What Is a Mechanism of Injury?

Injury refers to the damage to the human body caused by various sudden practices or accidents (generally refers to those who have not died). Including a variety of physical, chemical and biological factors.

hurt

(Medical concept)

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Injury refers to various practices or sudden occurrences

Injury refers to various practices or sudden occurrences

Fundamental

Public health method

Injury, like other health problems, cannot be explained by a single cause. Therefore, using public health methods to systematically and coordinately solve the problem from four steps based on reliable evidence has become a recognized model. The first step is to collect data at the local, national and international levels on the scale, characteristics, scope and consequences of the problem through monitoring and investigation. The second step is to identify the cause of the problem and increase or decrease the risk factors for the individual to encounter the problem, and see how to correct these factors. The third step is to design, implement, monitor and evaluate interventions to prevent problems based on the information obtained in the first and second steps. The fourth step is to disseminate information on the effectiveness of interventions; implement effective interventions on a larger scale; and assess the cost effectiveness of larger interventions.

2. Hatton matrix

In the 1960s, American public health physician William Haddon designed a chart based on the principles of public health, called the "Hatton matrix" (Table 1). He proposed that there should be three factors before the injury, when the injury occurred, and after the injury occurred. The stages evaluate the effects of causing harm to the host (human), pathogenicity (injury), and the environment, respectively, so as to determine the ways of harm intervention. Since then, it has been used as a development idea for all types of injury prevention.

3. Ecological model

The Hatton matrix involves the time and place of energy transfer and injury, and the ecological model describes the relationship between individuals and related factors, which is very suitable for understanding the causes of injury, especially violence. Injury and violence are behavioral products that are affected by multiple factors such as individuals, relationships, society, culture, and the environment. The ecological model states that prevention of injuries and violence requires comprehensive considerations in adjusting individual behavior, establishing a healthy family environment, providing safe public places, eliminating gender discrimination, and striving for greater social, cultural, and economic factors.

Important strategy

1. Tertiary prevention strategy

Tertiary prevention strategies that are widely used in other diseases are also applicable to injury prevention:

Primary prevention: prevent new injuries. If fences are set up around the pool to prevent drowning;

Secondary prevention: reduce the severity of the injury. Such as the use of seat belts and helmets to reduce road traffic injuries to humans;

Tertiary prevention: reduce the frequency and severity of disability after injury. Such as a complete emergency system, it is conducive to the treatment and rehabilitation of patients after the injury.

2.Haddon's top ten strategies

Haddon proposed the "Ten Major Strategies for Injury Prevention" in 1981 based on the "Hatton Matrix". With the support and promotion of the World Health Organization, it has been widely used in injury prevention work. These ten strategies include [58,59]:

Preventing risk factors: such as banning the manufacture of pistols and the establishment of nuclear reactors;

Reduce the content of existing risk factors: limit vehicle speed and reduce lead content in paint;

Prevention of the release of existing risk factors: reduction of nuclear or conventional weapons in the main military, pasteurization of milk;

Change the release rate of risk factors and their spatial distribution from the source: Reduce the slope of the slopes for beginner skiers and use parachutes;

Separate the risk factors from the protected person in time and space: such as setting up pedestrian overpasses on traffic-intensive roads, lightning protection devices during ground lightning strikes, motor vehicles, non-motor vehicles, and pedestrian lanes;

Use a barrier to separate the protected person from the risk factors: such as the use of helmets, safety glasses, mechanical barriers, fences in rural fish ponds to prevent drowning, etc .;

Change the basic nature of risk factors: such as rounded corners of furniture, use of fragile lighting columns and other roadside facilities;

Strengthen the human body's resistance to dangerous factors: such as setting strict standards for buildings in hurricane areas;

Elimination of risk factors: such as the use of fire trucks and fire detection systems, and the use of electronic pointing systems to prevent electric shock deaths;

Keep the injured patients stable and take effective treatment and rehabilitation measures: such as providing timely emergency medical assistance at the injury site, using appropriate medical procedures such as skin transplantation for burn patients.

