Traumatic asphyxia

Traumatic asphyxia occurs when the compression of the whole trunk, abdomen , and especially the chest. Outwardly manifested by a sharp posinenie skin and mucous membranes of eyes and mouth, and neck and shoulder area with the advent of many point hemorrhages; accompanied by shortness of breath, pain in the chest, armpits, in the young. Consciousness is saved. Develop disorders of hearing, vision, voice loses sonority. swallowing difficult, cough with bloody sputum. Auscultation of the lungs are determined moist rales, could rapidly develop pneumonia. Often marked broken ribs, pelvis, spine. The course and outcome of asphyxia depend on serious injuries and complications. In uncomplicated cases, recovery occurs in 2-3 weeks. During this period disappear cyanosis and hemorrhage.
Treatment of symptomatic, mainly antishock therapy (see Shock). Necessary measures to restore normal breathing, and improves the function of the cardiovascular system. Reasonable car-sympathetic blockade 1/4% solution novokaina (see Blockade procaine), anesthesia places fractures. The patient should be ensured peace; shows inhalation of oxygen, the introduction of anaesthetics, blood transfusion. When life-threatening injuries of internal organs - operative treatment.

Traumatic asphyxia (asphyxia traumatica; synonym congestive hemorrhage) - pathological condition that occurs immediately after a strong compression of the chest, abdomen, or the entire body. In appearance the victim reminds the patient deep asphyxia, accompanied by cyanosis (hence the synonym main title). Occurs in approximately 1% of cases specified damages.
Compression of the chest leads to increased intrathoracic pressure and compression intrathoracic pressure, particularly veins. In the system of the upper Vena cava is the rapid pressure increase up to capillary network, leading to reverse the flow of the blood. In mild cases occurs capillary stasis, heavy - restretching gap and venules and capillaries with hemorrhages, most prominent on the face, neck, chest.
In a cavity of a skull swelling and haemorrhages are rare because of back bone of the skull and brain membranes. Not is visible to the eyes of the changes and on the skin, pressed down, for example, braces or straps of a bra, and areas pressed at the time of compression. Congestion on the lower extremities never occur (the action of the power of the femoral veins valves).
The basic pathoanatomical a sign of traumatic asphyxia is the "athematically or cyanotic mask".
The brain, as a rule, is unchanged; sometimes there hyperemia, and even bleeding under the meninges. In the lungs - telegraficheskie field with protein soaking and expressed plethora of capillaries ("variegated red light"). Gleams of bronchi in these areas Delavigne contain bloody sputum.
Heart sometimes expanded. In the abdominal cavity - subserous bleeding, sometimes breaks individual organs.
Clinically - consciousness in cases of "pure" (without a concussion) traumatic asphyxia saved. Patient agitated or slowed down. Shortness of breath, chest pain and so-called valve pain in the armpits and young (restretching venous valves). On the head, neck and the upper part of the chest - diffuse swelling and sharp cyanosis (from purple-red to almost black color) with a clear, but not symmetric boundary. Zianoticnae does not disappear when pressed. The eyelids and eye and swollen, with subconjunctival hemorrhages in the form of a wedge with the tip at the outer corner of the eye. In some cases, exophthalmos, others swelling century (the inability to open the eyes). Pupils dilated, weak react to light. Ears lowered, beginning sometimes missing. The eardrum giperemiei, with point hemorrhages; in the ear passages is the blood. On the mucous membranes of the mouth and nose - drain and dotted haemorrhage. Swallowing difficult, the voice of the first days hoarse, may even be absent. In light - bubble wheezing; cough with bloody sputum; 3-4-day - often quickly passing contusion pneumonia.
In case of compression of the abdominal organs are gastrointestinal bleeding, venous stagnation, albuminuria. Women may come premature menstruation. Frequent fractures of the ribs, collarbones, blades, rarely pelvis, spine; sometimes there are extensive damage to the muscles. When rupture of internal organs - the corresponding symptoms.
The course and outcomes depend on serious injuries and complications. In uncomplicated cases, recovery occurs in 2-3 weeks. For the same term is liquidated cyanosis. Bleeding in the mucous membranes dissolve in 1-1,5 months. Persistent violations of sight, hearing, speech rare.
The treatment is symptomatic. The main attention is paid to the fight against shock, restore normal breathing, and improves the function of the cardiovascular system.
Patients need peace, warm, oxygen therapy, use of painkillers. Especially shown vagosimpatical blockade and anesthesia fractures. Appropriate blood transfusion, protivosokovh liquids and vitamin therapy.
When life-threatening injuries of internal organs - operative treatment. Cm. also Traumatic toxicosis.