An injury is any
physiological
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
damage to living tissue caused by immediate physical stress. An injury can occur
intention
Intentions are mental states in which the agent commits themselves to a course of action. Having the plan to visit the zoo tomorrow is an example of an intention. The action plan is the ''content'' of the intention while the commitment is the ''a ...
ally or
unintentionally and may be caused by
blunt trauma
Blunt trauma, also known as blunt force trauma or non-penetrating trauma, is physical traumas, and particularly in the elderly who fall. It is contrasted with penetrating trauma which occurs when an object pierces the skin and enters a tissue ...
,
penetrating trauma
Penetrating trauma is an open wound injury that occurs when an object pierces the skin and enters a tissue of the body, creating a deep but relatively narrow entry wound. In contrast, a blunt or ''non-penetrating'' trauma may have some deep dama ...
,
burn
A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur mainl ...
ing,
toxic exposure,
asphyxia
Asphyxia or asphyxiation is a condition of deficient supply of oxygen to the body which arises from abnormal breathing. Asphyxia causes generalized hypoxia, which affects primarily the tissues and organs. There are many circumstances that can i ...
tion, or
overexertion
Exertion is the physical or perceived use of energy.Newton's Third Law, Elert, Glenn. “Forces.” ''Viscosity – The Physics Hypertextbook'', physics.info/newton-first/. Exertion traditionally connotes a strenuous or costly ''effort'', resulting ...
. Injuries can occur in any part of the body, and different symptoms are associated with different injuries.
Treatment of a major injury is typically carried out by a
health professional
A health professional, healthcare professional, or healthcare worker (sometimes abbreviated HCW) is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician (suc ...
and varies greatly depending on the nature of the injury.
Traffic collisions are the most common cause of accidental injury and injury-related death among humans. Injuries are distinct from
chronic condition
A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three mo ...
s,
psychological trauma
Psychological trauma, mental trauma or psychotrauma is an emotional response to a distressing event or series of events, such as accidents, rape, or natural disasters. Reactions such as psychological shock and psychological denial are typical. ...
,
infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
s, or
medical procedure
A medical procedure is a course of action intended to achieve a result in the delivery of healthcare.
A medical procedure with the intention of determining, measuring, or diagnosing a patient condition or parameter is also called a medical test. ...
s, though injury can be a contributing factor to any of these.
Several major health organizations have established systems for the classification and description of human injuries.
Occurrence
![Intentional injuries world map-Deaths per million persons-WHO2012](https://upload.wikimedia.org/wikipedia/commons/d/d4/Intentional_injuries_world_map-Deaths_per_million_persons-WHO2012.svg)
Injuries may be intentional or unintentional. Intentional injuries may be acts of violence against others or
self-harm
Self-harm is intentional behavior that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury and self-mutilatio ...
against one's own person. Accidental injuries may be unforeseeable or they may be caused by
negligence
Negligence (Lat. ''negligentia'') is a failure to exercise appropriate and/or ethical ruled care expected to be exercised amongst specified circumstances. The area of tort law known as ''negligence'' involves harm caused by failing to act as a ...
The most common types of unintentional injuries in order are traffic accidents, falls,
drowning
Drowning is a type of suffocation induced by the submersion of the mouth and nose in a liquid. Most instances of fatal drowning occur alone or in situations where others present are either unaware of the victim's situation or unable to offer a ...
, burns, and accidental poisoning. Certain types of injuries are more common in
developed countries
A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
or
developing countries
A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
. Traffic injuries are more likely to kill pedestrians than drivers in developing countries. Scalding burns are more common in developed countries, while open-flame injuries are more common in developing countries.
As of 2021, approximately 4.4 million people are killed due to injuries each year worldwide, constituting nearly 8% of all deaths. 3.16 million of these injuries are unintentional and 1.25 million are intentional. Traffic accidents are the most common form of deadly injury, causing about one-third of injury-related deaths. One-sixth are caused by suicide, and one-tenth are caused by homicide. Tens of millions of individuals require medical treatment for nonfatal injuries each year, and injuries are responsible for about 10% of all years lived with disability. Men are twice as likely to be killed through injury than women. In 2013, 367,000 children under the age of five died from injuries, down from 766,000 in 1990.
Classification systems
The
World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
(WHO) developed the
International Classification of External Causes of Injury The International Classification of External Causes of Injury (ICECI) is a medical classification providing codes for external injuries. It is designed to aid professionals and researchers in the statistical tracking and prevention of injury.
Firs ...
(ICECI). Under this system, injuries are classified by mechanism of injury, objects/substances producing injury, place of occurrence, activity when injured, the role of human intent, and additional modules. These codes allow the identification of distributions of injuries in specific populations and case identification for more detailed research on causes and preventive efforts.
The United States
Bureau of Labor Statistics
The Bureau of Labor Statistics (BLS) is a unit of the United States Department of Labor. It is the principal fact-finding agency for the U.S. government in the broad field of labor economics and statistics and serves as a principal agency of t ...
developed the Occupational Injury and Illness Classification System (OIICS). Under this system injuries are classified by nature, part of body affected, source and secondary source, and event or exposure. The OIICS was first published in 1992 and has been updated several times since.
