Caring for Soft-Tissue Injuries and Bleeding Chapter 17 Flashcards
Which one of the following is NOT a typical characteristic of arterial bleeding?
A. Blood spurts from the wound.
B. Blood flows steadily from the wound.
C. The color of the blood is bright red.
D. Blood loss is often profuse in a short period of time.
B. Blood flows steadily from the wound.
When attempting to control bleeding, which one of the following procedures will follow direct pressure?
A. Indirect pressure
B. Tourniquet
C. Elevation combined with direct pressure
D. Pressure points
C. Elevation combined with direct pressure
Most cases of external bleeding can be controlled by: A. Applying direct pressure B. Using a tourniquet C. Securing a pressure bandage D. Applying a clotting agent
A. Applying direct pressure
The material placed directly over a wound to help control bleeding is called a (an): A. Bandage B. Elastic bandage C. Occlusive dressing D. Dressing
D. Dressing
The tearing loose or the tearing off of a large flap of skin describes which one of the following types of wounds? A. Abrasion B. Amputation C. Laceration D. Avulsion
D. Avulsion
You are caring for a patient with a severe soft tissue injury to the lower leg. You have exposed the wound. What should you do next? A. Apply direct pressure B. Remove debris from the wound C. Care for shock D. Elevate the extremity
A. Apply direct pressure
When providing care for an open injury to the cheek in which the object has entered through the skin into the mouth, you must ensure an open airway and:
A. Remove the impaled object
B. Turn the patient’s head to one side
C. Dress and bandage the outside of the wound
D. Place dressings into the mouth
A. Remove the impaled object
When providing care for an open injury to the external ear:
A. Pack the ear canal
B. Use a cotton swab to clear the ear canal
C. Wash out the ear canal
D. Apply dressings and bandage in place
D. Apply dressings and bandage in place
Which one of the following patients is most at risk for a multi-system trauma?
A. 16 year old who fell 4 feet from a ladder
B. 66-year-old female ejected from a vehicle rollover
C. 44-year-old male whose foot was crushed by a forklift
D. 27-year-old struck in the head by a baseball bat
B. 66 year old female ejected from a vehicle rollover
When caring for a patient with severe burns, you must take BSI precautions and then: A. Stop the burning process B. Prevent further contamination C. Flush only large burn areas D. Remove jewelry
A. Stop the burning process
All of the following our signs or symptoms of internal bleeding capital word EXCEPT: A. Increased pulse rate B. Decreasing blood pressure C. Decreasing pulse rate D. Pale skin color
C. Decreasing pulse rate
Your patient has a large open wound to his neck. You have controlled bleeding with direct pressure, so you should then:
A. Pack the inside of the wound with clean dressings
B. Pour sterile saline over the wound
C. Cover the wound with a dry, clean dressing
D. Cover the wound with an occlusive dressing
D. Cover the wound with an occlusive dressing
Which one of the following best describes the appropriate care for an amputated body part?
