Ministry of Health of Ukraine Ukrainian Medical stomatological Academy It is ratified On meeting department Of accident aid and military medicine «___»_____________20 __y. Protocol №_____ Manager of department DMSc ., assistant professor __________К. Shepitko METHODICAL INSTRUCTION FOR INDEPENDENT WORK OF STUDENTS DURING PREPARATIONS FOR THE PRACTICAL LESSON Educational discipline «Emergency First Aid» Module № 1 Emergency and Combat First Aid Topic 4 Types of Combat and Non-combat Injuries. First Aid in Wounds, Fractures, Lyxations and Strains Types of damage in combat and non- Lesson 6 combatconditions.premedical care for wounds ,fractures,dislocations,sprains.Premedical care for wounds. Сourse ІІ Foreing students training dentistry Faculty Training of specialists of the second (master) level of higher of education (название уровня высшего образования) Areas of knowledge _______ 22 «Health protection»_________ (шифр и название области знаний) Specialty ________222 «Medicine», 221 «Stomatology»________ (код и наименование специальности) Poltava 2019 Relevance of the topic: The skin protects a person from negative external influences (friction, germs, stretching, pressure) and dehydration. It is rich in nerve endings and nerve fibers, which provide its sensitivity. Therefore, the skin should be carefully protected from injuries. Specific objectives: Know the causes and signs of soft tissue wounds, penetrating and non-penetrating wounds of the skull, chest, abdomen. Protect soft tissue wounds by applying dressings. The technique of applying bandages for injuries to the skull, eyes, ears, lower jaw. Features of a chest wound, the concept of pneumothorax. Domestic care for open and intense pneumothorax. The specificity of dressings for penetrating wounds of the abdomen. Features of dressings in the presence of a foreign body in the wound. Basic knowledge, skills needed to study the topic (interdisciplinary integration): Name of previous disciplines Acquired skills 1. human anatomy Anatomy of the head and neck, anatomy of the chest, abdomen, pelvis and limbs. Anatomy of the vascular system. 2. Normal physiology Physiological basis of the functioning of the respiratory system. Tasks for independent work in preparation for the lesson and in the lesson: 1. Protection of wounds. 2. The technique of applying bandages for injuries to the skull, eyes, ears, lower jaw. 3. Wounds of the chest. 4.Features of applying bandages for penetrating wounds of the abdomen. 5. Bandages in the presence of a foreign body in the wound. The list of basic terms, parameters, characteristics that a student must learn in preparation for the lesson: Term Definition 1.Wound violations of the integrity of the skin or mucous membranes with possible damage to the surrounding tissue. 2. Closed pneumothorax the accumulation of air in the pleural cavity, accompanied by atelectasis and termination of ventilation. 3. Open pneumothorax the accumulation of air in the pleural cavity in the presence of a gaping wound and a constant suction of air in the respiratory excursions of the thorax. 4. Valve stress pneumothorax the growing accumulation of air in pleural cavity, accompanied by progressive compression of the lung with a damaged 2 hand, and compression of the opposite lung, displacement of mediastinum to the healthy side 5. A puncture wound arises from the action of the knife, bayonet, blade sharpening, sewing, spades. These wounds have a small outer size and a large depth. Sometimes these wounds are through and through. 6. Gunshot wound occurs as a result of the bullets of firearms. Such a wound is a wound channel filled wound detritus, and foreign bodies. Has a zone of traumatic necrosis of the tissues, as well as the zone of molecular concussion. 7. The phase of inflammation characterized by exudation, the development of an inflammatory edema, necrolysis, hydration. 8. Proliferation phase is characterized by a predominance of restorative, regenerative processes, the formation of granulation tissue dehydration. 9. Healing phase it is the maturation of scar tissue and epithelialization of the wound. Theoretical questions for the lesson: Theoretical questions for the lesson: 1. Causes and signs of soft tissue wounds, penetrating and non-penetrating wounds of the skull, chest, abdomen. 2. Features of combat injuries. 3.Protection of wounds. 3. The technique of applying bandages for injuries to the skull, eyes, ears, lower jaw. 4. Injury to the chest. 5. Features of applying bandages for penetrating wounds of the abdomen. 6. Bandages in the presence of a foreign body in the wound. Practical work (tasks) that are performed in class: 1. Diagnosis of soft tissue wounds. 2. Diagnosis of penetrating wounds. 3. The technique of applying dressings to various parts of the body. 4. Technique of a puncture of the chest with intense pneumothorax. 5. The technique of applying various types of occlusive dressings. 6. The technique of applying bandages with an extraneous body in the wound. The content of the topic: The concept of wounds: definition, classification. 