The Orchard Sports Injury and Illness Classification System (OSIICS), previously OSICS, is used to classify injuries to enable research into specific
sports injuries
Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children who participate in some form of organized sport. Of those, about three mil ...
.
The
injury severity score (ISS) is a medical score to assess trauma severity.
It correlates with mortality, morbidity, and hospitalization time after trauma. It is used to define the term ''major trauma'' (
polytrauma Polytrauma and multiple trauma are medical terms describing the condition of a person who has been subjected to multiple traumatic injuries, such as a serious head injury in addition to a serious burn. The term is defined via an Injury Severity Sc ...
), recognized when the ISS is greater than 15.
The AIS Committee of the
Association for the Advancement of Automotive Medicine
The Association for the Advancement of Automotive Medicine (AAAM) is a non-profit education and research organization founded in 1957 by the Medical Advisory committee to the Sports Car Club of America. It is the first and premier professional m ...
designed and updates the scale.
Mechanisms
Trauma
Traumatic injury is caused by an external object making forceful contact with the body, resulting in a
wound
A wound is a rapid onset of injury that involves laceration, lacerated or puncture wound, punctured skin (an ''open'' wound), or a bruise, contusion (a ''closed'' wound) from blunt force physical trauma, trauma or compression. In pathology, a '' ...
.
Major trauma
Major trauma is any injury that has the potential to cause prolonged disability or death. There are many causes of major trauma, blunt and penetrating, including falls, motor vehicle collisions, stabbing wounds, and gunshot wounds. Dependin ...
is a severe traumatic injury that has the potential to cause
disability
Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be Cognitive disability, cognitive, Developmental disability, dev ...
or
death
Death is the irreversible cessation of all biological functions that sustain an organism. For organisms with a brain, death can also be defined as the irreversible cessation of functioning of the whole brain, including brainstem, and brain ...
. Serious traumatic injury most often occurs as a result of traffic collisions.
Traumatic injury is the leading cause of death in people under the age of 45.
Blunt trauma injuries are caused by the forceful impact of an external object. Injuries from blunt trauma may cause
internal bleeding
Internal bleeding (also called internal hemorrhage) is a loss of blood from a blood vessel that collects inside the body. Internal bleeding is usually not visible from the outside. It is a serious medical emergency but the extent of severity depen ...
and
bruising
A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur clos ...
from ruptured
capillaries
A capillary is a small blood vessel from 5 to 10 micrometres (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: ...
beneath the skin, abrasion from scraping against the superficial
epidermis
The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water rele ...
, lacerated tears on the skin or internal organs, or
bone fracture
A bone fracture (abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a '' ...
s.
Crush injuries
A crush injury is injury by an object that causes compression of the body. This form of injury is rare in normal civilian practice, but common following a natural disaster. Other causes include industrial accidents, road traffic collisions, buil ...
are a severe form of blunt trauma damage that apply large force to a large area over a longer period of time.
Penetrating trauma injuries are caused by external objects entering the
tissue of the body through the
skin
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation.
Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...
. Low-velocity penetration injuries are caused by sharp objects, such as
stab wound
A stab wound is a specific form of penetrating trauma to the skin that results from a knife or a similar pointed object. While stab wounds are typically known to be caused by knives, they can also occur from a variety of implements, including brok ...
s, while high-velocity penetration injuries are caused by ballistic projectiles, such as
gunshot wound
A gunshot wound (GSW) is a penetrating injury caused by a projectile (e.g. a bullet) from a gun (typically firearm or air gun). Damages may include bleeding, bone fractures, organ damage, wound infection, loss of the ability to move part of th ...
s or injuries caused by
shell fragments. Perforated injuries result in an entry wound and an exit wound, while puncture wounds result only in an entry wound. Puncture injuries result in a cavity in the tissue.
Burns
![Burns](https://upload.wikimedia.org/wikipedia/commons/7/7e/Burns.png)
Burn injury is caused by contact with extreme temperature, chemicals, or radiation. The effects of burns vary depending on the depth and size. Superficial or first-degree burns only affect the
epidermis
The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water rele ...
, causing pain for a short period of time. Superficial partial-thickness burns cause weeping
blister
A blister is a small pocket of body fluid (lymph, serum, plasma, blood, or pus) within the upper layers of the skin, usually caused by forceful rubbing (friction), burning, freezing, chemical exposure or infection. Most blisters are filled wi ...
s and require dressing. Deep partial-thickness burns are dry and less painful due to the burning away of the skin and require surgery. Full-thickness or third-degree burns affect the entire
dermis
The dermis or corium is a layer of skin between the epidermis (with which it makes up the cutis) and subcutaneous tissues, that primarily consists of dense irregular connective tissue and cushions the body from stress and strain. It is divided i ...
and is susceptible to
infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
. Fourth-degree burns reach deep tissues such as muscles and bones, causing loss of the affected area.
