Critical states in case of trauma, their control and care at pre-hospital and early hospital stages (lecture)

In all countries of the world, there is an increase in injuries. In Ukraine, it is due to the military conflict and the increase in road traffic injuries. According to the World Health Organization, the annual increase in patients with brain injuries has increased by 2% in recent years. Ukraine is a leader in the number of people injured and killed in road traffic accidents. Over the past 5 years, more than 170 thousand road accidents have been registered. In the overall structure of injuries, brain injury accounts for 30 to 50%, and in the mortality structure it ranks 3rd, behind cardiovascular diseases and neoplasms. Traumatic shock occurs in severe injuries and traumas in 1/3 of the injured with an overall mortality rate of up to 7.4%. The impairment of vital functions in brain injury is prolonged, avalanche-like in phase and has a specific pathogenesis associated mainly with hypovolaemia (bleeding): external, intrathoracic, intra-abdominal. The most objective indicators of blood loss are: haematocrit (30–35%), Altgower shock index, haemoglobin level, hourly diuresis, disturbance of consciousness and mental state.

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