Treatments for Automobile accidents injury
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Blunt and penetrating abdominal injuries:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Emergency treatment of abdominal injuries controls hemorrhage and prevents hypovolemic shock through the infusion of I.V. fluids and blood components. After stabilization, most abdominal injuries require surgical repair; some patients, however, require immediate surgery. Analgesics and antibiotics increase patient comfort and prevent infection. Most patients require hospitalization; if they’re asymptomatic, they may require observation for only 6 to 24 hours.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Spinal injuries:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The primary treatment after a spinal injury is immediate immobilization to stabilize the spine and prevent cord damage; other measures are supportive. Cervical injuries require immobilization, using a type of cervical immobilization device (CID) on both sides of the patient’s head, a hard cervical collar, or skeletal traction with skull tongs or a halo device.
Treatment of stable lumbar and dorsal fractures consists of bed rest on firm support (such as a bed board), analgesics, and muscle relaxants until the fracture stabilizes (usually in 10 to 12 weeks). Later measures include exercises to strengthen the back muscles and use of a back brace or other device to provide support while walking.
An unstable dorsal or lumbar fracture requires a plaster cast, a turning frame and, in severe fracture, a laminectomy and spinal fusion.
When the spinal injury results in compression of the spinal column, neurosurgery may relieve the pressure. If the cause of compression is a metastatic lesion, chemotherapy and radiation may relieve it. Surface wounds accompanying the spinal injury require tetanus prophylaxis unless the patient has been immunized recently.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Traumatic amputation:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Because the greatest immediate threat after traumatic amputation is blood loss and hypovolemic shock, emergency treatment consists of local measures to control bleeding, fluid replacement with normal saline solution and colloids, and blood replacement as needed. Reimplantation remains controversial, but it’s becoming more common and successful because of advances in microsurgery techniques. If reconstruction or reimplantation is possible, surgical intervention attempts to preserve usable joints.
When arm or leg amputations are done, the surgeon creates a stump to be fitted with a prosthesis. A rigid dressing permits early prosthesis fitting and rehabilitation.
ELDER TIP Leg amputation can be a life-threatening procedure, especially in patients older than age 60 with peripheral vascular disease. Such patients suffer significant morbidity with above-the-knee amputations because of associated poor health, disease, or malnutrition; complications such as sepsis; and the physiologic insult of amputation.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Amputation, traumatic:
Treatment
(Handbook of Diseases)
Because the greatest immediate threat after traumatic amputation is blood loss and hypovolemic shock, emergency treatment consists of local measures to control bleeding, fluid replacement with normal saline solution and colloids, and blood replacement as needed.
Reimplantation remains controversial, but it’s becoming more common and successful because of advances in microsurgery. If reconstruction or reimplantation is possible, surgical intervention attempts to preserve usable joints. When arm or leg amputations are done, the surgeon creates a stump to be fitted with a prosthesis. A rigid dressing permits early prosthesis fitting and rehabilitation.
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Source: Handbook of Diseases, 2003
Spinal injuries:
Treatment
(Handbook of Diseases)
The primary treatment after spinal injury is immediate immobilization to stabilize the spine and prevent cord damage; other treatment is supportive. Cervical injuries require immobilization, using sandbags on both sides of the patient’s head, a hard cervical collar, or skeletal traction with skull tongs or a halo device. When patients show clinical evidence of cord injury, high doses of methylprednisone are started.
Supportive treatment
Treatment of stable lumbar and dorsal fractures consists of bed rest on firm support (such as a bed board), analgesics, and muscle relaxants until the fracture stabilizes (usually 10 to 12 weeks). Later treatment includes exercises to strengthen the back muscles and a back brace or corset to provide support while walking.
An unstable dorsal or lumbar fracture requires a plaster cast, a turning frame and, in severe fracture, laminectomy and spinal fusion.
Other treatment
When the damage results in compression of the spinal column, neurosurgery may relieve the pressure. If the cause of compression is a metastatic lesion, chemotherapy and radiation may relieve it. Surface wounds accompanying the spinal injury require tetanus prophylaxis unless the patient has had recent immunization.
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Source: Handbook of Diseases, 2003
Battle's sign:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Assess the patient’s neurologic function frequently. Keep him in a supine position to decrease pressure on dural tears and to minimize CSF leakage. Avoid nasogastric intubation and nasopharyngeal suction, which may cause cerebral infection. Also, caution the patient against blowing his nose, which may worsen a dural tear.
The patient may need skull X-rays and a CT scan to help confirm a basilar skull fracture and to evaluate the severity of the head injury. Typically, a basilar skull fracture and associated dural tears heal spontaneously within several days to weeks. However, if the patient has a large dural tear, a craniotomy may be necessary to repair the tear with a graft patch. If the injury was due to abuse, notify the appropriate authority in the facility.
Patient teaching
Explain all procedures and tests. Inform the patient with a basilar skull fracture that he’ll require bed rest for several days to weeks. Explain the need to avoid placing pressure on the brain tissue, and advise him on proper positioning. Also tell him to refrain from blowing his nose.
If the injury was due to an accidental fall, advise the patient’s family to assess the household for safety hazards and remove precipitating factors such as throw rugs.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Battle's sign:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Explain activity restrictions and the need for bed rest to the patient. Provide emotional support to the patient and his family. Caution the patient against blowing his nose, which may worsen a dural tear.
Before discharge, instruct the patient’s family or caregiver to watch closely for changes in mental status, LOC, or respirations. Tell them to give the patient acetaminophen if he experiences headaches.
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Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Battle's sign:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Expect a patient with a basilar skull fracture to be on bed rest for several days to weeks. (See Managing the patient with a basilar skull fracture.)
▪ Monitor his neurologic status closely.
▪ Anticipate that the patient may need skull X-rays and a computed tomography scan to help confirm basilar skull fracture and to evaluate the severity of head injury.
▪ Although a basilar skull fracture and associated dural tears typically heal spontaneously within several days to weeks, if the patient has a large dural tear, a craniotomy may be necessary to repair the tear with a graft patch.
Patient teaching
▪ Explain activities the patient should avoid, and emphasize the importance of bed rest.
▪ Explain to the patient and family the signs and symptoms to look for and report, such as changes in mental status, LOC, or breathing.
▪ Tell the patient to take acetaminophen for headaches.
▪ Explain what diagnostic tests the patient may need.
▪ Discuss surgery with the patient, if indicated, and answer his questions and concerns.
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Source: Nursing: Interpreting Signs and Symptoms, 2007
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