Damage, or injury, called the impact on the human environment (mechanical, physical, chemical, radioactive, X-rays, electricity, etc.) That violates the structure and integrity of the tissue and the normal course of physiological processes.
Depending on character of the injured tissue distinguish skin (bruises, wounds), hypodermic (ruptures of sheaves, fractures of bones and so forth) and band (bruises of hemorrhage, wound of a breast, stomach, joints) damages.
Damages share on direct and indirect, depending on a point of application of force. They can be single (for example, a cross fracture of a femur), multiple (a multiple fracture of edges), combined-1 (a fracture of bones of a basin with a rupture of a bladder) and combined-2 (a fracture of a hip and freezing injury of foot, etc.).
Action of the mechanical factor causing damages is shown in the form of compression, stretching, a gap, twisting or against blow as a result of which the tissue site opposite to force place of application is injured.
Injuries happen opened, to integrity violation, and closed when change of fabrics and bodies happens at the uninjured skin and a mucous membrane.
Traumatism — set of the injuries which have arisen in a certain group of the population for a certain interval of time. The largest level of traumatism is noted at men at the age of 20-49 years, and women have 30-59 years, and in all age groups this indicator is much higher at men.
1.2 Types of traumatism, division on industrial and non-industrial.
As injury severity they are divided into heavy, injuries of average complexity and minor injuries.
Heavy injuries – injuries is causing pronounced impairments and resulting in the loss of educational and athletic ability to work for a period over 30 days. Injured hospitalized or treated for a long time at the Children’s Orthopaedic Trauma in specialized departments or outpatient.
Injury of average complexity – it traumas with pronounced changes in the body, leading to educational and sports disability for a period of 10 to 30 days. Children with sports injuries of moderate severity should also be treated at the Children’s Orthopaedic Trauma.
Minor injuries – a trauma that do not cause significant disturbances in the body and loss of general and athletic performance. These include bruises, abrasions, superficial wounds, minor injuries, stretching, 1 st degree, etc., In which the student needs to provide first medical aid. Perhaps a combination of a prescribed treatment (up to 10 days) with the training and employment of reduced intensity.
Furthermore, there are acute and chronic injuries.
Acute injuries occur as a result of sudden impact of a traumatic factor.
Chronic injuries are the result of repeated action of the same traumatic factor on a particular area of the body.
There is another kind of trauma – microtrauma. This damage produced by cells of tissues as a result of one-time (or often damaged) exposure, slightly exceeding the limits of physiological resistance of tissue and causing a violation of their functions and structure (long-term burden on the fragile organism of children and adolescents).
Sometimes there are allocated very slight injuries (with no loss of disability sports) and very severe injuries (leading to disability sport and deaths).
Division of injuries on industrial and non-industrial.
– Transport and others.
– Road traffic,
– Children and others.
2.1 Reasons for industrial traumatism.
Industrial injury – injury received working in the production of non-compliance and the resulting safety requirements.
Reasons for industrial injuries are:
Organizational: shortcomings in the organization and content of the workplace, the use of improper methods of work, lack of supervision of the work, for the observance of safety regulations, permit to work untrained workers, the poor organization of the labor process, the absence or failure of individual protective devices.
Technical: arise because of imperfection of technological processes, design defects, equipment, appliances, tools, inadequate safety devices, alarms, locks, etc.
Hygiene: No special clothing and shoes or defects, improper lighting jobs, extremely high or low temperature air in the cleanroom, industrial dust, inadequate ventilation, clutter and contamination of the production area.
Socio-psychological: Their relationships to collective security, the microclimate in the team
Climate: Climate depends on the specific features, time of day, the working conditions.
Biographical: associated with gender, age, experience, qualification, health condition.
Psychophysiological: depend on the characteristics of attention, emotions, reactions, physical and neuro-psychological overload.
Economic: caused by the rhythm of work, violation of terms of payment of wages, shortcomings in living conditions, to provide childcare facilities.
- Prevention and ways to prevent industrial traumatism.
There are two main methods of prevention of industrial injuries: a retrospective and predictive.
Retrospective methods (statistical, monographic, topographic) require the accumulation of data on accidents. Herein lies one of the major drawbacks.
Prognostic methods allow to study the danger on the basis of logical and probabilistic analysis, safety regulations, expert opinions, special experiments.
