No abstract

Combined chest injuries in many cases are a serious threat to the life of the victim. Violation of the frame, loss of tightness of the chest, reduction of the internal volume of the chest cavity due to rib fractures, accumulation of blood or air in the pleural cavities with pain impulses attached to them, coming from injuries of other localizations, create conditions for disruption of vital functions of the body and the development of severe shock.

We analyzed case histories and forensic medical examination reports of 247 deceased patients with combined cranial and chest trauma, which allowed us to identify the following difficulties in the differential diagnosis of respiratory disorders.

A comprehensive clinical and electrophysiological examination of 72 patients with severe traumatic brain injury was carried out. The types of the body's reaction to trauma with various manifestations of hemodynamic and external respiration disorders and the possibility of a targeted impact on the main pathogenetic mechanisms were determined.

Diagnosis of brain damage in concomitant craniocerebral trauma (SCI) has certain difficulties. So, in contrast to isolated TBI, with TBI, intracranial hematomas are diagnosed 2 times less often (in 8% of cases). The main medical errors in the diagnosis of traumatic brain injury are associated with a disorder of consciousness of varying degrees, motor and psychomotor agitation, early resuscitation aids, which are needed by most of the patients in this group. Often, psychomotor agitation with existing damage to the skin of the head, inappropriate behavior of the patient is regarded as a brain injury. However, these symptoms are a consequence of cerebral hypoxia, caused, for example, by chest trauma or shock. Such complications of trauma as shock, fat embolism, thromboembolism, alcohol intoxication, respiratory failure, etc., play a certain role in provoking diagnostic errors and even mortality in TBI.