Thermal burn
A thermal burn is a type of burn resulting from making contact with heated objects, such as boiling water, steam, hot cooking oil, fire, and hot objects. Scalds are the most common type of thermal burn suffered by children, but for adults thermal ...
s are the most common type of burn, caused by contact with excessive heat, including contact with flame, contact with hot surfaces, or
scalding
Scalding is a form of thermal burn resulting from heated fluids such as boiling water or steam. Most scalds are considered first- or second-degree burns, but third-degree burns can result, especially with prolonged contact. The term is from the L ...
burns caused by contact with hot water or steam.
Frostbite
Frostbite is a skin injury that occurs when exposed to extreme low temperatures, causing the freezing of the skin or other tissues, commonly affecting the fingers, toes, nose, ears, cheeks and chin areas. Most often, frostbite occurs in the han ...
is a type of burn caused by contact with excessive cold, causing cellular injury and deep tissue damage through the crystallization of water in the tissue.
Friction burn
A friction burn is a form of abrasion caused by the friction of skin rubbing against a surface. A friction burn may also be referred to as skinning, chafing, or a term named for the surface causing the burn such as rope burn, carpet burn or ...
s are caused by
friction
Friction is the force resisting the relative motion of solid surfaces, fluid layers, and material elements sliding against each other. There are several types of friction:
*Dry friction is a force that opposes the relative lateral motion of t ...
with external objects, resulting in a burn and abrasion.
Radiation burn
A radiation burn is a damage to the skin or other biological tissue and organs as an effect of radiation. The radiation types of greatest concern are thermal radiation, radio frequency energy, ultraviolet light and ionizing radiation.
The most ...
s are caused by exposure to
ionizing radiation
Ionizing radiation (or ionising radiation), including nuclear radiation, consists of subatomic particles or electromagnetic waves that have sufficient energy to ionize atoms or molecules by detaching electrons from them. Some particles can travel ...
. Most radiation burns are
sunburn
Sunburn is a form of radiation burn that affects living tissue, such as skin, that results from an overexposure to ultraviolet (UV) radiation, usually from the Sun. Common symptoms in humans and animals include: red or reddish skin that is ho ...
s caused by
ultraviolet
Ultraviolet (UV) is a form of electromagnetic radiation with wavelength from 10 nanometer, nm (with a corresponding frequency around 30 Hertz, PHz) to 400 nm (750 Hertz, THz), shorter than that of visible light, but longer than ...
radiation or high exposure to radiation through medical treatments such as repeated
radiography
Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeut ...
or
radiation therapy
Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radia ...
.
Electrical burn
An electrical burn is a burn that results from electricity passing through the body causing rapid injury. Approximately 1000 deaths per year due to electrical injuries are reported in the United States, with a mortality rate of 3-5%. Electrical bur ...
s are caused by contact with
electricity
Electricity is the set of physical phenomena associated with the presence and motion of matter that has a property of electric charge. Electricity is related to magnetism, both being part of the phenomenon of electromagnetism, as described ...
as it enters and passes through the body. They are often deeper than other burns, affecting lower tissues as electricity penetrates the skin, and the full extent of electrical burns are often obscured. They will also cause extensive destruction of tissue at the entry and exit points. Electrical injuries in the home are often minor, while high tension power cables cause serious electrical injuries in the workplace.
Lightning strike
A lightning strike or lightning bolt is an electric discharge between the atmosphere and the ground. Most originate in a cumulonimbus cloud and terminate on the ground, called cloud-to-ground (CG) lightning. A less common type of strike, ground- ...
s can also cause severe electrical injuries. Fatal electrical injuries are often caused by tetanic spasm inducing
respiratory arrest
Respiratory arrest is a sickness caused by apnea (cessation of breathing) or respiratory dysfunction severe enough it will not sustain the body (such as agonal breathing). Prolonged apnea refers to a patient who has stopped breathing for a long p ...
or interference with the heart causing
cardiac arrest
Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...
.
Chemical burn
A chemical burn occurs when living tissue is exposed to a corrosive substance (such as a strong acid, base or oxidizer) or a cytotoxic agent (such as mustard gas, lewisite or arsine). Chemical burns follow standard burn classification and may ca ...
s are caused by contact with
corrosive substance
A corrosive substance is one that will damage or destroy other substances with which it comes into contact by means of a chemical reaction.
Etymology
The word ''corrosive'' is derived from the Latin verb ''corrodere'', which means ''to gnaw'', ...
s such as
acid
In computer science, ACID ( atomicity, consistency, isolation, durability) is a set of properties of database transactions intended to guarantee data validity despite errors, power failures, and other mishaps. In the context of databases, a sequ ...
or
alkali
In chemistry, an alkali (; from ar, القلوي, al-qaly, lit=ashes of the saltwort) is a basic, ionic salt of an alkali metal or an alkaline earth metal. An alkali can also be defined as a base that dissolves in water. A solution of a ...
. Chemical burns are rarer than most other burns, though there are many chemicals that can damage tissue. The most common chemical-related injuries are those caused by
carbon monoxide
Carbon monoxide (chemical formula CO) is a colorless, poisonous, odorless, tasteless, flammable gas that is slightly less dense than air. Carbon monoxide consists of one carbon atom and one oxygen atom connected by a triple bond. It is the simple ...
