traumatic asphyxia
Introduction
Introduction to traumatic asphyxia Traumatic asphyxia is caused by severe chest crush injury, which accounts for about 2% to 8% of chest injuries. In the moment of chest compression, the glottis suddenly closes, the air in the airway and lungs can not overflow, and the pressure in the chest rises suddenly, forcing the venous blood flow back to the upper body, causing the capillaries of the head, shoulder and upper thoracic tissue to rupture. The blood overflows, causing punctiform bleeding. Patients are often associated with other chest injuries: multiple rib fractures, pneumothorax, hemothorax or heart contusion. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific people Mode of infection: non-infectious Complications: blood gas chest rib fracture
Cause
Traumatic asphyxia
Common causes of injury include tunnel collapse, house collapse and vehicle crushing. When the chest and upper abdomen are subjected to strong compression, the glottis suddenly closes, and the air in the trachea and lungs cannot overflow. As a result of the action, the intrathoracic pressure suddenly rises, and the heart and large veins are compressed. Due to the lack of a venous valve in the superior vena cava system, this sudden high pressure causes the right heart blood to flow backwards, causing excessive filling of the veins and stasis of the blood, and a wide range of capillaries. Rupture and punctate hemorrhage, even rupture of small veins.
Prevention
Traumatic asphyxia prevention
Simple traumatic asphyxia has a good prognosis, skin bruising and bruising, and subconjunctival hemorrhage can be absorbed within 1 to 3 weeks. Severe intrathoracic and craniocerebral injuries can be life threatening.
Complication
Traumatic asphyxia complications Complications, blood, thoracic rib fracture
Traumatic asphyxia may coexist with other concomitant injuries, such as rib fractures, blood pneumothorax, heart contusions, and easily overlooked spinal fractures.
Symptom
Traumatic asphyxia symptoms Common symptoms Shock dizziness, convulsions, coma, spotting, dyspnea, dyspnea, reflexes, multiple rib fractures, visual impairment
Traumatic asphyxia is more common in adolescents and children with better thoracic elasticity, most of which are not associated with chest wall fractures, but when the external force is too strong, in addition to sternal and rib fractures, it may be accompanied by intrathoracic or intra-abdominal organ damage, and Difficulty in breathing or shock can occur in the spine and extremities.
(1) The disease manifests as subcutaneous tissue in the head, neck, chest and upper limbs, hemorrhagic silage or ecchymosis in the oral mucosa and conjunctiva. In severe cases, the skin and conjunctiva are purple-red and edema, so some people call it "traumatic cyanosis" or "crush injury purpura syndrome", so patients have a history of closed chest and upper abdominal crush injury, the wounded may have chest tightness, difficulty breathing and blood in the sputum, often accompanied by multiple rib fractures Pneumothorax or hemothorax, severely injured can even suffocate, sudden cardiac arrest.
(2) When there is bleeding in the deep tissue of the eyeball, the eyeball can be convex, and the retinal blood vessel can cause visual impairment or even blindness when it ruptures.
(3) Intracranial slight punctiform hemorrhage and cerebral edema produce hypoxia, which can cause transient disturbance of consciousness, dizziness, head swelling, irritability, a few limb convulsions, increased muscle tone and hyperreflexia. The pupil can be enlarged or reduced, causing hemiplegia and coma if an intracranial hematoma occurs.
Examine
Traumatic asphyxia
X-ray
It is an important means to diagnose pulmonary contusion. It changes about 70% of cases within 1 hour after injury, and 30% of cases can be delayed to 4 to 6 hours after injury. The range can be from small confined area to one side or both sides. Spotted infiltration, diffuse or local spot fusion infiltration, so that diffuse single lung or double lung infiltration or solid shadow, after treatment generally begins to absorb 2 to 3 days after injury, complete absorption takes 2 to 3 weeks or more.
CT examination
A new pathological view of the lung contusion is presented. The contusion shown on the X-ray film is a lung parenchymal laceration and a piece of alveolar blood around the laceration without pulmonary interstitial damage.
Diagnosis
Diagnosis and diagnosis of traumatic asphyxia
Traumatic asphyxia is special, easy to diagnose, once seen, never forgotten.
