Peculiarities of first aid to ophthalmologic victims at the first stage of medical evacuation
- Authors: Kozlova A.D.1, Mekhantyeva L.E.1, Dunaeva D.Y.1
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Affiliations:
- Voronezh State Medical University named after N.N. Burdenko
- Issue: Vol 13 (2024): Материалы XX Международного Бурденковского научного конгресса 18-20 апреля 2024 года
- Pages: 131-133
- Section: Военная и экстремальная медицина
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/9847
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Abstract
Introduction. The relevance of first aid on the battlefield is growing every year. A person, finding himself in the center of military operations, acquires risks of injuries of various etiologies. The visual analyzer is not an exception due to low protection. The purpose of the work is to determine the sequence of actions in eye traumatization. The literature on ophthalmology and first aid techniques and federal data were used as materials and methods. Results. A wide variety of etiologic factors are capable of causing both open and closed injuries of various genesis. The risks of subsequent complications associated with the spread of infection are high. Correct actions at different stages of medical and sanitary evacuation can preserve not only color perception and color vision of the victim in the course of further rehabilitation, but also subject vision. First aid includes not only local treatment, but also correct application of binocular dressing. Conclusion. Knowledge of the correct sequence of actions during the first stage of medical evacuation can preserve the correct anatomy and physiology of the eye, reduce the risks of enucleation.
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Introduction. The problem of first aid on the battlefield is rapidly gaining relevance. Availability of necessary skills and their timely use can save human life. War is a traumatic pandemic. More and more often there is a need for additional study of methods and rules of stopping bleeding, immobilization of limbs, bandaging. The most sensitive human analyzer is visual, so its injuries can entail severe consequences. Correct actions in the first minutes of traumatization will improve the outcome of subsequent treatment, help to avoid possible complications and improve the course of rehabilitation of the victim. Over 60% of the injured during the Great Patriotic War remained blind in one eye.
The aim of the work is to determine the correct step-by-step course of action in rendering first aid to the injured in case of ophthalmic traumatization on the battlefield.
Materials and methods of research. The study was carried out on the basis of retrospective analysis of statistical observation data conducted at the federal level, analysis of literature sources on the methods of first aid to victims in ophthalmology.
Results of the study. Due to the multifactorial impact of the environment on the human body during warfare, there is an increased risk of both traumatization of the whole body and the visual analyzer in particular, which is insufficiently protected. The etiology is quite diverse, for example, thermal, chemical or radiation burns, bullet, shrapnel or mine wounds.
The pattern of ocular analyzer injury includes both superficial and penetrating injuries. Penetrating ones are the most severe due to significant gaping of the wound, which serves as a gateway for infectious agents. This may result in the development of pan- and endophthalmitis, iridocyclitis, which, in turn, lead to the lesion of the second intact eyeball. Victims are at risk of hyphema, hemophthalmos, posttraumatic aphakia or lens dislocation, sclera rupture, retinal detachment, ocular crush, edematous keratinopathy, and lens subluxation [1]. Hematoma of the eyelids is the most frequent sign of blunt trauma to the visual analyzer [2]. In case of corneal integrity disruption, it is necessary to additionally investigate the deeper parts - iris, lens, vitreous body, vasculature, and even retina [3]. Also ophthalmic traumatization is often combined with the occurrence of craniocerebral pathologies.
Medical and sanitary support of population evacuation is a complex of medical and evacuation, sanitary-hygienic and anti-epidemic measures at assembly evacuation points, at the points of boarding vehicles, on the way of the population, at the points of its reception and places of temporary resettlement. In addition to the general tasks of the medical service, it became necessary to study the methods of first aid in order to reduce the risks of post-traumatic complications. At the first stage of medical and evacuation support, ophthalmologic assistance is provided by a company medical instructor who administers injection anesthesia and sterile binocular dressings. Emergency care also includes instillations of sulfanilamide 20% into the conjunctival sac. The high speed of these measures allows preserving not only light perception and light vision, but also subject vision. After that, immediate transportation to a specialized medical organization is necessary. Due to the severe general condition of the patient there is not timely first aid.
During transportation of the injured person to a specialized medical institution it is necessary to provide complete rest in the position lying on the side on the side of the injured eye, limit physical activity. It is carried out in accordance with the previously established rules and instructions for evacuation. Carrying out the necessary reconstructive treatment in a short time and restoration of the correct anatomical features of the eye increase the chances of preserving vision without resorting to enucleation.
Conclusion. Health care plays an important role in cases of traumatization of the visual analyzer. Correct and quick first aid with further compliance with the established rules on evacuation can be crucial to both the physical and social well-being of the injured person. Having the necessary skills will not only help save the patient's life, but also preserve visual function. Severe concomitant somatic pathologies acquired on the battlefield reduce the chance of preserving or restoring vision.
About the authors
Angelina Dmitrievna Kozlova
Voronezh State Medical University named after N.N. Burdenko
Email: kozlova.angelina2002@yandex.ru
ORCID iD: 0000-0002-3932-0023
SPIN-code: 5044-8240
medical student
Russian Federation, 10 Studentskaya str., Voronezh, 394036.Lyudmila Evgenievna Mekhantyeva
Voronezh State Medical University named after N.N. Burdenko
Email: medkat@vrngmu.ru
ORCID iD: 0000-0002-2439-3625
SPIN-code: 6735-7330
Doctor of Medical Sciences, professor
Russian Federation, 10 Studentskaya str., Voronezh, 394036.Daria Yuryevna Dunaeva
Voronezh State Medical University named after N.N. Burdenko
Author for correspondence.
Email: dashadunaeva@mail.ru
ORCID iD: 0000-0002-3923-1282
SPIN-code: 8784-8828
Assistant Department of Disaster Medicine and Life Safety
Russian Federation, 10 Studentskaya str., Voronezh, 394036.References
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