Ways to prevent industrial injuries is the number of the measures taken:
– Mechanization, automation and remote control of processes and equipment, the use of robots;
– Human adaptation to the production environment to the working environment;
– Professional selection of people, appropriate training conditions;
– Education of positive attitudes towards OSH;
– Rewards and incentives system, disciplinary action, the use of personal protective equipment, etc .;
– The creation of safe equipment, machinery and technology, protection means and tools, optimizing their production environment settings.
- Non-industrial traumatism.
3.1 Household traumatism, its prevention.
Personal injury include accidents arising out of communication with the affected industrial activity – in a house, apartment, in the yard, etc. This includes accidents arising out of communication with the affected industrial activity – in a house, apartment, in the yard, own garage, etc. Household injuries are very high and does not tend to decrease. The leading cause of these injuries (about a third of cases) is doing homework -cooking, cleaning and repair facilities, etc. Among the injuries predominate bruises, wounds, burns, etc. The most commonly damaged by the brush. About a quarter of household injuries occur when falling in the courtyard of the apartment, and so on. D. Less damage produced in a variety of consumer excesses. In their substantial role belongs to intoxication, especially on holidays and weekends. Personal injury in men occur 3-4 times more often than women, and in individuals 18-25 years, they occur 4-5 times more often than in men 45-50 years of age.
Below are the main measures for the prevention of household traumatism:
– Improvement of living conditions;
– Extension of public services to the population;
– Rational organization of leisure;
– Carrying out a variety of cultural events;
– A broad anti-alcohol propaganda;
– Purposeful work to create a healthy life;
– Organization at housing offices of special commissions to combat domestic injury;
– Broad public involvement.
3.2 Road traffic traumatism: causes of death and traumatism of people on the roads.
Road traffic injuries are inflicted various kinds of vehicles using them (movement) in cases not related to production activity affected, regardless of the location of the victim at the time of the accident in the vehicle (driver, passenger) or outside (pedestrian). The vehicle is considered to be any means used for transportation of goods, objects, people (car, motorcycle, bicycle, airplane, boat, trolley, tram, train, horse-drawn carts, and so on.). Injuries in road traffic accidents due to the large complex of reasons. Injured in an accident are often disabled.
Among the causes of deaths and injuries of people on the roads experts admit negligence in the observance of traffic rules:
– Over speed;
– Running a red color;
– Driving under the influence of alcohol;
– Not wearing a seat belt;
– Crossing the street in the wrong place and at a red light, etc.
The greatest number of road accidents occurs in the winter and in the early autumn months. Road traffic injuries are becoming more frequent in the last days of the week and in the afternoon. Less commonly, they occur at night, but their effects are much harder. In the cities, the main cause of traffic injury is considered to run over pedestrians, mainly passenger cars on the road is dominated by the collision of road transport. In rural areas, traffic accidents are more related to motorcycle and truck transport. The fight against road traffic injuries and their consequences – one of the most acute problems. In our country, provided the implementation of national measures aimed at the prevention of traffic accidents; improvement of the state system of medical assistance to victims of road accidents and increasing research in the field of road safety.
3.3 The reasons of street traumatism.
By the street include injuries suffered outside the production activities on the streets, in open public places, in the field, in the forest and so on., Regardless of their causes (except vehicles). They are connected with the fall (especially during icy conditions), so their number is significantly increased in the autumn-winter period. It reveals the dependence of this type of injury on time of day. In the fall of the people on the streets of bone fractures occur in 68-70% of cases, bruises and sprains in 20-22% of soft tissue injury in the 4-6%. Mainly damaged limbs (83-85%).
The reasons of street traumatism:
– Poor organization of traffic,
– Narrow streets with heavy traffic,
– The lack of lighting and signaling;
– Violation of traffic rules by pedestrians;
– A fault condition street pavements, ice, etc.
3.4 Child traumatism: the houshold and the school, causes.
Injuries children worldwide become a major concern of a wide range of people and workers of various specialties. At the present time from injuries and accidents die many times more children than children from infectious diseases. In the event of damage are essential anatomical and physiological and psychological characteristics of children and their physical and mental development, lack of everyday skills, increased curiosity, and so on. In the analysis of children’s and school accidents take into account that each age group has its own characteristics. It is necessary to teach children how to behave at home, outdoors, in public places, while you exercise. There are the following types of childhood injuries: consumer; Street (transport related, non-transport); school; sports. It’s household injuries are injuries that occur at home, in the yard, in day care centers. The most serious ones are burns (especially in infants) and fractures. Quite often in children from 1 to 3 years meet damage ligamentous apparatus of the elbow as a result of sudden stretching of the child by the hand. Among the reasons for isolated injuries (30-35%), injuries in the fall (22-20%), damage by sharp objects (18-20%), thermal effects (15-17%). Injuries are explained primarily lack of supervision of children.
