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"code": "W01",
"name": "Падение",
"icd_name": "Падение на поверхности одного уровня в результате поскальзывания, ложного шага или спотыкания",
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"age_min": 1,
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"slug": "w01_padenie",
"lead": "Последствия падения могут быть очень разными в зависимости от характера повреждений",
"description": "",
"etiology": "<p>Характер и тяжесть повреждений от падения зависит от многих причин:</p>\r\n<p>Высоты падения, особенностей почвы и предметов, на которые произошло падение, и позы пострадавшего. Одновременно имеют значение область тела, которой оно ударилось в момент падения, наличие или отсутствие выступающих предметов, о которые тело пострадавшего могло удариться при падении и, конечно, состояние здоровья и индивидуальные особенности потерпевшего.</p>\r\n<p>При прямом падении основные повреждения на теле человека возникают от однократного удара о поверхность. При непрямом падении тело встречает при своем движении какие-либо выступающие предметы с ограниченной травмирующей поверхностью. Вместе с человеком могут падать и различные предметы, которые могут причинять ему повреждения как во время движения, так и после падения тела на поверхность.</p>\r\n<p>Большое значение имеет характер поверхности, на которую упал пострадавший, твердая поверхность (бетон) приводит к более обширным повреждениям и даже в некоторых случаях к смерти.</p>\r\n<p> </p>",
"pathogenesis": "",
"diagnostics": "<p> </p>\r\n<p> </p>",
"treatment": "<p>При падении, первым делом нужно определить степень повреждений, чтобы решить, нужно ли вызывать скорую или нет. При этом важно не усугубить травмы: например, при переломе любое движение может еще больше повредить кости и мышцы.<br /><br />Как правило, человек находится в сознании - стонет или ругается. Если он лежит неподвижно - попросите его подвигать пальцами рук и ног. Если получается - значит позвоночник скорее всего не поврежден. Далее, попросите подвигать руками и ногами. Острая боль при движении, как правило, означает вывих или перелом - нужно вызывать скорую. До приезда скорой - не двигать больной конечностью.</p>\r\n<p>Вывих легко определить по неестественно вывернутой конечности и почти полному отсутствию подвижности в суставе. Облегчить состояние больного до осмотра врачом можно с помощью обезболивающих средств, ограничения подвижности конечности, холода. </p>\r\n<p>Принять обезболивающее рекомендуется и при подозрениях на перелом. Зафиксируйте область повреждения кости и срочно поторопитесь в травматологию. </p>\r\n<p>Самой серьезной является травма головы. При любых ушибах обращение к врачу должно быть незамедлительным, особенно, если падение сопровождалось потерей сознания и последующей головной болью. Опасность такой травмы заключается в возможности образования внутренней гематомы. Проверьте возможность сотрясения мозга. Симптомы: головная боль, вялость, сонливость, бледность, тошнота, рвота, кровь из носа. В этом случае вызов скорой - тоже обязателен.</p>\r\n<p>Практика показывает, что переломы рук – самая распространенная травма. Объясняется это тем, что при падении человек выставляет инстинктивно руки вперед, обрушивая на них всю тяжесть тела. Именно поэтому специалисты советуют, поскользнувшись и потеряв равновесие, не падать на выпрямленные руки, а сгруппироваться, сделать поворот в сторону, чтобы упасть на бок. </p>\r\n<p>Растяжение связок можно распознать, если основными симптомами является резкая и сильная боль в месте травмы, наряду с которой наблюдается нехарактерная подвижность сустава и появляющийся на глазах отек. Первая помощь заключается в наложение вокруг сустава тугой повязки, ограничивающей его движение, а также применение холода. </p>\r\n<p>Появившийся в результате падения синяк является индикатором состояния травмы. Если он постепенно краснеет, синеет, зеленеет, желтеет, значит падение обошлось ушибом. Если синяк приобретает багровый оттенок, боль усиливается и даже начинается нагноение - немедленно отправляйтесь к врачу.</p>",
"prevention": "<p>Исследования показывают, что регулярные (даже умеренные) силовые нагрузки снижают риск падения на 65%. А если дополнить силовые нагрузки упражнениями на координацию (например, танцами), то падения будут достаточно редкими </p>",
"clinical_picture": "<p>При наличии после падения любого из перечисленных ниже симптомов следует обратиться за медицинской помощью</p>\r\n<ul>\r\n<li>нарушение сознания любой выраженности и любой продолжительности;</li>\r\n<li>расстройство речи;</li>\r\n<li>неадекватное поведение;</li>\r\n<li>необычная сонливость;</li>\r\n<li>интенсивная головная боль, которая сохраняется более одного часа после травмы;</li>\r\n<li>судороги;</li>\r\n<li>более одного приступа рвоты;</li>\r\n<li>головокружение и (или) нарушение равновесия, которое сохраняется более одного часа после травмы;</li>\r\n<li>неспособность двигать рукой или ногой, слабость в руке или ноге;</li>\r\n<li>разные по размеру зрачки;</li>\r\n<li>появление темных (темно-синих) пятен под глазами или за ушами;</li>\r\n<li>кровотечение из носа или ушей;</li>\r\n<li>выделение бесцветной или кровянистой жидкости из носа или ушей;</li>\r\n<li>любые, даже незначительные, нарушения со стороны органов чувств.</li>\r\n</ul>",
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