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坠楼损伤如何急救?

坠楼损伤如何急救?

来源:健康养生网 时间:2023-09-02

  坠楼见于儿童玩耍不慎从阳台等处掉下,或者施工时不慎从高处摔下,或者自杀者从高楼跳下。无论哪一种情况,都会造成不同程度损伤,以至死亡。依据楼层高度、着地部位、地面状况等因素,坠楼可形成颅脑外伤、胸外伤、腹外伤、四肢及脊柱骨折等损伤。

  坠楼时臀部着地往往发生脊柱压缩性骨折。下肢瘫痪,有时合并骨盆骨折,尿道断裂。四肢骨折是坠楼常见损伤。

  腹部伤多发生肝、脾破裂和肾挫裂伤。病人有内脏出血表现:面色苍白、脉搏细弱且快、口渴、腹痛、恶心呕吐、血压下降。肾挫裂伤时出现血尿。

  胸部外伤主要是肋骨骨折。单纯肋骨骨折时吸气时胸痛,不敢咳嗽。多发性肋骨骨折,则呼吸困难、烦躁不安、口唇青紫。

  对坠楼病人现场处置十分重要,否则会延误伤情,而不正确的处置又容易使病人“雪上加霜”。

  颅脑损伤是因为头部着地,形成颅骨骨折脑挫裂伤。如果病人坠楼后即刻昏迷不醒,为原发性脑损伤;如果病人有中间清醒期,即先是昏迷,后意识转清,又陷入昏迷,为颅内血肿引起。对于这类病人要严密观察血压、脉搏、呼吸变化,严密观察瞳孔变化。瞳孔一大一小,意识障碍,偏瘫,说明有脑疝发生。

  坠楼病人往往是多发性损伤,救护时不能顾此失彼。一般有脑疝发生时,要赶快输入甘露醇、高渗葡萄糖,同时赶紧送往医院。胸部肋骨骨折先包扎固定,其方法多种多样。四肢骨折可就地取材,用木材等固定,木板长度应超过上下两个关节。脊柱损伤特别注意颈椎骨折的处理。搬动伤员时应有一人抱头牵引固定颈部抬上木板担架,用衣服、毛巾、砂袋等固定头颈两侧,以防摆动头部。用担架运送伤员时使伤员脚在先头在后,这样便于抬担架的人观察病人神志及病情变化。

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