Emergency Management Of Soft Tissue Injuries Flashcards
Phases of Healing With Soft Tissue Injuries
Inflammation: Begins immediately and only lasts a few days
Proliferation: First few days to 4-6 weeks (first development of scar tissue from laying down collagen fibers)
Remodeling: May take years
Treatment for open soft tissue injuries
- Stop the bleeding. This needs to be addressed first
- Reduce risk for infection. Cleanse it as best as possible. Use saline but if none available can use clean drinking water or clean tap water. Try to get out debris and bacteria. Don’t scrub.
- Bandage with occlusive or non-occlusive dressings (usually non-occlusive on field). Occlusive bandages in cases you’re worried about infection.
- Make a referral. Especially if you see deeper tissues or think it needs suturing.
How long to ligamentous sprains take to heal?
Grade 1: Usually 10-14 days (because it’s just a stretch)
Grade 2: Usually 4 weeks (since there was tearing you need the full proliferative phase to lay down scar tissue)
Grade 3: At least 6 weeks
Treatment for grade 3 muscle strains
Usually they need surgery but in small tendons like the extensor tendons of the fingers you can often splint them to promote healing
Abrasion
Most often unreported but can get infected. Need to cleanse these with solution and keep them covered.
Blisters
Encourage athlete not to open them themselves because you take a closed wound and make it an open wound. If it is interfering with performance a trained professional can open it with more sterile equipment and cleanse it/cover it properly.
Order of operations for laceration?
- If severely bleeding then stop this first
- Cleanse the wound (saline, clean tap/drinking water)
- Well covered before going back into play
- Be careful using adhesives or skin glue because the athletes play in contaminated environments and you need to make sure it’s clean before trapping the bacteria in
Punctures
- Don’t remove the object if it’s in
- If the object is still in you can pack material around it to control the bleeding around it
- Limit their motion around this object and immobilize joint above and below
- If object is out, treat like laceration
Skin Avulsion
High risk of infection. Stop the bleeding, cleanse it, cover it, get them to the hospital.
Traumatic Amputation
- Control bleeding on remaining/attached segment (direct pressure)
- If won’t stop then make a tourniquet proximal to it
- Cleanse and cover it (gauze or cover) and the amputated part as well
- Put amputated part in sealed bag and on ice
Nose Bleeds
- Don’t tilt the head back
- Give direct pressure (direct pressure right over the nose for about 5 minutes)
- If this doesn’t work then you can also roll up a piece of gauze and put it up under the top lip which puts pressure on the artery that supplies blood to the nasal mucosa (helps with additional pressure)
- Can try to use rolled gauze in nose as well
How to control SEVERE bleeding
Severe = spurting blood (artery), pooled on the ground, or soaking through clothes
Extremities = Apply direct pressure or a tourniquet
Non-Extremity = Direct pressure or pack the wound
Chest or Abdomen = Need RAPID transport (these are triaged first)
Don’t take hands off to check the wound.
What to use for packing or compressing wound
Ideally you want sterile or packaged dressings but if there are none then any clean clothing or gauze will do. Hemostatic dressings have properties that help stop the bleeding better.
Are tourniquets safe?
Research shows that any tourniquet that has been on for 2 hours or less has led to no amputations
Deep wound blood stop
Pack the wound with gauze or clean cloth to completely fill it then apply direct pressure over it.
