Flashcards in Mod 5 Soft Tissue Damage Deck (59):
The skins major functions (Protection)
-The skin is a barrier that keeps out microorganisms, debris, and unwanted chemicals.
The skins major functions (Water balance)
-The skin helps prevent water loss and stops environmental water from entering the body
The skins major functions (Temperature regulation)
-Blood vessels in the skin dilate to carry more blood to the skin allowing heat to radiate away from the body.
The skins major functions (Excretion)
-Salts, carbon dioxide, and excess water can be released through the skin.
The skins major functions (Shock impact absorption)
The skin and its layers of fat help protect the underlying organs from minor impacts and pressure.
The skins 3 major layers
-The outer layer of the skin
-The inner (second) layer of skin found beneath the epidermis. It is rich in blood vessels and nerves.
-The layers of fat and soft tissues found below the dermis
-An internal injury with no open pathway from the outside
Types of closed wounds
-Closed crush injury
-Simply a bruise
-The most frequently encountered type of closed wounds
-A swelling caused by the collection of blood under the skin or in damaged tissues as a result of an injured or broken blood vessel.
Closed crush injury
-An injury caused when force is transmitted from the body's exterior to its internal structures. Bones can be broken, muscles nerves, and tissues damaged, and internal organs ruptured, causing internal bleeding.
Blast injuries (Closed wound)
-The most common closed injuries associated with blast trauma are the rupture of hollow organs.
-Air filled organs such as lungs and ear drums will commonly burst when struck by the high pressure of a blast.
Types of open wounds
-High pressure injection injuries
-An injury in which the skin interrupted, exposing the tissue beneath
-Simple scrapes and scratches in which the outer layer of skin is damaged but not all the layers are penetrated.
-A cut often caused by a sharp object.
-May be smooth or jagged.
Penetrating trauma and punctures
-When an object passes through the skin.
-The tearing away or tearing off of a piece or flap of skin or other soft tissue.
-May also be used for an eye being pulled from socket or tooth dislodged from socket.
-The surgical removal or traumatic severing of a body part, usually an extremity.
Open crush injuries
-An open crush injury can result when an extremity is caught between heavy items such as a piece of machinery.
-Assessed and treated like any other open wound
-Be watchful for infection
-Could be a sign of abuse or assault.
Blast injuries (open wound)
-When a patient is injured from a blast or explosion may sustain any number or injuries open or closed.
Primary injury (Blast injuries)
-Blast winds hit the patient causing damage to any air or fluid filled organs.
Secondary injury (Blast injuries)
-Result in projectiles hitting patient causing open and penetrating wounds.
Tertiary injury (Blast injuries)
-Blast wind may propel patient to ground or against objects causing further injury.
Quaternary injury (Blast injuries)
-Patient exposed to hazardous material or structural collapse.
-Injury due to exposure of toxins, burns, and crush injuries.
High pressure injection injury
-Can occur when a patient is working with a machine that injects grease, paint, air, or some other substance under high pressure.
Treating penetrating trauma
-Search for additional penetrations including exit wounds. Control bleeding.
-Assess need for BLS whenever there is a gunshot wound. Care for shock administer oxygen
-Follow local protocols in regards to spine stabilization.
Treating impaled objects
-Expose wound area
-Control profuse bleeding by direct pressure if possible
-Have another rescuer apply several layers of bulky dressing around injury site.
-Secure dressing in place
-Care for shock
-Keep patient at rest
-Transport carefully and as soon as possible
-Reassure patient throughout care.
If an object penetrates the cheek
-Examine wound site
-Remove the object if you find perforation and you can see both ends of the object.
-Position the patient appropriately
-Monitor patients airway after object has been removed or stabilized
-Dress outside of wound using pressure dressing.
-Consider the need for oxygen and care for shock.
Object impaled in eye
-apply rigid protection using a cup not Styrofoam.
-Secure cup with bandage or wrapping gauze.
-Dress and bandage uninjured eye.
-Consider need for oxygen and care for shock.
-Reassure patient and provide emotional support.
-Clean the wound surface
-Fold the skin back to its normal position as gently as possible
-Control bleeding and dress the wound using bulky pressure dressing.
-Use tourniquet if bleeding cannot be controlled.
-Wrap or bag amputated part in a plastic bag and keep it cool by cold packs
-Do not put directly on ice or amerce in water.
Care for genital injuries
-Preserve any avulsed parts
-Consider another possible injury
-Display calm mannerisms to maintain patients dignity
-Dress and bandage
-Consider possibility of sexual assault.