,
ammonia
Ammonia is an inorganic compound of nitrogen and hydrogen with the formula . A stable binary hydride, and the simplest pnictogen hydride, ammonia is a colourless gas with a distinct pungent smell. Biologically, it is a common nitrogenous was ...
,
chlorine
Chlorine is a chemical element with the Symbol (chemistry), symbol Cl and atomic number 17. The second-lightest of the halogens, it appears between fluorine and bromine in the periodic table and its properties are mostly intermediate betwee ...
,
hydrochloric acid
Hydrochloric acid, also known as muriatic acid, is an aqueous solution of hydrogen chloride. It is a colorless solution with a distinctive pungent smell. It is classified as a strong acid
Acid strength is the tendency of an acid, symbol ...
, and
sulfuric acid
Sulfuric acid (American spelling and the preferred IUPAC name) or sulphuric acid ( Commonwealth spelling), known in antiquity as oil of vitriol, is a mineral acid composed of the elements sulfur, oxygen and hydrogen, with the molecular formu ...
. Some
chemical weapon
A chemical weapon (CW) is a specialized munition that uses chemicals formulated to inflict death or harm on humans. According to the Organisation for the Prohibition of Chemical Weapons (OPCW), this can be any chemical compound intended as a ...
s induce chemical burns, such as
white phosphorus
Elemental phosphorus can exist in several allotropes, the most common of which are white and red solids. Solid violet and black allotropes are also known. Gaseous phosphorus exists as diphosphorus and atomic phosphorus.
White phosphorus
White ...
. Most chemical burns are treated with extensive application of water to remove the chemical contaminant, though some burn-inducing chemicals react with water to create more severe injuries. The ingestion of corrosive substances can cause chemical burns to the larynx and stomach.
Other mechanisms
Toxic injury
A toxic injury is a type of injury caused by toxin. Toxic injuries can cause teratogenic effects, respiratory effects, gastrointestinal effects, cardiovascular effects, hepatic effects, renal effects and neurological effects. They can also lead to ...
is caused by the ingestion, inhalation, injection, or absorption of a
toxin
A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. Toxins occur especially as a protein or conjugated protein. The term toxin was first used by organic chemist Ludwig Brieger (1849– ...
. This may occur through an interaction caused by a
drug
A drug is any chemical substance that causes a change in an organism's physiology or psychology when consumed. Drugs are typically distinguished from food and substances that provide nutritional support. Consumption of drugs can be via insuffla ...
or the ingestion of a
poison
Poison is a chemical substance that has a detrimental effect to life. The term is used in a wide range of scientific fields and industries, where it is often specifically defined. It may also be applied colloquially or figuratively, with a broa ...
. Different toxins may cause different types of injuries, and many will cause injury to specific organs. Toxins in gases, dusts, aerosols, and smoke can be inhaled, potentially causing respiratory failure. Respiratory toxins can be released by structural fires, industrial accidents, domestic mishaps, or through chemical weapons. Some toxicants may affect other parts of the body after inhalation, such as carbon monoxide.
Asphyxia causes injury to the body from a lack of oxygen. It can be caused by
drowning
Drowning is a type of suffocation induced by the submersion of the mouth and nose in a liquid. Most instances of fatal drowning occur alone or in situations where others present are either unaware of the victim's situation or unable to offer a ...
,
inhalation
Inhalation (or Inspiration) happens when air or other gases enter the lungs.
Inhalation of air
Inhalation of air, as part of the cycle of breathing, is a vital process for all human life. The process is autonomic (though there are exceptions ...
of certain substances,
strangulation
Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hanging ...
,
blockage of the airway, traumatic injury to the airway,
apnea
Apnea, BrE: apnoea, is the temporal cessation of breathing. During apnea, there is no movement of the muscles of inhalation, and the volume of the lungs initially remains unchanged. Depending on how blocked the airways are ( patency), there ...
, and other means. The most immediate injury caused by asphyxia is
hypoxia
Hypoxia means a lower than normal level of oxygen, and may refer to:
Reduced or insufficient oxygen
* Hypoxia (environmental), abnormally low oxygen content of the specific environment
* Hypoxia (medical), abnormally low level of oxygen in the tis ...
, which can in turn cause acute lung injury or
acute respiratory distress syndrome
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin colo ...
as well as damage to the circulatory system. The most severe injury associated with asphyxiation is cerebral
hypoxia
Hypoxia means a lower than normal level of oxygen, and may refer to:
Reduced or insufficient oxygen
* Hypoxia (environmental), abnormally low oxygen content of the specific environment
* Hypoxia (medical), abnormally low level of oxygen in the tis ...
and
ischemia
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems wi ...
, in which the brain receives insufficient oxygen or blood, resulting in neurological damage or death. Specific injuries are associated with water inhalation, including alveolar collapse,
atelectasis
Atelectasis is the collapse or closure of a lung resulting in reduced or absent gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the alveoli are deflated down to little or no volume, as distinct ...
