1.1 CAUSES OF TRAUMATIC INJURY:
Traumatic injury can occur on a mass scale such as in military conflicts or natural disasters or can
occur on a more limited scale to individuals or groups of individuals in the community or the workplace. Injuries may be intentional
or non-intentional. The intentional ones may be criminal aggression against another person, self harm due to mental problems,
or attempted suicide. The unintentional are usually called accidents but this term is not accurate. The final event like a
car crash may appear accidental but it has intentional antecedents like driving recklessly at a high speed.
1.2 TYPES OF TRAUMATIC INJURY:
Traumatic injury can be classifieD as blunt injury, penetrating injury, burns (thermal, chemical, electrical),
and bites (animal and human). In practice, several of these injuries occur at the same time in the same individual. For examples
car accidents, an increasing cause of injury, can cause blunt injury to the head, penetrating abdominal injury, and even burns.
1.3 MANIFESTATIONS OF TRAUMATIC INJURY:
Trauma to the skin is in the form of lacerations, abrasions, open wounds, and contusions. Trauma to
the chest can manifest as flail chest due to fracture of ribs, open pneumothorax, tension pneumothorax (due to air leakage
into the pleural cavity), hemothorax, cardiac tamponade, and aortic rupture. Trauma to the abdomen manifests as hemoperitoneum,
penetrating wounds, as well as blunt injury. Trauma to CNS can result into coma and spinal injuries. Burns can be thermal,
chemical, or electric. Primary degree involves only the epidermis. Secondary degree involves the dermis. Third degree involves
all the skin and subcutaneous fat.
1.4 PATHOPHYSIOLOGY OF TRAUMATIC INJURY
The Pathophysiologic response to injury can manifest in any of the following ways: metabolic derangement,
cardio-respiratory failure and shock, coagulopathy, multi-organ dysfunction syndrome, and neuropathophysiology. The body always
attempts to repair traumatic injury through the process of wound healing (primary and secondary) which proceeds in three stages:
inflammatory phase, proliferation phase, and maturation phase.
ETHICO-LEGAL ISSUES IN EMERGENCY CARE
RELIGIOUS and SOCIAL DUTIES
Acts of worship, ‘ibadat
Law under the principle of hardship provides for the injured by simplifying acts of worship for them. A patient with injury
and incapable of making wudhu on his own could have another one pour water for him. If there is a wound that prevents
use of water, you can rub with wet fingers on the bandage. Wiping on leather socks or on ordinary socks is undertaken in case
of wounds preventing used of water. If water cannot be used at all tayammum is undertaken. Tayamum can be carried
out instead of wudhu for patients with burns. Physical movements of salat are restricted for those with disabilities;
they pray in the most comfortable position that they can manage.
in paraplegia can be grounds for nullification of marriage if the wife requests. Disabled husbands who can no longer work
to support the family may have the marriage nullified at the request of the wife.
Business transactions, buyuu’u:
of the disabled must consider their limited performance.
Activities of daily living, aadaat
physically disabled have special problems in feeding and drinking.
following statements are true about traumatic injury
It is allowed to wash a patient in ablution if he cannot use his hands
Tayammum is preferred for cases of profuse or active bleeding at sites of wudhu
C. In cases of wounds, a wet hand is rubbed on the bandage during wudhu
Tayammum is carried out instead of ghusl
in cases of burns
Patients with physical disabilities offer salat in the most comfortable position