Nonaccidental injury Health Dictionary

Any injury to the head, whether associated with a skull fracture (see BONE, DISORDERS OF – Bone fractures) or not. Patients with head injuries should be assessed for signs of neurological damage, which may not develop at once. Patients who after a head injury are or have been UNCONSCIOUS or who are drowsy, vomiting, confused or have any focal neurological signs – for example, blurred vision or a motor or sensory malfunction – should be seen by a doctor. Particular care should be taken with individuals who have consumed alcohol and sustained a head injury in a ?ght, fall or vehicle accident. Symptoms indicative of a severe head injury may be attributed (wrongly) to the effects of alcohol, and crucial time thus lost in treating the injury.

In hospital the possible need for urgent action is monitored by use of the GLASGOW COMA SCALE.

People suffering the results of such injuries and their relatives can obtain help and advice from Headway – the brain injury association.... head injury

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

(RSI) An overuse injury that affects keyboard workers and musicians, causing weakness and pain in the wrists and fingers.... repetitive strain injury

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)

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 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

Harm to any part of the body.

It may arise from many causes, including physical influences (for example, force, heat, cold, electricity, vibration, and radiation), chemical causes (for example, poisons), bites, or oxygen deprivation.... 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

The act of deliberately injuring oneself. Self-mutilation most often occurs in young adults, many of whom are also drug or alcohol abusers, and is 3 times more common in women. It may take the form of cutting the wrists or burning the forearms with cigarettes. In some, it is a means of dealing with stress, such as that caused by child abuse.

More unusual forms of self-harm, such as mutilating the genitals, are usually due to psychosis. Self-destructive biting is a feature of Lesch–Nyhan syndrome, a rare metabolic disorder.... self-injury

Localized tissue damage caused by chilling, the most serious form of which is frostbite. Cold injury is distinct from hypothermia, which refers to chilling of the whole body.

In frostbite, an area of skin and flesh becomes frozen, hard, and white as a result of exposure to very cold, dry air.

Sometimes there is restriction of the blood supply to the affected area.

Another type of cold injury, immersion foot, occurs when the legs and feet are kept cold and damp for hours or days.

The main risk of both conditions is that blood flow will be slowed so much that the tissues will die, leading to gangrene.

Less serious forms of cold injury include chilblains and chapped skin.... cold injury

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. ... electrical injury

Illnesses, disorders, or injuries that result from exposure to chemicals or dust, or are due to physical, psychological, or biological factors in the workplace.

Pneumoconiosis is fibrosis of the lung due to inhalation of industrial dusts, such as coal. Asbestosis is associated with asbestos in industry. Allergic alveolitis is caused by organic dusts (see farmer’s lung).

Industrial chemicals can damage the lungs if inhaled, or other major organs if they enter the bloodstream via the lungs or skin. Examples include fumes of cadmium, beryllium, lead, and benzene. Carbon tetrachloride and vinyl chloride are causes of liver disease. Many of these compounds can cause kidney damage. Work-related skin disorders include contact dermatitis and squamous cell carcinoma. Rare infectious diseases that are more common in certain jobs include brucellosis and Q fever (from livestock), psittacosis (from birds), and leptospirosis (from sewage). People who work with blood or blood products are at increased risk of viral hepatitis (see hepatitis, viral) and AIDS, as are healthcare professionals. The nuclear industry and some healthcare professions use measures to reduce the danger from radiation hazards. Other occupational disorders include writer’s cramp, carpal tunnel syndrome, singer’s nodes, Raynaud’s phenomenon, deafness, and cataracts.... occupational disease and injury

Also called repetitive strain injury, a term, for any injury caused by repetitive movement of part of the body. Symptoms include pain and stiffness in the affected joints and muscles.

Examples include epicondylitis: painful inflammation of one of the bony prominences at the elbow, caused by the pull of the attached forearm muscles during strenuous activities (see golfer’s elbow; tennis elbow).

Overuse injuries of the fingers, thumb, and wrist joints may affect assembly-line and keyboard workers, and musicians; injuries of the neck may affect violinists.

Rest relieves the symptoms.

A change in the technique used during the activity may prevent recurrence.... overuse injury

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

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