3. "5E" Strategy

Due to the multiple causes of injury, a single injury strategy is often ineffective and requires a combination of engineering, environment, enforcement, education, and evaluation. This is the form of comprehensive intervention. Often called the "5E" strategy. "Engineering strategy" includes making products that are safer for people; "Environmental strategy" refers to reducing the possibility of individuals being harmed by reducing environmental risk factors; "Strengthening law enforcement strategy" refers to ensuring that a certain population is maintained through law and public security measures The implementation of these behaviors and regulations includes the enforcement of laws to create a safe environment, as well as laws and regulations to ensure the production and sale of safe products; the "education strategy" aims to change the attitudes, beliefs and behaviors of the general population and special populations; " "Assessment strategies" involves determining which interventions, programs, and policies are most effective in preventing harm, and providing methodological advice to researchers and policy makers.

Fighting injuries or brawl injuries, that is, injuries caused by fighting. The Qin law stipulates that "fighting against people's ears and endurance" (sentence of torture); "or fight with others and bind them to the fullest extent of their eyebrows, what's the matter? Become a city" (sentence a city); or Fighting with people, deciding people's lips, what's the matter? Bi ", that is, the sentence of bruising or trauma caused by beating. The Tang law stipulates that, for fighting, sixty canes are injured with hands and feet, and eighty canes with a square inch or more are wounded with other things. If the blood comes out of the ears, eyes, and internal spitting, the blood will be increased by two. As for severe injuries such as falling limbs, damaging people (two organs), etc., there are corresponding penalties. The Ming and Qing laws have similar provisions, but the sentence is slightly lighter, and an abortion has been added.

Injury by thieves . In Qin and Han laws, thief injuries are often commensurate with fighting injuries, and the crime is more serious than fighting injuries. One of Qin Jian's "Answers to the Law" states: "A thief hurts a person, but the official thinks that the fight hurts the person, but the official shouldn't be the right one? Dangyu." That is, a wrong judgment of a thief's injury as a fight injury should be reprimanded. Another said: "Do you fight with Pro, , Cone, Ruo, , Cone hurt people? What's the matter? Fight, when you are the top two, thieves, when you are the city." This and later Han law " The fight hurts people with a blade, and it's a city, and the thief adds first-class sin, "meaning the same. After the Wei and Jin dynasties, the laws and texts were more detailed, and plots such as conspiracy and assault were no longer used.

Consequences of Injury In ancient Chinese criminal law, apart from the subjective intentions of offenders and the means used to distinguish the severity of the crime of injury, they also distinguished from the consequences of injury. It divides the consequences of injuries into three categories: disability, obsolescence, and dysentery according to their severity:

Disability refers to the loss of function of part of the body. Notes on the "Gubao period" of the Qing law: "The disabled are incomplete. They can still hold things if they fold their fingers, but they can't lose money." Tang "Houling": "Everyone is blind, deaf, and has no hands Two fingers, no thumb, no bald ulcers, long leaks, heavy bloatedness, and so on are all disabled. "" Song Criminal Law, Household Marriage Law "also has similar provisions.

Disused disease refers to the mental or physical function to the extent that it is wasted by personnel. "Song's Criminal Law and Household Marriage Law" contains: "Idiot, dumb, dwarf, waist and spine broken, one limb abolished, and so on are waste diseases." Qing law "guarantee period" article note: "waste diseases It is useless to say that if you have already folded your hand, you ca nt hold it. "Also," Legends and Regulations "" Old and disabled waste collection and redemption "article notes:" Waste disease, or folded one hand, or folded one foot, or folded waist, Or blindness and dwarfism, deafness, dementia, madness, fetters and the like. "Harm to a person results in a disease, which is a heavier punishment than the general crime of injury. The law of the Tang Dynasty stipulates that: "Those who fight and toss a person's limbs and blind one's eyes will be punished for three years." The rules of the Ming and Qing laws are "one hundred sticks and three years."

Benevolence means severe physical or mental injury, which is more serious than illness. In ancient China, there was no clear distinction between the dismissal of abandonment and abandonment, and the Northern Qi law distinguished "disease" from "disability" as a special word. "Song's Criminal Law, Household Marriage Law": "Crazy, limbs abolish, blindness, and so on, all are dukes." Qinglu Notes: "People with dukes, either blind or blind. Limbs, or blindfolded limbs, and madness, paralysis, and the like. "Tang law stipulates:" Brawls "will damage two or more things and cause illness to the old due to old problems, if the tongue is broken and the people are yin and yang "Three thousand li." The Ming and Qing dynasties are "one hundred sticks, three thousand li, and half of the prisoner's property will still be paid to the injured and sick."