The reasons for the children’s household traumatism are:
– Improper care and lack of parental supervision;
– The lack of order in the maintenance of buildings Management (unsecured access to the roof, railing unprotected stairwells, open hatches cellars, wells, not fenced while digging trenches, no fences repaired buildings, careless storage of materials at construction sites, and others.);
– Lack of special furniture and fences in apartments, playgrounds, non-flammable clothing;
– Defects in education at home and at school, the lack of proper behavior in public spaces, etc.
Causes of children of school injuries. School traumatism include accidents in students general education day schools of all types (including music, sports, vocational school) arising during the period of their stay in the school (in the classroom, including gym class, at recess, in educational workshops on school grounds). Because of the great congestion, hourly move from class to class, short-change, when children’s energy stored per lesson, splashed out for a few minutes, injuries are inevitable. with students Every fifth injury occurs at school, and 4/5 of them – on the reverse. Child traumatsm prevention today concerned about the whole world.
3.5 Sports traumatisam, its causes and prevention of.
Sports traumatism – accidents arising from sports activities (planning, group or individual, at the stadium, in the sports section, on the sports field) under the supervision of a teacher or a coach. Accidents with students during physical training on the curriculum in this group of injuries are not included. Sports injuries account for 2-3% of all injuries. Most often they arise in the classroom boxing, football, hockey, wrestling, motorcycling, gym. With every sport there are common injuries. So, the players and the players are more often observed damage to the meniscus of the knee joint; skiers and skaters – helical diaphysis fractures shin, ankle and stretching ligament apparatus of the ankle joint. The most common soft tissue injury with a predominance of abrasions and scuffs; fractures do not exceed 3% of the total number of injuries, sprains account for 3-5%. By localizing the largest number of injuries falls on the limbs, followed by the head and body injuries. An objective indicator of the severity of the damage is the duration and resistance losses athletic performance.
The main causes of sport traumatism:
– Irregularities in the organization of training sessions and competitions;
– Unsatisfactory condition of employment places and unfavorable conditions for their implementation;
– The poor state of sports goods and equipment, clothes, shoes;
– The lack of medical supervision;
– Weak physical fitness athlete (long breaks in employment by the lack of systematic training, fatigue, etc…);
– Breach of discipline athletes during training and competition.
The main activities for the prevention of:
– Control over the organization and methodology of training sessions and competitions (especially for beginners). It is very important so-called insurance and assistance in the classroom;
– Technical and hygienic supervision over places of training and competitions, sports equipment, clothing, footwear and equipment athlete. The use of special safety devices (guards, elbow pads, knee pads, wristbands, etc.); protection against adverse weather conditions (heat and sunstroke, frostbite, etc.);
– Medical monitoring of sports. Primary and secondary medical examination before taking part in the competition, before resuming training after the break;
– Education of the athletes discipline, friendly relations, as well as the suppression of all manifestations of indiscipline;
– A mandatory analysis of sports injuries, together with the instructor, coaches, athletes.
- General prevention of traumatism.
Questions traumstism prevention can be successfully resolved with the participation of health workers, as they are responsible for the treatment of patients with injuries, the organization of specialized care to victims, combating the adverse effects of injuries.
The objectives of the health workers in the fight against traumatism are:
– Recording and analysis of all production and non-injury by their nature and location;
– Analysis of the causes and circumstances of the injury, the information of all concerned institutions;
– The development of health, sanitation and hygiene interventions to reduce injuries;
– Constant contact with the safety service enterprises;
– Education of the public methods of self and mutual help;
– Hygienic education of the population and the promotion of healthy lifestyles;
– Monitor the implementation of measures to reduce all types of accidents.
In each case of injury statistical coupon filled on the basis of which in health care facilities make up the “summary sheet accounting of newly diagnosed cases of poisoning accidents and injuries.” Accurate and complete information on injuries – required condition of its effective prevention.
