Volume the stages:

1. measures;

2. fight against an asphyxia;

3. fight against bleeding;

4. temporal immobilization of bones;

5. correct evacuation (lying on the side of defeat with entered of injured).

In an induction centre carry out obligatory consultation of surgeon-traumatologist, neuro-surgeon, neurologist, begin reanimation and intensive therapy.

The specialized treatment is divided by urgent, rapid and deferred treatment.

To urgent treatment behaves: stop of bleeding, providing of breathing (prophylaxis of asphyxia).

To rapid treatment behaves: operation of PKHO of wounds, temporal immobilization of bones (term to 2 days after entering medical establishment).

The deferred treatment is carried out in 48 hours: operation of PKHO of wounds, permanent immobilization of bones.

The leadthrough of the specialized treatment is carried out after stabilizing by hemodynamicss (12 hours from the beginning measures) or in the period of conclusion from shock (4-7 hours).

Treatment of damages of lower jaw:

1. at combination with the concussion of cerebrum is a non-traumatic replicon and fixing under the careful anaesthetizing;

2. at combination with injury of cerebrum – after consultation of neurologist do a replicon and fixing or остеосинтез tires in terms which depend on the dynamics of neurological;

3. at combination with the heavy closed craniocerebral trauma – after consultation with a neurologist do a replicon and fixing tires in terms which depend on the dynamics of neurological.

Treatment of breaks of supramaxilla:

1. at combination with the concussion of cerebrum: fixing individual wire or plastic tires, by the vehicle of Zbarzha in 1-2 days after a trauma; operative treatment in 3-5 days after a trauma;

2. at combination with injury of brain and by the heavy closed craniocerebral trauma: after consultation of neurologist is fixing the vehicle of Zbarzha or operative fixing in terms which depend on the dynamics of neurological.

Treatment of breaks of bones of nose:

1. at combination from brain:

• replicon under the careful anaesthetizing;

– fixing the tire of Sheftelya or contour bandage;

2. at combination with injury of brain and by a heavy craniocerebral trauma (after consultation of neurologist):

– or replicon under the careful anaesthetizing;

– fixing the tire of Sheftelya or contour bandage in terms which depend on the dynamics of neurological.

Treatment of injuries of soft fabrics of person:

1. at combination with and contusion of brain – early PKHO of wound;

2. at combination with a heavy craniocerebral trauma after consultation of neurologist – initially-deferred or late PKHO of wound in terms which depend on the dynamics of neurological.

Complications and consequences of combined

traumas of person and cerebrum:

1. slow consolidation.

2. suppuration of wound;

3. repeated bleeding;

4. paropsiss;

5. decline of ear;

6. decline of sensitiveness on face;

7. head pain;

8. dizziness;

9. declines of memory;

10. rapid fatigueability;

11. arachnoidite;

12. traumatic epilepsy and degradation of personality;

13. stenocardia of reflex genesis.

The combined is name defeats which are caused a few (two or anymore) different on the origin striking factors. The combined defeats can arise up as a result of the direct operating of one or a few types of battle weapon on an organism, second damaging factors (for example, hearths of fires) and development of extraordinary situations which are related to extreme influence of factors of external environment.

A pathological process which arises up at the combined defeat is a not simple sum two or a few defeats, and difficult reaction of organism, which is characterized in a number of high-quality features among which the cross-coupling of components of the combined defeat comes forward most notedly.

Important condition of correct organization of grant the mass contingent of staggered is the use of single terminology. Term the “combined defeat” can be applied only to such, at which each of damaging factors results in death, violates ability to work. At different those at which time between their action does not exceed duration of flow of the first defeat consider in time of action of a few factors the combined damages, in other case these will be independent one from other successive damages. Examining of the combined damages, it is necessary to select leading and concomitant factors.

The leading factor of the combined damage is that, the degree of influence of which on development of violations of functions of organs and systems of organism is most.

Co-factors are brought in by additional violations in the function of organs and systems, changing the prognosis of trauma. Co-factors can be a few.

Now there is not the single generally accepted classification of the combined defeats. De bene esse they can be distributed on two groups: with advantage of surgical or therapeutic pathology – depending on a leading striking factor. To foresee all of possible combinations of damaging factors very difficultly, and doubtfully, that similar classification would have a serious practical value.

General lines of the combined damages:

• syndrome of the mutual burdening;

• complications of providing;

• unsatisfactory functional consequences of treatment.

Graphology structure of theme: