Ch 12: Soft Tissue Injuries Flashcards
Closed Wound
A wound in which soft tissue damage damage occurs beneath the skin and the skin is not broken
General Care for a Closed Wound
- Apply an ice or a cold pack, covered with cloth to protect the skin
- Apply this cold for 20 minutes every hour until the pain is relieved.
-Patient complains of severe pain or trauma caused by great force, seek advanced medical care.
Contusion
Bruise
Crush Injury
A crushing force is applied causing fractures and organ damage with the skin still intact
Compartment Syndrome
When pressure builds up to dangerous levels within the muscles and blocks circulation to the cells. Occurs in muscle groups covered by tough membranes that do not readily expand.
Signs and Symptoms of Compartment Syndrome
- Pain intensely out of proportion to the injury
- Tingling or burning in the muscle
- Muscle may feel tight or full
- The area becomes numb or paralyzed
Care for Compartment Syndrome
- Obtain advanced medical care
- Monitor vitals and distal circulation
Blast Injuries
When pressure waves generated by an explosion strike the body surface.
Injuries from:
- The blast itself
- Shrapnel
- Trauma from being thrown
- Injuries or illnesses caused by hazardous material
Myocardial Contusion
Heart muscle bruising after blunt force to the chest
Subungual Hematoma
A collection of blood under the nail bed
Care for Subungual Hematoma
- Wear proper PPE as blood may spatter
- Clean the area
- Ensure patients hand is on firm surface
- Use a nail drill to create a small hole in the middle of the blood pocket.
- If no nail drill, heat the end of a paperclip until red hot and use it to create a hole.
- Procedure should be painless
- If releasing the blood does not stop the pain, suspect a fracture.
- The hole may require reopening
- Clean the injured area and apply a dressing
Open Wounds
Injuries that break the skin
Care for Open Wounds
- With a gloved hand, control bleeding using direct pressure
- Continue direct pressure by applying a pressure bandage
- Obtain more advanced medical care
- Wash your hands immediately after completing care even though you wore gloves.
Abrasion
Skin that has been rubbed or scraped away.
Care for an Abrasion
- Clean the wound as debris may be embedded
- Rinse under water for 5 minutes
- Control bleeding
- Apply sterile dressing and bandage
Laceration
A cut. Can be caused by a sharp object or when blunt forces split the skin.
Care for a Laceration
Deep lacerations may effect the layers of fat and muscle and bleed fairly freely.
- Clean the wound and rinse for 5
- Control bleeding
- Apply sterile dressing and bandage
Avulsion
An injury in which a portion of the skin and other soft tissues is partially or completely torn away. A portion may hang like a flap.
Care for an Avulsion
- Clean and disinfect wound and rinse for 5
- Put any hanging flaps back down into position
- Control bleeding
- Apply sterile dressing and bandage
Amputation
A complete severing of a body part
Care for Amputations
- Clean and disinfect wound and rinse for 5
- Control bleeding
- Apply sterile dressing and bandage
- Locate amputated part
- Keep amputated part in sanitary container, wrapped in gauze and kept cool
Puncture
An injury caused by the skin being pierced with a pointed object.
ie: Needle sticks, bullet wound
Impaled Object
An object that remains in the open wound
Abscess
A localized collection of pus within tissues
Care for Abscesses
- Cleanse the area
- Drain the abscess using a hot compress until the skin bursts
- Continue to cleanse intermittently with antibacterial solution
- Do not squeeze as it will spread the infection deeper
- If the abscess involves the face, neck, groin or buttocks or is very painful, seek further medical attention.
Infection
When bacteria have entered the system.
Signs and Symptoms of Infection
- Wound area becomes swollen and red
- Area may feel warm or throb with pain
- Pus discharge
- Red streaks toward heart
- Fever
Care for Infection
- Cleanse the area thoroughly
- Do not use alcohol
- Rinse the wound under running water for five minutes
- Apply an antibiotic ointment
- Control any bleeding
- Severe infection or spreading infection seek advanced medical care
Tetanus
A serious infection caused by the bacterium Clostridium Tetani, found in soil and animal feces.
Signs and Symptoms of Tetanus
- Difficulty swallowing
- Irritability
- Headache
- Fever
- Muscle spasms near infected area
- Lockjaw
Care for Tetanus
- Thoroughly clean an open wound
- Apply sterile dressings and bandage
- Seek advanced medical care
Gangrene
A severe, infection caused by a bacteria that thrives in the absence of oxygen.
Signs and Symptoms of Gangrene
- Sudden onset of pain and swelling
- Local tissue discoloration
- Brownish, fowl smelling, watery discharge
- The discharge is highly infectious
- Crepitus beneath the skin
Care for Gangrene
- Perform first aid
- Rapid transport
- Care for shock
Necrotizing Fasciitis
Rapidly progressive and very painful infection. “Flesh eating disease”
Dermatitis
Inflammation of the skin, usually a result from contact with a chemical irritant or from an allergy
Signs and Symptoms of Dermatitis
- A history of reaction to an irritant
- Redness, irritation, swelling
- Itchiness or pain
- Blisters
- Thickening and cracking of the skin
Care for Dermatitis
- For serious cases treat as a poisoning
- Avoid the irritant
- Protect skin
- Seek further medical attention if signs of irritation persist for more than 3-4 days
Dressings
Pads placed directly on the wound to absorb blood and other fluids, and to prevent infection
Occlusive Dressing
A dressing or bandage that seals a wound and protects it from air
Bandage
Any material used to wrap or cover any part of the body. Used to hold dressings in place, to appl y pressure to control bleeding, to help protect a wound form dirt and infection and to support in injured limb or body part.
