External forces, such as falls and motor vehicle accidents, cause most closed wounds. May closed wounds are relatively small and involve soft tissues; the black eye is an example: Others, however, involve fractures of the limbs, spine, or skill and damage to vital organs within the skull, chest, or abdomen. Massive injury to soft tissues – such as muscles, blood vessels, and nerves – can be very serious and can result in lasting disabilities.
Signs and Symptoms
Pain and tenderness are most common. Usual signs are swelling and discoloration of soft tissues and deformity of limbs caused by fractures or discolorations, Suspect a closed wound with internal bleeding and possible rupture of a body organ whenever powerful force exerted on the body has produced severe shock or unconsciousness. Even of signs of injury are obvious, internal injury is probable when any of the following general symptoms are present:
- Cold, clammy pale skin, very rapid but weak pulse, rapid breathing and dizziness.
- Pain and tenderness in a part of the body in which injury is suspected, especially if deep pain continues but seems out of proportion to the outward signs of injury.
- Uncontrolled restlessness and excessive thirst.
- Vomiting or coughing up of blood or passage of blood in the urine or feces.
To stop severe bleeding:
- Have the injured person lie down. If possible, position the person’s head slightly lower than the trunk or elevate the legs. This position reduces the risk of fainting by increasing blood flow to the brain. If also possible, elevate the site of bleeding.
- Remove any obvious dirt or debris from the wound. Don’t remove any large or more deeply embedded objects. Don’t probe the wound or attempt to clean it at this point. Your principal concern is to stop the bleeding.
- Apply pressure directly on the wound. Use a sterile bandage, clean cloth or even a piece of clothing. If nothing else is available, use your hand.
- Maintain pressure until the bleeding stops. When it does, bind the wound tightly with a bandage (or even a piece of clean clothing) and adhesive tape.
- Don’t reposition displaced organs. If the wound is abdominal and organs have been displaced, don’t try to reposition them. Cover the wound with a dressing.