A. Wrap it with clean gauze and place it on ice
B. Apply a tourniquet to the exposed end of the part
C. Bandage the part back onto the body
D. Place the part in sterile water
A. Wrap it with clean gauze and place it on ice
A bandage that is applied to tightly is at risk for:
A. restricting circulation to the distal extremity
B. Pushing the dressings too far into the wound
C. Restricting blood flow to the proximal extremity
D. Causing a blood clot
A. Restricting circulation to the distal extremity
A 23-year-old female has been kicked in the abdomen by a horse. She is alert and oriented and complaining of pain to her lower abdomen. You should suspect: A. A flail chest B. Internal bleeding C. A fractured pelvis D. An ectopic pregnancy
B. Internal bleeding
Your patient has been impaled through the right thigh by a long piece of metal bar. The ABC’s are intact and there is very little external bleeding. You should:
A. Carefully remove the object
B. Tie both legs together
C. Stabilize the object with bulky dressings
D. Cut both ends of the bar to make it shorter
C. Stabilize the object with bulky dressings
You are caring for a 10-year-old boy whose eye has been pulled from the socket following a dog attack. The eye is hanging down the cheek by some tissue. The ABCs are intact and bleeding has been controlled. You should:
A. Place the injured eye back in the socket
B. Remove the injured eye & placed it on ice
C. Cover the uninjured eye
D. Cover both eyes with bulky dressings
D. Cover both eyes with bulky dressings
You arrive on the scene to find a young girl with an active nosebleed. She is crying and the sight of the blood is scaring her. You should:
A. Position her on her side while holding pressure on the nose
B. Have her lean forward while you pinch the nostrils
C. Have her lean backward as far as possible while holding the nose D. Pack both nostrils with sterile gauze
B. Have her lean forward while you pinch the nostrils
You are caring for a burn victim who has partial thickness burns covering his entire right arm and the front of his torso. What is the estimated BSA affected? A. 18% B. 25% C. 27% D. 36%
C. 27%
You are caring for a burn victim with both partial and full thickness burns over 40% of her body. The ABCs are intact and you have her on high flow oxygen. You should:
A. Cover her with sterile burn sheets
B. Apply cool water over the burns
C. Apply moist dressings over the burns
D. Not cover the burns, but you should arrange transport
A. Cover her with sterile burn sheets
Arterial bleeding is characterized by blood that:
Spurts or sprays from a wound.
Venous bleeding can be heavy, but flows:
Steadily from a wound.
Capillary bleeding will:
Slowly ooze from a wound.
If a patient is bleeding from an open wound, you should:
Apply direct pressure, apply a pressure bandage, and elevate the injury site if necessary. If none of these techniques work, consider applying a tourniquet.
Emergency care for internal bleeding involves:
Recognition, activating the EMS system, keeping the patient still and comfortable, being alert for vomiting, and treating for shock.
External soft tissue injuries include:
Abrasions, lacerations, Avulsions, punctures, and amputations.
Impaled objects should be:
Stabilized in place using bulky dressings or improvised materials.
Never remove an impaled object unless it is interfering with the patient’s airway. True or False?
True
Multisystem trauma occurs when a patient:
Has suffered a significant mechanism of injury that has caused trauma to numerous body systems, such as the skin, muscles, circulation, and nerves.
Amputations should initially be cared for with:
Direct pressure or tourniquets to control bleeding. The patient should then be treated for shock (with the amputated part) and transported by ambulance as soon as possible.
Nose bleeds should be cared for by:
Pinching the nostrils together and having the patient lean forward.
Eye injuries can be very serious and must be treated carefully to prevent permanent damage and blindness. It is important to cover the uninjured eye to prevent movement of the injured eye. True or False?
True.
Three burn classifications according to the depth of the burn are:
- superficial
- partial thickness
- full thickness
What are the characteristics of superficial burns?
- Red & painful
2. Only affect the top layer of skin (epidermis)
What are the characteristics of partial thickness burns?
- Damage reaches into the epidermis & dermis, &
2. Presents with pain, swelling, & blisters
What are the characteristics of full thickness burns?
- Causes damage down to the bone,
- Kills affected nerves and tissues,
- Dry & leathery
- Presents with white, dark brown, or charred, rigid skin and very little pain.
The first step in treating burns is to:
- Stop the burning process
2. Remove any affected clothing or jewelry
Treatment for severe burns includes:
- Constant monitor of the patient’s airway,
2. Treatment for shock.
Awidely accepted method of determining the body surface area affected by a burn is:
The “rule of nines”
How does the “rule of nines” work?
It divides the body into quadrants valued in 9% increments and allows for easy estimation of the burned area.
What are dressings made of & what are their purpose?
Made of clean sterile cloth; to help control bleeding & protect wounds from contamination.
What is the purpose of a bandage?
Bandages are used to hold dressings in place.
What are the 6 classifications of burns according to the agent that caused the injury (source of the burn)?
- Heat (thermal) burns which may be caused by fire, steam, or hot objects
- Chemical burns, which may be caused by caustics, such as acids and alkalis
- Electrical burns, which originate from outlets, fried wires, and faulty circuits
- Lightning burns, which occur during electrical storms
- Light burns, which occur with intense light. Light from the arc welder or industrial laser, or ultraviolet light, including sunlight, can burn the eyes and skin.