,
intrapulmonary shunting, and
ventilation perfusion mismatch
Ventilation perfusion mismatch or V/Q defects are defects in the total lung ventilation/perfusion ratio (V/Q ratio). It is a condition in which one or more areas of the lung receive oxygen but no blood flow, or they receive blood flow but no oxy ...
. Simple asphyxia is caused by a lack of external oxygen supply. Systemic asphyxia is caused by exposure to a compound that prevents oxygen from being transported or used by the body. This can be caused by
azide
In chemistry, azide is a linear, polyatomic anion with the formula and structure . It is the conjugate base of hydrazoic acid . Organic azides are organic compounds with the formula , containing the azide functional group. The dominant applic ...
s, carbon monoxide,
cyanide
Cyanide is a naturally occurring, rapidly acting, toxic chemical that can exist in many different forms.
In chemistry, a cyanide () is a chemical compound that contains a functional group. This group, known as the cyano group, consists of ...
,
smoke inhalation
Smoke inhalation is the breathing in of harmful fumes (produced as by-products of combusting substances) through the respiratory tract. This can cause smoke inhalation injury (subtype of acute inhalation injury) which is damage to the respirator ...
,
hydrogen sulfide
Hydrogen sulfide is a chemical compound with the formula . It is a colorless chalcogen-hydride gas, and is poisonous, corrosive, and flammable, with trace amounts in ambient atmosphere having a characteristic foul odor of rotten eggs. The unde ...
,
methemoglobinemia
Methemoglobinemia, or methaemoglobinaemia, is a condition of elevated methemoglobin in the blood. Symptoms may include headache, dizziness, shortness of breath, nausea, poor muscle coordination, and blue-colored skin (cyanosis). Complications m ...
-inducing substances,
opioid
Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid us ...
s, or other systemic asphyxiants. Ventilation and oxygenation are necessary for treatment of asphyxiation, and some asphyxiants can be treated with antidotes.
Injuries of overuse or overexertion can occur when the body is strained through use, affecting the bones, muscles, ligaments, or tendons.
Sports injuries
Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children who participate in some form of organized sport. Of those, about three mil ...
are often overuse injuries such as
tendinopathy
Tendinopathy, a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder ( rotator cuff tendinitis, biceps tendinitis), elbow (tennis el ...
. Over-extension of the ligaments and tendons can result in
sprain
A sprain, also known as a torn ligament, is an acute soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers ...
s and
strains, respectively.
Repetitive sedentary behaviors such as extended use of a computer or a physically repetitive occupation may cause a
repetitive strain injury
A repetitive strain injury (RSI) is an injury to part of the musculoskeletal or nervous system caused by repetitive use, vibrations, compression or long periods in a fixed position. Other common names include repetitive stress disorders, cumula ...
. Extended use of brightly lit screens may also cause
eye strain
Eye strain, also known as asthenopia (from Greek ''a-sthen-opia'', grc, ἀσθενωπία, ), is a common eye condition that manifests through non-specific symptoms such as fatigue, pain in or around the eyes, blurred vision, headache, and ...
.
Locations
Abdomen
Abdominal trauma includes injuries to the
stomach
The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
,
intestines
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
,
liver
The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...
,
pancreas
The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an end ...
,
kidney
The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
s,
gallbladder
In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...
, and
spleen
The spleen is an organ found in almost all vertebrates. Similar in structure to a large lymph node, it acts primarily as a blood filter. The word spleen comes . . Abdominal injuries are typically caused by traffic accidents, assaults, falls, and work-related injuries, and physical examination is often unreliable in diagnosing blunt abdominal trauma.
Splenic injury
A splenic injury, which includes a ruptured spleen, is any injury to the spleen. The rupture of a normal spleen can be caused by trauma, such as a traffic collision.
Signs and symptoms
In minor injuries with little bleeding, there may be abdomin ...
can cause
low blood volume
Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. This may be due to either a loss of both salt and water or a decrease in blood volume. Hypovolemia refers to the los ...
or
blood in the peritoneal cavity. The treatment and prognosis of splenic injuries are dependent on cardiovascular stability. The gallbladder is rarely injured in blunt trauma, occurring in about 2% of blunt abdominal trauma cases. Injuries to the gallbladder are typically associated with injuries to other abdominal organs. The intestines are susceptible to injury following blunt abdominal trauma. The kidneys are protected by other structures in the abdomen, and most injuries to the kidney are a result of blunt trauma. Kidney injuries typically cause blood in the urine.
Due to its location in the body,
pancreatic injury
A pancreatic injury is some form of trauma sustained by the pancreas. The injury can be sustained through either blunt forces, such as a motor vehicle accident, or penetrative forces, such as that of a gunshot wound. The pancreas is one of the l ...
is relatively uncommon but more difficult to diagnose. Most injuries to the pancreas are caused by penetrative trauma, such as gunshot wounds and stab wounds. Pancreatic injuries occur in under 5% of blunt abdominal trauma cases. The severity of pancreatic injury depends primarily on the amount of harm caused to the
pancreatic duct
The pancreatic duct, or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct), is a duct joining the pancreas to the common bile duct. This supplies it with pancreatic juice from the exocrine pancre ...