3 ways burns can be classified and evaluated
-By agent and source
-A burn that only involves the epidermis.
-Characterized by reddening of the skin and some swelling
-Commonly known as a first degree burn.
Partial thickness burn
-The epidermis is burned through and the dermis is damaged.
-Causes reddening, blistering, and a mottled appearance.
-Commonly known as a second degree burn
Full thickness burn
-All the layers of the skin are damaged
-There are areas that are charred black and areas that are dry and white.
-Commonly known as a third degree burn
Minor burn classifications (Full thickness, Partial thickness, Superficial)
-Full thickness burns of less than 2 percent of the body surface, excluding the face, hands, feet, genitalia, or respiratory tract
-Partial thickness burns less than 15 percent of the body surface
-Superficial burns of 50 percent of the body surface or less
Moderate burn classification (Full thickness, Partial thickness, Superficial)
-Full thickness burns of 2 to 10 percent of the body surface, excluding face, hands, feet, genitalia, or respiratory tract.
-Partial thickness burns of 15 to 30 percent of the body surface
-Superficial burns that involve more than 50 percent of the body surface
Critical Burn (Full thickness, Partial thickness, Superficial)
-All burns complicated by injuries of the respiratory tract, other soft tissue injuries, and injuries of the bones
-Partial thickness or full thickness burns involving the face, hands, feet, genitalia, or respiratory tract.
-Full thickness burns of more than 10 percent of the body's surface
-Partial thickness burns of more than 30 percent
-Burns complicated by musculoskeletal injuries
Minor, moderate, critical burn classifications for children under the age of 5
-Minor is a partial thickness burn of less than 10 percent
-Moderate is a partial thickness burn of 10-20 percent
-Critical is a full thickness burn of any extent or partial thickness burn of more than 20 percent
Care for thermal burns
-Stop the burning process/cool the burned area (flame wet down, smother, then remove affected clothing. semi solid (grease, tar, wax) cool with water, do not remove substance.)
-Ensure open airway
-Look for signs of airway injury
-Complete primary assessment
-Treat for shock. Provide O2. Treat serious injuries.
-Evaluate burns by depth, extent, and severity
-Do not clear debris. Remove clothing and jewelry
-Wrap with dry sterile dressing
-Remove jewelry that may constrict blood flow. Separate fingers or toes with sterile gauze pads.
Treating chemical burns
-Primary care is to wash away the chemical with copious slow flowing water for 20 mins. If dry chemical brush away as much as possible.
-Apply a sterile dressing or burn sheet
-Treat for shock
Treating specific chemical burns (Mixed strong acids, dry lime, carbolic acid, sulfuric acid, hydrofluoric acid, inhaled vapors.
-Mixed or strong acids or unidentified substances continue to wash even if patient no longer feels pain.
-Dry lime do not wash must brush
-Carbolic acid start with alcohol to unbroken skin then wash with water.
-Sulfuric acid wash skin
-Hydrofluoric acid has slow onset still flood with water
-Inhaled vapors provide O2 and transport immediately
Chemical burns to eyes
-Flood eyes with water
-Start transport and continue washing for 20 mins
-After washing cover both eyes with moistened pads
-Wash for 5 more mins if patient still complains of pain
Care for electrical injuries
-Provide airway and breathing care
-Provide basic cardiac life support
-Care for shock and administer O2
-Care for spine injuries, head injuries, and severe fractures.
-Evaluate electrical burns, look for at least two external burn sites.
-Cool like thermal burn
-Apply sterile dressings
-Transport as soon as possible
-Material used to cover a wound that will help control bleeding and prevent contamination
-Any material used to hold dressing in place
-A bulky dressing
-A dressing applied tightly to control bleeding
-Any dressing that forms an airtight seal.
Dressing open wounds
-Take standard precautions
-Expose the wound
-Use sterile or very clean materials
-Cover entire wound
-Do not remove dressings
Bandaging open wounds
-Do not bandage too tightly
-Do not bandage too loosely
-Do not leave loose ends
-Do not cover tips of fingers and toes
-Cover all edges of the dressing
Rule of nines
-Each of the following areas represents 9 percent of body surface: head, and neck, chest, abdomen, upper back, lower back, buttocks, the front of each lower extremity, and the back of each lower extremity. 4 1/2 percent for front and back of arms. 1 percent for genitalia. For children and infant 14 percent is assigned to head, 14 percent to each lower extremity.