3 A wound is a lesion characterized by a violation of the integrity of the skin, mucous membranes, and sometimes deep tissues, which is accompanied by pain and bleeding. By their origin, wounds are gunshot, chopped, chopped, chopped, clogged, torn, bitten, operating. Surface and penetrating wounds are also distinguished (when the inner membranes of the abdominal, chest, and other cavities are damaged). A wound is a violation of the integrity of the skin or mucous membrane with possible damage to surrounding tissues. Wound Classification: 1. By the nature of the action of the subject, which injured, wounds are: - a stab wound arises from the action of a knife, bayonet, sharpening, awl, peaks. These wounds have small external dimensions with great depth. Sometimes such wounds are through. Due to the large depth of damage, internal bleeding and damage to internal organs can occur inside, which makes these wounds difficult to diagnose and especially dangerous from this. Also the risk of infection; - a cut wound has equal intact edges and sometimes a considerable length. They bleed a lot. They arise as a result of the action of a knife, a scalpel; - the chopped wound is very similar to the cut, but the damage is much more extensive. Sometimes there is a collapse of soft tissues, crushing and bone fractures. Arise as a result of the action of the ax, saber; - a bruised wound occurs due to the impact of a blunt object (pipe, hammer, ax butt, etc.), when falling from a height. Due to damage to the vessels around the wound and their blockage, the nutrition of the edges of the wound with blood is disturbed and, as a result, their death. Do not underestimate the danger - such wounds are easily infected, which can cause a large infection; - crushed occurs as a result of limbs between moving parts; - laceration is characterized by torn pieces of tissue, uneven edges, damage to muscles, tendons, peeling of skin; - a scalped wound occurs as a result of a blow with a sharp object, moves tangentially to the surface of the skin. The peculiarity of this wound is that significant skin defects are formed, which leads to prolonged healing; - bitten occurs when a bite of animals, humans. The wound is deep, lacerated, with the presence of saliva, usually massive infection is characteristic; - a gunshot wound occurs due to the action of a bullet of a firearm. Such a wound has a wound channel filled with wound detritus, foreign bodies. It has a zone of traumatic tissue necrosis, as well as a zone of molecular concussion. Such wounds are very infected. There are stupid (when the bullet remained in the body) and penetrating (on the fly) wounds. Through wounds are characterized by the presence of an outlet, which is always larger than the inlet. Depending on the type of bullet and the firing distance, the wound channel may not be straight and cause great damage. Sometimes the outlet may be located on the side of the inlet (wounds to the head, chest, or abdomen with bulletproof vest). The inlet is characterized by the presence of so-called circle dots around the wound, black. The caliber of the weapon is determined from this trace (the size of the wound itself is usually smaller). A bullet can attract particles of clothing and equipment to the wound, which in turn can lead to infection; - poisoned wound occurs under the influence of toxic substances: organophosphorus substances, acids, alkalis. 2. According to the degree of pollution: 4 - aseptic (surgical wound); - contaminated with microbes (a wound formed in non-sterile conditions or applied in everyday life, at work, etc.) 3. The depth of damage: - surface - permeable - through - tangent - blind 4. By the nature of healing: - healing by primary intention itself is observed with incised wounds, when the walls and edges of the wound are connected to each other, when surgical wounds are sutured. In this case, the wound walls stick together, stick together among themselves due to the fibrin film. The primary tension during wound healing is characterized by irrigation of the edges of the wound without macroscopically visible intermediate tissue. Such healing is possible with a complete and close connection of the edges of the wound, but without tension of the tissues, in the absence of infection in the wound, in the absence of a hematoma, while maintaining the vitality of the edges of the wound, in the absence of foreign bodies, infected bodies and foci of necrosis; - healing under a scab - when a wound defect is covered with a crust (scab), which consists of blood, lymph, interstitial fluid. The scab performs a protective, barrier function, under it there is a reparative process due to the formation of granulation tissue and regenerating epidermis. After ettalization, the scab disappears. These types of healing do not have a qualitative difference between themselves, the wound healing process goes through all phases of development, the same cell cultures participate in regenerative processes.