. The stomach is also well protected from injury due to its heavy layering, its extensive blood supply, and its position relative to the
rib cage
The rib cage, as an enclosure that comprises the ribs, vertebral column and sternum in the thorax of most vertebrates, protects vital organs such as the heart, lungs and great vessels.
The sternum, together known as the thoracic cage, is a semi- ...
. As with pancreatic injuries, most traumatic stomach injuries are caused by penetrative trauma, and most civilian weapons do not cause long-term tissue damage to the stomach. Blunt trauma injuries to the stomach are typically caused by traffic accidents. Ingestion of corrosive substances can cause chemical burns to the stomach.
Liver injury
A liver injury, also known as liver laceration, is some form of trauma sustained to the liver. This can occur through either a blunt force such as a car accident, or a penetrating foreign object such as a knife. Liver injuries constitute 5% of a ...
is the most common type of organ damage in cases of abdominal trauma.
The liver's size and location in the body makes injury relatively common compared to other abdominal organs, and blunt trauma injury to the liver is typically treated with nonoperative management. Liver injuries are rarely serious, though most injuries to the liver are concomitant with other injuries, particularly to the spleen, ribs, pelvis, or spinal cord.
The liver is also susceptible to toxic injury, with overdose of
paracetamol
Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol.
At a standard dose, paracetamol only slightly decreases body temperature; it is inferior ...
being a common cause of liver failure.
Face
Facial trauma
Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures ...
may affect the
eyes,
nose
A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes th ...
, ears, or mouth. Nasal trauma is a common injury and the most common type of facial injury. Oral injuries are typically caused by traffic accidents or alcohol-related violence, though falls are a more common cause in young children. The primary concerns regarding oral injuries are that the airway is clear and that there are no concurrent injuries to other parts of the head or neck. Oral injuries may occur in the soft tissue of the face, the hard tissue of the mandible, or as dental trauma.
The ear is susceptible to trauma in head injuries due to its prominent location and exposed structure. Ear injuries may be internal or external. Injuries of the external ear are typically lacerations of the cartilage or the formation of a hematoma. Injuries of the middle and internal ear may include a perforated eardrum or trauma caused by extreme pressure changes. The ear is also highly sensitive to blast injury. The bones of the ear are connected to facial nerves, and ear injuries can cause paralysis of the face. Trauma to the ear can cause hearing loss.
Eye injury, Eye injuries often take place in the cornea, and they have the potential to permanently damage vision. Corneal abrasions are a common injury caused by contact with foreign objects. The eye can also be injured by a foreign object remaining in the cornea. Radiation damage can be caused by exposure to excessive light, often caused by welding without eye protection or being exposed to excessive ultraviolet radiation, such as sunlight. Exposure to corrosive chemicals can permanently damage the eyes, causing Visual impairment, blindness if not sufficiently irrigated. The eye is protected from most blunt injuries by the infraorbital margin, but in some cases blunt force may cause an eye to hemorrhage or tear. Overuse of the eyes can cause eye strain, particularly when looking at brightly lit screens for an extended period.
Heart
Cardiac injuries affect the heart and blood vessels. Blunt cardiac injury in a common injury caused by blunt trauma to the heart. It can be difficult to diagnose, and it can have many effects on the heart, including contusions, ruptures, acute valvular disorders, arrhythmia, or heart failure. Penetrative trauma to the heart is typically caused by stab wounds or gunshot wounds. Accidental cardiac penetration can also occur in rare cases from a fractured sternum or rib. Stab wounds to the heart are typically survivable with medical attention, though gunshot wounds to the heart are not. The Ventricle (heart), right ventricle is most susceptible to injury due to its prominent location. The two primary consequences of traumatic injury to the heart are severe hemorrhaging and Cardiac tamponade, fluid buildup around the heart.
Musculoskeletal
![Types of fracture](https://upload.wikimedia.org/wikipedia/commons/c/c7/Types_of_fracture.jpg)
Musculoskeletal injury, Musculoskeletal injuries affect the Human skeleton, skeleton and the muscular system. Soft tissue injury, Soft tissue injuries affect the skeletal muscles, ligaments, and tendons. Ligament and tendon injuries account for half of all musculoskeletal injuries. Ligament sprains and tendon strains are common injuries that do not require intervention, but the healing process is slow. Physical therapy can be used to assist reconstruction and use of injured ligaments and tendons. Torn ligaments or tendons typically require surgery.
Skeletal muscles are abundant in the body and commonly injured when engaging in athletic activity. Muscle injuries trigger an inflammatory response to facilitate healing. Blunt trauma to the muscles can cause contusions and hematomas. Excessive tensile strength can overstretch a muscle, causing a strain. Strains may present with torn muscle fibers, hemorrhaging, or Edema, fluid in the muscles. Severe muscle injuries in which a tear extends across the muscle can cause total loss of function. Penetrative trauma can cause laceration to muscles, which may take an extended time to heal. Unlike contusions and strains, lacerations are uncommon in sports injuries.
