Lecture 10 - Emergency Wound Management Flashcards Preview

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Flashcards in Lecture 10 - Emergency Wound Management Deck (39)
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1

What is the plan of attach when addressing emergency wounds?

1. initial patient assessment
2. analgesia
3. principles of healing
4. wound evaluation
5. wound management (surgical or open)

2

What does 'A CRASH PLAN' stand for?

airway, cardivascular, respiratory, abdomen, spine, head, pelvis, limbs, arteries, and nerves

3

What can be used for pain control in emergency wound management?

opioids, NSAIDs, ketamine, lidocaine, local/regional anesthetic, and A2-agonists

4

What are the principles of healing?

hemostasis and inflammation, debridement, repair, and maturation

5

What is the hallmark of hemostasis/inflammation?

hemostatic plug

6

What occurs during hemostasis/inflammation?

Blood and lymph from damaged blood vessels fill the wound and cleanse the wound surface. Vasoactive compounds are then released for vasoconstriction near the wound to decrease blood loss. After about 15 minutes a fibrin clot will form and vasodilation will begin.

7

What is the hemostatic plug a barrier for?

any further infection

8

What happens during debridement?

neutrophils, monocytes, and macrophages infiltrate into the wound to clean the debris via enzymatic and phagocytic mechanisms

9

What is the repair phase also known as?

the proliferative phase

10

What is the hallmark of the repair phase?

granulation tissue

11

What occurs during the repair phase?

fibroblasts infiltrate for collagen formation, angiogenesis occurs, and epithelialization occurs

12

What do myofibroblasts do?

they shrink down to make the wound smaller

13

What occurs in the maturation phase?

there is collagen deposition and significant wound contraction

14

What are the local factors influencing healing?

vascular supply to the area, presence of infection, mechanical stress on the wound, and tissue edema

15

What are the systemic factors influencing healing?

hypoproteinemia, malnutrition, glucocorticoid excess, diabetes mellitus, immunosuppression, illness, and age

16

What are the different types of wounds?

incisional, penetrating, abrasions, shearing, avulsion/degloving, firearm,n and burns

17

What are incisional wounds created by?

sharp objects moving in parallel to the skin by surgical incision or glass fragments

18

Incisional wounds cause ______ trauma to surrounding tissues.

minimal

19

Incisional wounds are _____ prone to infection?

less

20

What are penetrating wounds caused by?

sharp object moving perpendicular to the skin

21

Would you want to close a penetrating wound?

no because there will be dead space and contusion which is ideal for bacterial growth

22

What causes abrasion wounds?

friction

23

What layers do abrasion wounds affect?

epidermis and superficial dermis

24

What can cause shearing wounds?

dragging (friction) or bone and joint injury (medial carpus, phalanges, tarsus)

25

What is avulsion/degloving?

separation of the skin from underlying attachment

26

What is physiological avulsion/degloving?

blood vessel damage occurs and the skin is no longer attached to the tissue

27

What tissue does a 1st degree burn involve?

superficial

28

What tissue does a 2nd degree burn involve?

partial thickness of the skin

29

what tissue does a 3rd degree burn involve?

full thickness of the skin

30

What are the effects that heat has in burns?

capillary permeability, loss of ECM integrity, and tissue edema