Injuries to the chest and abdomen: emergency child care

A child may be injured in the chest and abdomen( abdominal organs) when falling from a height, from a bicycle, in a traffic accident.

Another common reason for such injuries is teenagers' fights. Modern teenagers, brought up on the examples of "cool" movie heroes, straying into packs, form an aggressive, not knowing pity and indulgence crowd, capable of unjustifiably beat and mutilate their victim. As a result of bloody scuffles, traumatologic departments receive children with severe injuries, often leading to disability and a tragic outcome.

It is necessary to be able in time and correctly to render the first first aid and urgent help to the child.

CONTENTS

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Chest injuries

Chest injuries occur most frequently: during the run, the child ran into the doorjamb, struckI side on the corner of a table or desk, falling from the bike, breast touched the steering wheel, and so on. e. there is pain at the site of injury, and sometimes swelling and bleeding. The pain increases with a deep breath, coughing and probing the bruised place. A few days the child will spare the injured half of the chest, wrinkle in the face of awkward movements, but gradually the pain will subside, and after 7-10 days from trauma and traces will not remain.

No special treatment for chest bruises is required.

For strong pains, you can give an analgesic tablet( analgin, aspirin, orthophene, nurofen, efferlangan) and rub the ointment into the place of the bruise( finalgon, indomethacin, dolgite cream).

Fracture of clavicle

Fracture of clavicle in children is one of the most common injuries, representing 13% of limb fractures and yielding only the fractures of the bones of the forearm in frequency. The mechanism of damage may be different, but most often a fracture occurs when it falls on the shoulder or an elongated arm. Depending on the degree of displacement, complete or incomplete( subperiosteal) fractures are distinguished. The latter form is more common in newborns and small children, so it is easy to see.

Age of 2 to 4 years accounted for 30% of clavicle fractures.

Deformation and displacement of with incomplete fractures of clavicles absent or expressed minimally. The function of the hand is retained, only the removal of it above the level of the shoulder-strap is limited. The pains are not expressed, therefore such fractures are often not determined and the diagnosis is made after 10-15 days, when the bone callus is found in the form of a significant thickening on the collarbone.

With complete fractures of the , fragments are displaced, therefore, recognition of the fracture is not difficult.

Treatment consists in comparing the fragments and fixing them in the correct position. Young children are given a dressing of Dezo, pribintovyvaya arm to the body for 7-10 days. Older children need a stronger fixation with the retraction of the shoulder back and lifting of the outer fragments of the clavicle. The growth of the clavicle fragments in older children occurs within 2-3 weeks.

Breast and rib fractures

Breast and rib fractures in infancy are rare, due to the elasticity and good cushioning of the ribbed framework in trauma, and are caused by strong shocks or falls on solid objects. There is a sharp pain, intensified by movement, deep inspiration, palpation of the affected area. Breathing becomes superficial and rapid. The patient takes a forced position, which makes his condition as easy as possible, and tries not to move. In this situation, you deliver it to a traumatologist.

A dangerous complication of rib fracture is damage to the pleura and lung tissue with acute bone fragments and development of pneumo- or hemothorax ( ingress of air or blood into the pleural cavity).This is a serious and life-threatening complication it is important to recognize in the first minutes, as the deterioration develops very quickly. Air and blood, accumulating in the pleural cavity, press the lung upward, turning it off from the process of breathing. Sometimes the air from the pleural cavity falls under the skin, the neck and the chest are inflated, and when the skin is palpated, a sound resembles a creak of the snow. This sign reliably indicates that there is air under the skin. The intact lung works for two, breathing becomes frequent and superficial, the patient feels shortness of breath, lack of air, becomes pale, covered with cold sticky sweat, lips and fingertips turn blue, indicating a respiratory failure. The heart rate increases, and for some time keeps the blood pressure, but soon it falls, and then the development of shock is possible.

The victim needs an immediate surgical operation, without it he will die in a matter of hours.

Penetrating chest wounds

With penetrating chest injuries , affecting the lung tissue, air into the pleural cavity and under the skin comes not only from the respiratory tract, but also from the environment as a result of the sucking action of the chest. Each respiratory movement is accompanied by extraneous sounds arising at the site of injury. And with each breath the patient's condition worsens. Before transporting the patient to a hospital, it is necessary to cover the wound with an airtight bandage( cellophane, oilcloth) in order to avoid air sucking.

If an object sticks out of the wound( knife, screwdriver, scissors), do not remove it.

While it clogs the wound, the risk of developing pneumothorax and bleeding is small. The victim is hospitalized in a semi-sitting or sitting position, so it is easier for him to breathe.

Blunt abdominal trauma

Blunt abdominal injury of the abdomen can be limited to a bruised abdominal wall, and with a strong impact, internal organs( liver, spleen, intestine) may suffer, until they break, accompanied by internal bleeding.

Damage to internal organs is more common in boys, which is the result of their increased activity. The degree of damage to organs depends on their condition at the time of injury. So, a blow to the stomach after a plentiful meal will soon lead to a rupture of the hollow organ, than a blow of the same strength, but applied to an empty stomach. If the abdominal press is well developed, then at the time of impact muscle tension will protect internal organs from extraneous exposure.

Probability of internal bleeding

Internal bleeding does not always occur immediately. Sometimes after an injury the child rises to his feet and does not complain, and the palpation of the abdomen reveals neither the tension of the abdominal wall, nor the soreness. However, the child should be monitored because the symptoms of internal bleeding build up within a few hours. There is weakness, lethargy, pallor, sometimes nausea and vomiting. When the hollow organ ruptures, the child complains of severe pain throughout the abdomen, repeated vomiting is almost constant. The clinical picture corresponds to peritonitis.

Liver or spleen ruptures

If an ruptured the liver or spleen , the pain is not severe, and vomiting occurs on the second or third day after the injury. Even more insidious are the subcapsular ruptures of the liver and spleen. There was a rupture of the organ and bleeding from it, but the capsule was not damaged, so the blood accumulates beneath it, and there is no evidence of internal bleeding. The child continues to lead an active lifestyle, and suddenly after a few days, unexpectedly after a sharp movement, the capsule bursts and the blood flows into the abdominal cavity. Therefore, with closed abdominal injuries, a surgeon's consultation is necessary, and in some cases, dynamic monitoring of the child in a hospital.

Penetrating abdominal trauma

Penetrating wounds of the abdomen are always a reason for hospitalization in the surgical department. On the need to leave a foreign object in the wound, which was the cause of injury, we have already said more than once. So in a panic state, do not pull the knife out of the wound. Apply a pressure bandage and take the child to the hospital. During transportation, the victim must lie with his legs raised.