Traumatic injury may cause various
bone fracture
A bone fracture (abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a '' ...
s depending on the amount of force, direction of the force, and width of the area affected. Pathologic fractures occur when a previous condition weakens the bone until it can be easily fractured. Stress fractures occur when the bone is overused or suffers under excessive or traumatic pressure, often during athletic activity. Hematomas occur immediately following a bone fracture, and the healing process often takes from six weeks to three months to complete, though continued use of the fractured bone will prevent healing. Articular cartilage damage may also affect function of the skeletal system, and it can cause posttraumatic osteoarthritis. Unlike most bodily structures, cartilage cannot be healed once it is damaged.
Nervous system
![Parachemableedwithedema](https://upload.wikimedia.org/wikipedia/commons/3/32/Parachemableedwithedema.png)
Injuries to the nervous system include Brain damage, brain injury, spinal cord injury, and nerve injury. Trauma to the brain causes traumatic brain injury (TBI), causing "long-term physical, emotional, behavioral, and cognitive consequences". Mild TBI, including concussion, often occurs during athletic activity, military service, or as a result of untreated epilepsy, and its effects are typically short-term. More severe injuries to the brain cause moderate TBI, which may cause confusion or lethargy, or severe TBI, which may result in a coma or a secondary brain injury. TBI is a leading cause of mortality. Approximately half of all trauma-related deaths involve TBI.
Non-traumatic injuries to the brain causeacquired brain injury (ABI). This can be caused by stroke, a brain tumor, poison, infection, cerebral hypoxia, drug use, or the secondary effect of a TBI.
Injury to the spinal cord is not immediately terminal, but it is associated with concomitant injuries, lifelong medical complications, and reduction in life expectancy. It may result in complications in several major organ systems and a significant reduction in mobility or paralysis. Spinal shock causes temporary paralysis and loss of reflexes. Unlike most other injuries, damage to the Peripheral nervous system, peripheral nerves is not healed through cellular proliferation. Following nerve injury, the nerves undergo degeneration before regenerating, and other pathways can be strengthened or reprogrammed to make up for lost function. The most common form of peripheral nerve injury is stretching, due to their inherent elasticity. Nerve injuries may also be caused by laceration or compression.
Pelvis
Injuries to the Pelvic cavity, pelvic area include injuries to the Urinary bladder, bladder, rectum, Colon (anatomy), colon, and Human reproductive system, reproductive organs. Traumatic injury to the bladder is rare and often occurs with other injuries to the abdomen and pelvis. The bladder is protected by the peritoneum, and most cases of bladder injury are concurrent with a fracture of the pelvis. Bladder trauma typically causes hematuria, or blood in the urine. Ingestion of alcohol may cause distension of the bladder, increasing the risk of injury. A catheter may be used to extract blood from the bladder in the case of hemorrhaging, though injuries that break the peritoneum typically require surgery. The colon is rarely injured by blunt trauma, with most cases occurring from penetrative trauma through the abdomen. Rectal injury is less common than injury to the colon, though the rectum is more susceptible to injury following blunt force trauma to the pelvis.
Injuries to the male reproductive system are rarely fatal and typically treatable through grafts and reconstruction. The elastic nature of the scrotum makes it resistant to injury, accounting for 1% of traumatic injuries. Trauma to the scrotum may cause damage to the Testicle, testis or the spermatic cord. Trauma to the penis can cause penile fracture, typically as a result of vigorous Sexual intercourse, intercourse. Injuries to the female reproductive system are often a result of pregnancy and childbirth or sexual activity. They are rarely fatal, but they can produce a variety of complications, such as chronic discomfort, dyspareunia, infertility, or the formation of fistulas. Age can greatly affect the nature of genital injuries in women due to changes in hormone composition. Childbirth is the most common cause of genital injury to women of reproductive age. Many cultures practice female genital mutilation, which is estimated to affect over 125 million women and girls worldwide as of 2018. Tears and abrasions to the vagina are common during sexual intercourse, and these may be exacerbated in instances of non-consensual sexual activity.
Respiratory tract
Injuries to the respiratory tract affect the lungs, Thoracic diaphragm, diaphragm, trachea, bronchus, pharynx, or larynx. Tracheobronchial injury, Tracheobronchial injuries are rare and often associated with other injuries. Bronchoscopy is necessary for an accurate diagnosis of tracheobronchial injury. The neck, including the pharynx and larynx, is highly vulnerable to injury due to its complex, compacted anatomy. Injuries to this area can cause airway obstruction. Ingestion of corrosive chemicals can cause chemical burns to the larynx.
Inhalation of toxic materials can also cause serious injury to the respiratory tract.
Severe trauma to the chest can cause damage to the lungs, including pulmonary contusions, Hemothorax, accumulation of blood, or a Pneumothorax, collapsed lung. The inflammation response to a lung injury can cause acute respiratory distress syndrome. Injuries to the lungs may cause symptoms ranging from shortness of breath to terminal respiratory failure. Injuries to the lungs are often fatal, and survivors often have a reduced quality of life. Injuries to the diaphragm are uncommon and rarely serious, but blunt trauma to the diaphragm can result in the formation of a hernia over time. Injuries to the diaphragm may present in many ways, including abnormal blood pressure, cardiac arrest, gastroinetestinal obstruction, and respiratory insufficiency. Injuries to the diaphragm are often associated with other injuries in the chest or abdomen, and its position between two major cavities of the human body may complicate diagnosis.
