Lecture 9B: Soft tissue injuries Flashcards
(37 cards)
What is considered soft tissue?
Skin
epidermis
dermis (nerves, sweat glands, blood vessels)
fat
muscle
tendon
ligament
What is a closed wound?
soft tissue damage
secondary hypoxia
epidermis layer of skin intact
What is the general treatment of closed wounds?
PIER/ PRICE/ RICE
what does the time of application of a cryotherapy modality depend on?
tissue type/ location/ latest research
What is an open wound?
Break in the epidermis layer of skin
Abrasion
Laceration
Avulsion
Puncture wound
Crush injury
Amputation
What is the general treatment of minor open wounds?
Wash wound with saline solution or clean under running water for 3-5min
disinfect periphery of wound with clear anti-septic solution
On the sideline: anti-septic solution is okay for cleaning small minor wounds, use clean running water or sterile saline solution once available
What are the steps to acute wound management?
direct pressure a few minutes to control bleeding
if wound is clean and bleeding has stopped, apply new non-adhesive dressing
Apply triple anti-biotic ointment such as polysporin
adhesive bandage over dressing
educate: home care, follow-up, referral
What are the three types of tetanus shots?
Diphtheria, tetanus, and pertussis (DTaP)
What is tetanus?
disease caused by a bacterial infection following a break in the skin or mucous membrane. bacteria makes a toxin that causes severe muscle spasms and seizures. Also called lockjaw because muscle spasms in your jaw make it hard to open your mouth, difficult to swallow or breathe
What is the best way to prevent a tetanus infection?
it is to have a tetanus shot before and if you need one. Having the DTaP vax series and getting the Tdap booster and then as an adult getting the Td booster every 10 years
When should you refer your athletes to a physician?
Puncture wounds or animal bites
burns that are more severe than minor second degree
gaping wounds that may require stitches (>1in, face, hands)
wounds that have exposed fatty tissue, white tissue, or muscle
Wounds with embedded visible foreign material
wounds with blood spurting from them
wounds causing severe pain or resulting in a numb feeling or inability to move structures below the wound
new wounds in patients with diabetes or bleeding problems
Chronic wounds that do not heal
infected wounds
do not glue or put ointment on wounds being sent for assessment/advanced care
What are the general instructions for wound care when using skin glue?
Day 1-5: keep wound dry
Day 5-10: okay to wash (do not soak)
If wound is on head, can wash hair after 5 days
Pat your wound dry gently do not rub it
monitor wound healing
don’t stick a bandaid on top of skin glue
don’t put creams or lotions on wound
don’t try to remove skin glue (will come off in 7-10 days)
don’t scratch, pick or mess with wound
When should you seek medical advice when using skin glue for wound care?
if wound:
splits open again
starts to bleed
infected: red or swollen, increase pain, discharge or pus, fever
what are the different types of dressings?
Woven: dry gauze, impregnated gauze, paraffin gauze
Skin tapes: closure or superficial or linear lacerations with minimal tension
semi-occlusive/occlusive: film, foam, hydrogel, hydrocolloid, dermal adhesives
What are the general treatment steps for major open wounds?
do not waste time washing wound
sterile gauze dressing
Bleeding control (direct pressure, wound packing, tourniquet)
Pressure bandage to maintain compression
seek further medical care
What should you do with an impaled object?
Do not remove object unless it is in the cheek/jaw or it affects airway
Bulky dressing to stabilize it
Control bleeding by bandaging dressing in place around object
log cabin technique/donut
Styrofoam/paper cup/ gauze for eye
What are the management steps for amputations?
control bleeding (easier with complete versus partial)
Sterile/diaper bandage over stump and severed amputated part
Keep amputated part (gauze on wound) in a dry plastic bag on ice (tissue should not be in contact)
Transport part with victim when possible
What are avulsions?
tearing away of soft tissue with no bone tissue, complete or partial avulsion flap
What are the management steps for complete avulsions?
use sterile gauze and direct pressure to stop bleeding and dress wound for complete avulsion.
What are the management steps for partial avulsions?
use flap to close wound for bleeding control
ideally irrigate first with sterile saline before replacing flap
Dress wound/flap with sterile gauze, inform EMS of approx. avulsion flap depth/size
What are the types of burns (etiology)?
thermal
chemical
electricity
solar radiation
other forms of radiation
What does the severity of burns depends on?
temperature of object
location of burn
victim’s age
under 5 or over 55 - thin skin
medical conditions: chronic diseases, heart disease, diabetes, impaired circulation
What are the typical MOIs of 1st degree (epidermis) burns?
flash
flame
scald
sun
What are the s/s of 1st degree burns?
dry
red
swelling possible
pain at site
heals in a few days without scarring
