Electrical Injury: From 1 Different Sources
Damage to the tissues caused by the passage of an electric current through the body and by its associated heat release. The internal tissues of the body, being moist and salty, are good conductors of electricity. Dry skin provides a high resistance to current flow, but moist skin has a low resistance and thus allows a substantial current to flow into the body. Serious injury or death from domestic voltage levels is thus more likely to occur in the presence of water.
All except the mildest electric shocks may result in unconsciousness. Alternating current (AC) is more dangerous than direct current (DC) because it causes sustained muscle contractions, which may prevent the victim from letting go of the source of the current. A current as small as 0.1 of an amp passing through the heart can cause a fatal arrhythmia. The same current passing through the brainstem may cause the heart to stop beating and breathing to cease. Larger currents, generated by high voltages, may cause charring of tissues, especially where the current enters and exits the body.
An injury to the neck region caused by the neck being forcibly bent backwards and forwards (or the other way around). Car accidents are a common cause, when a driver or passenger is suddenly decelerated. The injury usually affects the ligaments, spinal joints and soft tissues of the neck. Subluxation (partial dislocation) of a cervical joint sometimes occurs and cervical vertebra may occasionally be fractured if the forces are severe. Pain and sti?ness of the neck result and these may worsen after a day or so. Treatment includes immobilisation of the neck in a collar, and analgesic and muscle-relaxing drugs. PHYSIOTHERAPY may be necessary. The patient usually recovers fully but may take several weeks to do so.... whiplash injury
Accidental perforation of the skin by an injection needle, commonly of the hand or ?nger and usually by a nurse or doctor administering a therapeutic injection. The term also refers to accidental injuries from injection needles discarded by drug abusers. Dangerous infections such as viral HEPATITIS or HIV may be acquired from needle-stick injuries, and there are strict procedures about the disposal of used syringes and needles in medical settings.... needle-stick injury
See child abuse.... nonaccidental injury
(RSI) An overuse injury that affects keyboard workers and musicians, causing weakness and pain in the wrists and fingers.... repetitive strain injury
See TENS.... transcutaneous electrical nerve stimulation
Negative effect resulting from a medical treatment.... iatrogenic illness (or injury)
(See also CHILD ABUSE). Though NAI has traditionally been seen as abuse against children – and they are still the main victims – such injuries can also be in?icted on vulnerable adults. Adults with learning diffculties, dementias or physical disabilities su?ciently serious as to require institutional care (or who make heavy demands on relatives) are sometimes the victims of NAI. Health professionals, social workers and relatives should bear this possibility in mind when discovering unusual, severe or repeated bruising or fractures in vulnerable adults, even in circumstances where NAI may seem unlikely. (See also MUNCHAUSEN’S SYNDROME; PAEDOPHILIA.)... non-accidental injury (nai)
See UPPER LIMB DISORDERS.... repetitive strain injury (rsi)
A method of electrical stimulation that is being used for the relief of PAIN, including that of MIGRAINE, NEURALGIA and phantom limbs (see AMPUTATION). Known as TENS, its mode of action appears to have some resemblance to that of ACUPUNCTURE. Several controlled trials suggest that it provides at least a modicum of relief of pain after operations, thereby reducing the amount of ANALGESICS that may be called for.... transcutaneous electrical nerve stimulation (tens)
Damage sustained during birth. Minor injuries, such as bruising and swelling of the scalp during a vaginal delivery (see cephalhaematoma) are common. More serious injury can occur, particularly if the baby is excessively large and has difficulty in passing through the birth canal. A breech delivery may result in injury to nerves in the shoulder, causing temporary paralysis in the arm. The face may be paralysed temporarily if the facial nerve is traumatized by forceps. Fractured bones are another hazard of difficult deliveries, but the bones usually heal easily. (See also birth defects; brain damage.)... birth injury
Accidental puncture of the skin by a contaminated hypodermic needle. Hospital staff are most likely to be at risk. Needlestick injuries carry the risk of serious infections, such as HIV and hepatitis, and need immediate attention. The wound should be cleaned thoroughly; blood tests may be needed to determine whether infection has been transmitted.... needlestick injury
Trauma Injury to the urethra is often the result of severe trauma to the pelvis – for example, in a car accident or as the result of a fall. Trauma can also result from catheter insertion (see CATHETERS) or the insertion of foreign bodies into the urethra. The signs are the inability to pass urine, and blood at the exit of the urethra. The major complication of trauma is the development of a urethral stricture (see below).
Urethritis is in?ammation of the urethra from infection.
Causes The sexually transmitted disease GONORRHOEA affects the urethra, mainly in men, and causes severe in?ammation and urethritis. Non-speci?c urethritis (NSU) is an in?ammation of the urethra caused by one of many di?erent micro-organisms including BACTERIA, YEAST and CHLAMYDIA.
Symptoms The classic signs and symptoms are a urethral discharge associated with urethral pain, particularly on micturition (passing urine), and DYSURIA.
Treatment This involves taking urethral swabs, culturing the causative organism and treating it with the appropriate antibiotic. The complications of urethritis include stricture formation.
Stricture This is an abrupt narrowing of the urethra at one or more places. Strictures can be a result of trauma or infection or a congenital abnormality from birth. Rarely, tumours can cause strictures.
Symptoms The usual presenting complaint is one of a slow urinary stream. Other symptoms include hesitancy of micturition, variable stream and terminal dribbling. Measurement of the urine ?ow rate may help in the diagnosis, but often strictures are detected during cystoscopy (see CYSTOSCOPE).
Treatment The traditional treatment was the periodic dilation of the strictures with ‘sounds’
– solid metal rods passed into the urethra. However, a more permanent solution is achieved by cutting the stricture with an endoscopic knife (optical urethrotomy). For more complicated long or multiple strictures, an open operation (urethroplasty) is required.... urethra, diseases of and injury to
Damage to the tissues (see ligament; tendon; muscle) that surround bones and joints.... soft-tissue injury
a quick method for determining the severity of a case of serious trauma. It can be used for purposes of *triage and *clinical audit.... abbreviated injury scale
see AKI.... acute kidney injury
(injury severity scale, ISS) a system used, particularly in *triage, for grading the severity of an injury. See also abbreviated injury scale.... injury scoring system
(OASIS) a spectrum of injuries that encompasses both third- and fourth-degree *perineal tears. Injury to the anal sphincter mechanism during childbirth may arise secondarily to direct disruption of the sphincter muscles and/or traction of the pudendal nerves. Disruption of the anal sphincter muscles is best assessed by anal ultrasound examination. This is usually performed using a high-frequency (10 MHz) endoanal probe. In selected cases with complex injury and/or suspected rectovaginal *fistula, magnetic resonance imaging (MRI) may also be employed.... obstetric anal sphincter injury
(electromechanical dissociation) the appearance of normal-looking complexes on the electrocardiogram that are, however, associated with a state of *cardiac arrest. It is usually caused by large pulmonary emboli (see pulmonary embolism), *cardiac tamponade, tension *pneumothorax, severe disturbance of body salt levels, severe haemorrhage, or hypothermia causing severe lack of oxygen to the heart muscle.... pulseless electrical activity
a penetrating injury by a ski stick.... ski-stick injury
any injury related to the practice of a sport, often resulting from the overuse and stretching of muscles, tendons, and ligaments.... sports injury
(TBI) injury to the brain due to external force, such as occurs following falls, road traffic accidents, and violence. It is a major cause of death and chronic disability worldwide, especially in young males.... traumatic brain injury
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