restore the beating of the heart. After that, oxygen inhalation, respiratory stimulants, dehydration diuretics and so on. It should be given to maintain the relative stability of breathing, circulation and brain function to avoid cardiac arrest again.
The third is to stop bleeding actively. Internal bleeding and external bleeding are both causes of death. Therefore, when the injured person continues to bleed and the amount of bleeding is large, measures must be taken to stop bleeding urgently, and pressure dressing or bandage dressing should be implemented to prevent hemorrhagic shock.
The fourth is to open intravenous rapid infusion. For patients with blood pressure drop and shock, besides oxygen inhalation and keeping warm, 2 ~ 3 venous channels should be established and opened quickly, and 2000 ~ 3000 ml balanced salt should be given intravenously, so as to quickly replenish blood volume, improve microcirculation, raise blood pressure, prevent disseminated intravascular coagulation and organ failure, and reduce mortality.
The fifth is to deal with fractures and trauma. Generally, the wound is stopped and bandaged, and the opening is closed; Simple reduction and fixation for patients with limb fractures to prevent secondary injuries; The severed limb should be preserved at low temperature for replantation. Tension pneumothorax should be punctured and decompressed immediately to prevent interference with breathing and circulation.
Main points of observation on emergency treatment of multiple injuries
1. Observe the patient's head injury, consciousness, pupil, complexion, vital signs and active bleeding.
2. Observe whether the patient's respiratory tract is unobstructed and whether there is tension pneumothorax or open pneumothorax.
3. Observe whether the patient has intra-abdominal bleeding and visceral injury.
4. Observe whether the patient has urinary system injury, hematuria, abdominal pain, etc.
5. Observe whether the patient has bone trauma, pelvic and spinal fractures and limb fractures.
6. Check whether the patient has a large area of panel avulsion injury.
Main nursing problems and related factors in first aid of multiple injuries
1. Impaired gas exchange: related to pain, chest injury and limited chest activity.
2, lack of body fluids: related to massive bleeding and decreased blood volume.
3, pain: related to tissue damage.
4. Anxiety and fear: It is related to sudden and strong accidental injuries.
5. Risk of infection: related to hematoma and tissue necrosis.
Nursing measures of main nursing problems in first aid of multiple injuries
1, gas exchange damage:
1 immediately wrap the affected area with a thick dressing. If it is an open pneumothorax, seal the wound with vaseline gauze.
2 keep the respiratory tract unobstructed to prevent suffocation. Encourage and assist patients to maintain their functions and remove blood, phlegm and vomit in the oral cavity and respiratory tract in time.
3 give a large flow of oxygen inhalation, prepare an aspirator at the bedside, and give sputum aspiration in time when the sputum is thick and difficult to cough up or there is a blood clot blockage.
Watch your breathing carefully. If you have difficulty breathing, obstruction or suffocation, intubate immediately, cut the trachea if necessary, and use a ventilator to assist breathing.
2. Insufficient body fluid:
1 Establishing venous access quickly and supplementing effective circulating blood volume are important measures for rescue and the key to anti-shock. More than two effective venous access should be established immediately, and blood type examination and cross matching should be carried out. For those who may go into shock, speed up the drip.
2 control bleeding, patients with active bleeding should quickly find out the cause and stop bleeding.
On the premise of monitoring the central venous pressure, replenish the amount of liquid and maintain the balance of water, electrolyte and acid-base.
Follow the principle of diagnosis while treating, treatment first and diagnosis later, and make good preoperative preparation while resisting shock.
5 Close observation of vital signs, attention to consciousness, pupil, chest, abdomen and limb activities, and timely detection of injured parts.
6 indwelling catheterization, recording 24-hour urine volume, observing whether there is hematuria, microcirculation perfusion, heart and kidney function, etc.
3. Pain:
1 closely observe the patient's vital signs, 15~30 minutes to measure pulse, respiration and blood pressure 1 time.
2 Observe the location and nature of the patient's pain, and give painkillers according to the doctor's advice if the diagnosis is clear.
4. Anxiety and fear: communicate with patients more, introduce the illness well, explain the necessity of various diagnosis, treatment and nursing operations, and explain the causes, duration and prognosis of various symptoms and discomfort.
5. Risk of infection:
1 closely observe the changes of body temperature, and report to the doctor in time if there is any abnormality.
Cooperate with the doctor to debride, suture and bandage the wound in time, and pay attention to aseptic operation.
3. Rational use of antibiotics according to doctor's advice.
4 open wounds should be injected with tetanus antitoxin.