Skin
Most injuries to the skin are minor and do not require specialist treatment. Lacerations of the skin are typically repaired with Surgical suture, sutures, Surgical staple, staples, or adhesives. The skin is susceptible to burns, and burns to the skin often cause blistering. Abrasive trauma scrapes or rubs off the skin, and severe abrasions require skin grafting to repair. Skin tears involve the removal of the epidermis or dermis through friction or shearing forces, often in vulnerable populations such as the elderly. Skin injuries are potentially complicated by foreign bodies such as glass, metal, or dirt that entered the wound, and skin wounds often require cleaning.
Treatment
Much of medical practice is dedicated to the treatment of injuries. Traumatology is the study of traumatic injuries and injury repair. Certain injuries may be treated by Medical specialty, specialists. Serious injuries sometimes require trauma surgery. Following serious injuries, physical therapy and occupational therapy are sometimes used for rehabilitation. Medication is commonly used to treat injuries.
Emergency medicine during major trauma prioritizes the immediate consideration of life-threatening injuries that can be quickly addressed. The airway is evaluated, clearing bodily fluids with suctioning or creating an artificial airway if necessary. Breathing is evaluated by evaluating motion of the chest wall and checking for Hemothorax, blood or Pneumothorax, air in the pleural cavity. Circulation is evaluated to resuscitate the patient, including the application of intravenous therapy. Disability is evaluated by checking for responsiveness and reflexes. Exposure is then used to examine the patient for external injury. Following immediate life-saving procedures, a CT scan is used for a more thorough diagnosis. Further resuscitation may be required, including ongoing blood transfusion, mechanical ventilation and nutritional support.
Pain management is another aspect of injury treatment. Pain serves as an indicator to determine the nature and severity of an injury, but it can also worsen an injury, reduce mobility, and affect quality of life. Analgesic drugs are used to reduce the pain associated with injuries, depending on the person's age, the severity of the injury, and previous medical conditions that may affect pain relief. NSAIDs such as aspirin and ibuprofen are commonly used for acute pain. Opioid medications such as fentanyl, methadone, and morphine are used to treat severe pain in major trauma, but their use is limited due to associated long-term risks such as addiction.
Complications
Complication (medicine), Complications may arise as a result of certain injuries, increasing the recovery time, further exasperating the symptoms, or potentially causing death. The extent of the injury and the age of the injured person may contribute to the likelihood of complications. Infection of wounds is a common complication in traumatic injury, resulting in diagnoses such as pneumonia or sepsis. Wound infection prevents the healing process from taking place and can cause further damage to the body. A majority of wounds are contaminated with microbes from other parts of the body, and infection takes place when the immune system is unable to address this contamination. The surgical removing of devitalized tissue and the use of topical antimicrobial agents can prevent infection.
Hemorrhaging of blood is a common result of injuries, and it can cause several complications. Pooling of blood under the skin can cause a hematoma, particularly after blunt trauma or the suture of a laceration. Hematomas are susceptible to infection and are typically treated compression, though surgery is necessary in severe cases. Excessive blood loss can cause hypovolemic shock in which cellular oxygenation can no longer take place. This can cause tachycardia, hypotension, coma, or organ failure. Fluid replacement is often necessary to treat blood loss. Other complications of injuries include cavitation, development of fistulas, and organ failure.
Social and psychological aspects
Injuries often cause psychological harm in addition to physical harm. Traumatic injuries are associated with psychological trauma and distress, and some victims of traumatic injuries will display symptoms of post-traumatic stress disorder during and after the recovery of the injury. The specific symptoms and their Trauma trigger, triggers vary depending on the nature of the injury. Body image and self-esteem can also be affected by injury. Injuries that cause permanent disabilities, such as spinal cord injuries, can have severe effects on self-esteem. Disfiguring injuries can negatively affect body image, leading to a lower quality of life. Burn injuries in particular can cause dramatic changes in a person's appearance that may negatively affect body image.
Severe injury can also cause social harm. Disfiguring injuries may also result in stigma due to scarring or other changes in appearance. Certain injuries may necessitate a change in occupation or prevent employment entirely. Leisure activities are similarly limited, and athletic activities in particular may be impossible following severe injury. In some cases, the effects of injury may strain personal relationships, such as marriages. Psychological and social variables have been found to affect the likelihood of injuries among athletes. Increased life stress can cause an increase in the likelihood of athletic injury, while social support can decrease the likelihood of injury. Social support also assists in the recovery process after athletic injuries occur.
See also
* Injury prevention
* List of causes of death by rate
* First aid
* Medical emergency
References
External links
International Trauma Conferences(registered trauma charity providing trauma education for medical professionals worldwide)
Trauma.org(trauma resources for medical professionals)
Emergency Medicine Research and Perspectives(emergency medicine procedure videos)
American Trauma SocietyScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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