头部外伤紧急处理常识
<P style="LINE-HEIGHT: 150%"><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"><FONT face=宋体>头皮伤 头皮血管丰富,故损伤时出血多而且时间长,为了防止出血加重,防止异物进入伤口,不宜在现场冲洗伤口。现场处理:</FONT></SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">1</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、对伤口直接压迫暂时止血,撕脱的头皮应与伤者一起送医院。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">2</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、若无颈椎损伤,可抬高头部减少出血。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">3</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、尽快转送医院。</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"> <SPAN lang=EN-US><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p></SPAN></SPAN></FONT></P>
<P style="LINE-HEIGHT: 150%"><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"><FONT face=宋体> 颅骨伤 头皮、颅骨和硬脑膜均破裂或伤口漏脑脊液(透明无色的液体),或脑组织暴露在伤口内,若见刃刺入颅内,不要在现场拔出。如果见到双眼眶皮下出血(熊猫眼)、鼻出血、外耳道出血,说明有颅底骨折。现场处理:</FONT></SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">1</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、如果伤口边缘有大出血点,应立即用干净棉布压迫,制止大出血。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">2</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、用一只消毒碗反扣在伤口上包紧。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">3</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、拨打</SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">“120”</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">叫救护车,工医护人员的监护下就近送到专科医院。</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"> <SPAN lang=EN-US><o:p></o:p></SPAN></SPAN></FONT></P>
<P style="LINE-HEIGHT: 150%"><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> 脑外伤 </SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%">①</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">脑震荡:颅脑损伤后伤者立即会产生意识障碍或精神紊乱遗忘,甚至昏迷,常在</SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">30</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">分钟内醒来,感到头痛、头晕、耳鸣、事业心、呕吐。</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%">②</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">脑挫裂伤:颅脑损伤后伤者有长时间意识障碍,会很快发生严重脑肿胀。除意识障碍外,可能伴有抽搐、呕吐和各种神经损害症等,严重者很快死亡。</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%">③</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">颅内血肿常见有硬膜外血肿、硬膜下血肿和脑内血肿等。常由颅骨冲击伤后骨折、动静脉破裂出血而造成,随着出血量的增加,伤者意识障碍、瞳孔明显变化、昏迷不断加深,早期治疗可减少死亡率。现场处理:</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">1</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、保持呼吸通畅,确保供氧、颈部制动(用颈托或颈固定),有条件保作气管插管。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">2</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、检查血压、脉博、瞳孔(大小、形态、光瓜)等身体况状。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">3</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、如有血液、脑脊液经耳鼻外流,可用无菌棉球松松地放在外耳道和鼻孔处吸除之,禁止耳鼻内填塞或冲洗,以防感染。切不可擤鼻。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">4</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、开通静脉补液,无休克者应使用高渗利尿药和脱水药物。</SPAN></FONT><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><FONT face=宋体> </FONT><SPAN lang=EN-US><BR></SPAN></SPAN><FONT face=宋体><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥"> </SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">5</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">、拨打</SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥">“120”</SPAN><SPAN style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; mso-ascii-font-family: ˎ̥; mso-hansi-font-family: ˎ̥">叫救护车,在医生监护下送往医院</SPAN><SPAN lang=EN-US style="FONT-SIZE: 9pt; LINE-HEIGHT: 150%; FONT-FAMILY: ˎ̥"><o:p></o:p></SPAN></FONT></P>
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