Chapter 19: Effects of Injury

**External hemorrhage**

It can result in loss of blood with consequent hypovolemic shock and death.

**Respiratory tract**

produces a condition called drowning in one’s own blood leading to death due to mechanical asphyxia.

**Pericardial Sac**

Accumulation of blood more than 250 ml into the pericardial sac can result in cardiac standstill due to inability of myocardial muscle to function — *cardiac tamponade*.

Pericardial tamponade

 a medical emergency in which pericardial pressure is elevated and this puts significant pressure on the heart, causing a decrease in diastolic filling of the ventricles, and hence in stroke volume.

**Intracranial hemorrhage**

bleeding within the skull or bleeding into the cranial cavity.

**Septic Shock**

 this is due to toxins and bacterial colonization of the blood. It may be due to gram-positive bacteria where death is due to exotoxins originating in unsuspected foci of infection.

**Embolism**

a mechanism wherein there is an introduction of undissolvable foreign material – gaseous or solid within the living circulation which is then distributed in the blood stream, and may cause decrease in blood supply or impaction in end-arteries or veins with consequent ischaemic necrosis of the tissues involved.

Intrinsic fat

the actual origin of the fat is either from adipose tissue or from bone marrow, and only occasionally from the lipids in the plasma.

Extrinsic Fat

Example is injecting oily substances in radiography and in total parenteral nutrition.

Gas Embolism

It is one of the diving disorders SCUBA divers sometimes suffer when they receive pressure damage to their lungs following a rapid ascent where the breath is inappropriately held against a closed glottis, allowing pressure to build up inside the lungs, relative to the blood.

Suprarenal Hemorrhage

It tends to occur a few days after severe trauma, preceded by cortical depletion of yellow lipoid, which is a common sequel to stress.

**Amniotic Fluid Embolism**

a complication of childbirth; in complicated labor, there may be an escape of amniotic fluid into maternal circulation.

**Adult respiratory distress syndrome**

a complication of a whole range of traumatic or stressful incidents, including aspiration of gastric contents, near-drowning, blast injuries to the chest, heavy impacts on thorax, inhalation of irritant gasses, infections, acute pancreatitis, burns and systemic shock.

Systemic Air Embolism

Causes as with penetrating injury or other wounds of the chest.