Adhesive Compress
A small pad of non stick gauze on a strip of adhesive tape.
ie: Band-aids
Roller Bandage
A bandage usually made of gauze or gauze like material used to wrap around a body part.
Triangular Bandage
Folded, it can hold a dressing or splint in place, or be used as a sling to support an injured shoulder, arm or hand.
Care for an Impaled object
- Leave the object alone unless it involves the cheek or interferes with breathing
- Use bulky dressings to stabilize the object. Movement can cause further damage
- Control bleeding by bandaging the dressings in place around the object
Sliver
A sharp, thin piece of some material that has broken off and penetrated the skin.
Three general types:
Wood
Metal
Glass
Wood Sliver
Flesh colored and difficult to see.
- Wet the area with a colored antiseptic solution (iodine)
- Soak for 30 seconds
- Gently wipe away the remaining liquid
- The sliver will likely soak up fluid, making it easier to see
Metal Sliver
Usually easy to see and remove
Glass Sliver
Usually invisible and difficult to see
-Soak in warm, diluted antibacterial detergent for 20 minutes
How to Remove a Sliver
- Determine the angle at which the sliver entered the skin
- Grasp the sliver with disinfected forceps and withdraw it at the same angle
- Treat as a puncture or laceration
How to Remove a Fish Hook
Method 1:
- With one hand, press down on the back of the hook shank, by the eye of the hook to push the barb away from any tissue
- With the other hand, quickly jerk out the hook. This causes less damage than the second method
- Wash the injured area with soap and water
- Dress the wounds
Method 2:
- Move the hook in a curve so that the barbed tip exits through the skin
- Clip off the barbed tip and remove the remainder of the hook by pulling it back the way it entered. This avoids forcing the eye of the hook through tissue
- Wash the injured area
- Dress wounds
Burns
A soft tissue injury caused by heat, electricity or chemical
Superficial Burns
Involve the top layer of skin.
Signs and Symptoms of Superficial Burn
- Skin is red and dry
- Area is painful
- Swelling
Partial-Thickness Burn
A burn involving both the epidermis and the dermis
Signs and Symptoms of Partial-Thickness Burn
- Skin is red
- Blistering
- Skin may look blotched
- Fluid may ooze
- Pain
- Swelling
Full-Thickness Burn
A burn that destroys both layers of skin, as well as any or all underlying structures
Signs and Symtoms of a Full-Thickness Burn
- Skin may look brown or charred with tissue underneath appearing white
- Either extremely painful or relatively painless
- Surrounded by painful partial-thickness burns
Critical Burn
A burn that requires immediate, more advanced medical care. They are potentially life threatening, disfiguring or disabling.
Types of Critical Burns
- Inhalation injuries causing dyspnea, or signs of burns around the nose and mouth.
- Flame burns that occurred in a confined space
- Burns covering more than one body part
- Burns to the head, neck, hands, feet or groin
- Any partial-thickness or full thickness burned to a child or elderly adult
- Burns resulting from chemicals, explosions, or electricity
- Burns that result in a great deal of pain or loss of LOC in the patient
Rule of Nines
A method in which to estimate the percent of body surface area burned.
Rule of Nines - Adult
Head - 9 Upper Extremities (each) - 9 Lower Extremities (each) - 18 Torso - 18 Back - 18 Groin - 1
Rule of Nines - Child
Head and Neck - 18 Upper Extremities (each) - 9 Lower Extremities (each) - 14 Torso - 18 Back - 18
Care for Thermal Burns
Cool
Cover
Minimize Shock
Cooling a Thermal Burn
If a partial-thickness or full thickness burn covers more than 10% of the body, cool only a small area at a time.
Do not use ice
When the burn is cool, remove any clothing from the area, unless it is sticking to the wound
Covering a Thermal Burn
Use non stick sterile dressings and loosely bandage them in place
Do not put pressure on the burn surface
Small superficial burns may be covered with a moist dressing
Do not break blisters
Chemical Burns
Burns that are caused by caustic chemicals such as strong acids or alkalis
Care for a Chemical Burn
- Brush the chemical from the skin
- Flush the burn continuously with large amounts of cool, running water for at least 20 minutes
- Protect yourself and avoid contaminating unaffected areas of the patient
Electrical Burn
A burn caused by an electrical source that often effects tissues beneath the skin.
Will be marked by characteristic entry and exit wounds.
Care for an Electrical Burn
- Cover any burn injuries with a non-stick sterile dressing
- Minimize shock
Inhalation Injuries
Burns that resulted from a fire in an enclosed, confined space are likely to be associated with inhalation injuries.
Care for Inhalation Injuries
- Move the patient to a well-ventilated place
- Continually monitor breathing and obtain advanced medical care immediately
- Administer O2
Radiation Burns
A burn caused by rays, energy or electromagnetic waves. Similar to thermal burns and may blister and involve more than one skin layer.
Care for Radiation Burns
- Cool
- Cover
- Minimize shock