Work on the prevention of occupational injuries is carried out mainly business administration and safety service. It includes respect for the correctness and consistency of production and technological processes, control over the safety of work, timely and high-quality training of workers, promotion of safe working practices, increasing technological literacy of workers, ensuring their individual and collective means of protection, the creation of decent safe workplace, the introduction of automation and mechanization, troubleshooting and design flaws vehicles, machinery and equipment. Sanitation activities should be aimed at eliminating the clutter of jobs and passes on the creation of optimal hygienic conditions – temperature, humidity, light, ventilation, compliance with the rules of industrial hygiene.
Trauma surgeon respective medical institutions visited industrial enterprises attached at least once a quarter. They check compliance with the number of injuries registered service safety data uptake in the affected emergency station, identifying the facts of concealment of occupational injuries, timeliness and completeness of the investigation, the adoption of the necessary measures. Oversee the sanitary posts, the status of first-aid kits to be involved in drawing up comprehensive plans to combat injuries, train health workers in first aid enterprises. Doctors Traumatologists – orthopedists and surgeons are involved in the investigation of the most serious occupational injuries, massive trauma and repetitive trauma that occurred at the same workplace. They spend analysis and comparative assessment of indicators of injury at the enterprise. Check the correctness of medical care for injuries and supervise the work of health education and health promotion.
Traumatism Prevention nonproductive promote legislation on the protection of nature, the environment, fire safety, design and construction, the implementation of sanitary and epidemiological surveillance. Local authorities decide questions of improvement of roads, recreation areas, beaches, courtyards, streets cleaning. Trauma surgeon identify the circumstances of domestic and street injuries, signal the most severe cases, the police agency for housing maintenance, carried out work on health education of the population, aimed at preventing injuries, are introduced to the first aid rules, using for this purpose the media.
Tasks of doctors in the prevention of road traffic injuries are as accurate recording of all traffic injuries with the obligatory indication of the circumstances of injury, providing information about each traffic police handling of victims of transport, organization of health centers in the fleets, conducting pre- and post voyage driver examinations.
Consideration and development of measures to reduce sports injuries conduct medical-sports clinics.
Traumatism – part of the overall morbidity. Among all the causes of primary disability and injury mortality rank third, while the working-age injured persons occupy the first place among the causes of death. The aim of the study is to damage not only treatment of injuries, but also their prevention.
There are injuries production (industrial, construction, agricultural, and others.) And non-manufacturing (home, street, sports, etc.).
The growth of industrial traumatism in most countries due to the development of heavy industry. Organisation of events to prevent it is determined by social and technical factors. Legislatively regimented routine prevention of occupational injuries conducted jointly administration of enterprises, trade unions and health care facilities.
Non-industrial traumatism increased primarily due to the rapid growth in the second half of the 20th century, traffic injuries, which determines the frequency of serious injuries leading to disability and death. The growth of road traffic injuries in a significant percentage of cases associated with the deterioration of the coordination and slower reaction to external influences due to drunkenness, fatigue, illness.
The growth of domestic accidents, particularly among children, is associated with urbanization, the introduction into the life of the mechanical and electrical appliances. Preventive role improving the safety and health education for these types of injuries. Preventing injuries in children and adolescents is complicated by their physical activity and age characteristics of the psyche. In the fight against child injury prevention is very important, ie the proper upbringing of children, explaining the dangers of the games in the street..; the creation of a wide network of playgrounds, parks and gardens; improving urban transport safety (automatic doors, footrests, etc. liquidation. d.). These measures help to reduce the number of injuries among street children. However, the proportion of street injuries among children is still considerable.
Sports injuries are increasing due to the massive spread of sports and increasing training loads; its prevention – educational organization of trainings and competitions, medical control. In our country, where there is a strong development of physical culture and sports, where numerous sports covers a significant part of the population, especially young people, must be very careful to treat this type of injury. Only a careful study of the causes of sports injuries will allow to reduce it as it is not associated with the sport as such, but depends on a number of causes that can be eliminated. These causes can generally be reduced to two groups: the shortcomings and lack of preparation techniques of athletes, poor material conditions in employment. It gives the right to claim that proper organization and preparation of the athletes can be reduced, and this kind of damage to the tiny percentage.
As it turned out a significant role in the prevention of injury, in both the production and non-production, it belongs to health care workers. In front of them a number of tasks, the solution of which helps to reduce injury rates. Also, they provide reliable and complete information on injuries, which is a prerequisite for its effective prevention. A crucial role is played by health professionals in the implementation of qualified treatment suffered from injuries, shorten the duration of temporary disability, disability prevention, reduction
mortality from trauma.
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