The choice of a method of temporary hemostasis for injuries of the facial part of the skull resulting from road accidents

The purpose of the study. To determine the choice of the method of temporary hemostasis in patients with facial skull injuries resulting from road accidents.

Materials and methods. The work is retrospective, the sample is continuous, based on the analysis of the results of 230 patients with facial skull injuries having both isolated and/or combined injuries sustained in road accidents in the Saratov region from 2010 to 2021. The average age of patients was 29±5 years (M±m). There were 159 men (69,1%) and 71 women (30,9%). Medical histories, outpatient cards, and accompanying sheets of the ambulance team were used as primary documentation. The study included all patients who were delivered by ambulance crews, who had open and closed, isolated, multiple and/or combined injuries to the facial skull resulting from road accidents, starting at the age of 15. Patients with combined injuries of the extremities, cervical spine, pelvis, as well as patients who were not delivered by ambulance crews were excluded. Isolated injuries were detected in 58,6% of the victims, combined and multiple — in 41,7% of people. In the majority of observations — 72,6% — medical care at the prehospital stage was provided by medical teams of emergency medical care, such assistance was provided by paramedic teams only in 27,4% of observations. The time of delivery of the wounded to the medical institution from the moment of injury was on average 27±8 minutes (M±m). At the time of admission, open injuries were registered in 34,4% of people, patients with closed injuries of the facial skull prevailed — 65,6% of the victims.

Results. As a result of the study, it was found that all victims with such injuries can be conditionally divided into three groups, depending on the mechanism of injury: venous bleeding prevailed in the first group — in 6,9%, arterial bleeding was noted in 0,9% of cases, and capillary bleeding — in 3,9%. In the second group, bleeding was distributed as follows: capillary bleeding prevailed — in 13% of cases, arterial bleeding was noted in 2,6% of cases, and venous bleeding — in 4,3%. In the third group, capillary bleeding was detected in all 2.6% of cases. Based on this, the main method of temporary hemostasis was the imposition of a pressure bandage, which was applied in 23,5% of cases, in another 3,5% of cases, an anterior nasal tamponade was used to stop bleeding, in 7,4% of cases, a clamp was applied to stop bleeding. Of the total number of hemostases performed, as can be correctly characterized in 29,6% of cases, which was manifested by stopping bleeding. At the same time, in 4,8% of cases, the method of temporary hemostasis was not chosen correctly, which was manifested by continued bleeding at the time of delivery of the victim to a medical institution.

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