- Radiation burns, which usually result from nuclear sources.
A superficial or partial thickness burn that involves less than _____ patients total body surface area is considered a __________ burn.
9%
Minor burn
What is the name of the skin’s surface?
Epidermis
What are the functions of blood?
- To carry oxygen and carbon dioxide,
- to carry food to the tissues nutrition,
- to carry wastes from the tissues to the organs of excretion (kidneys lungs and liver),
- to carry hormones, water, salts, and other compounds needed to keep the body functions in balance (body regulation),
- to protect against disease causing organisms (defense)
The volume of blood in the typical adults body is approximately:
6 liters or about 12 pints
What is an artery?
A vessel that carries blood away from the heart, typically carrying oxygenated blood.
What is a vein?
A vessel that returns blood to the heart, typically carrying deoxygenated blood.
What is the largest artery?
The aorta
What is the smallest artery?
An arteriole
The places where you can feel the blood pumping through the artery is called?
Pulse points
What are the largest veins?
The superior and inferior vena cava
What is the smallest being called?
Venule
Blood is compiled of:
Red blood cells,
white blood cells, and
elements involved in forming blood clots
What is plasma?
A watery salty fluid carrying the elements involved in forming blood clots.
What is the smallest of the body’s blood vessels called?
Capillaries
What is perfusion?
The adequate supply of well oxygenated blood to the vital organs and tissues.
What a shock?
The condition that results when there is an inadequate supply of well oxygenated blood to all body systems.
Why should uncontrolled bleeding always be taken seriously?
If not stopped, it will lead to shock and eventually death.
What is the body’s automatic response to bleeding?
Blood vessel constriction and clotting.
In cases of major bleeding clotting may not occur because:
The flow of blood from the wound is too great to allow for the formation of clots.
The color of arterial blood is:
Bright red because it contains oxygen.
The color of venous bleeding is:
Dark red blood
The color of capillary bleeding is:
Bright red blood. It oozes from tissues common with minor scrapes and abrasions.
With venous bleeding, a great deal of blood can be lost in a short amount of time. True or False?
False, arterial bleeding causes a great deal of blood loss in a short time depending on the size of the artery injured.
Veins have a tendency to collapse as soon as they are cut. True or False?
True. This often reduces bleeding.
If a pressure dressing becomes soaked with blood, you should:
Add another additional dressing to the dressing already immediately against the wound.
What is a cravat?
Folded triangular bandages
What can be used in combination with direct pressure to deal with bleeding from an arm or leg?
Elevation: the effects of gravity may help reduce blood pressure at the wound and slow the bleeding. Do not elevate if you suspect fractures to the extremities or a possible spinal injury.
Where do you place a tourniquet?
Just above the injury site.
When should a tourniquet be used?
- If you were unable to control bleeding using direct pressure within two or three minutes, or
- If pleading is very severe from the beginning,
- If there is a partial or full amputation
How tight should the tourniquet it be?
Tighten to the point where the bleeding is stopped and not beyond.
What is a dressing that has been treated with a specialized chemical that when placed onto a wound promotes clotting.
A hemostatic dressing
Why is an air splint sometimes used to control bleeding?
- An air splint and elevation can work well on long, bleeding wounds
- It serves to immobilize the limb, even when there is no suspected fracture.
What is an occlusive dressing?
A dressing made of sterile gauze that has been saturated with petroleum jelly. It is used to create an airtight seal over a wound that penetrates a body cavity.
What can be substituted to use for an occlusive dressing to help seal off an open wound to the chest or abdomen?
Folded plastic wrap or a plastic bag
What are the rules for dressing wounds?
- A dressing and bandage are of little value if they do not help control bleeding.
- Use sterile or clean materials.
- Cover the entire surface of the wound and, if possible, the immediate area surrounding the wound.
- Once the dressing is applied to a wound, it must remain in place. Add new dressings on top of blood-soaked dressings.
What are the rules that apply to bandaging?
- Do not bandage too tightly.
- Do not bandage to loosely.
- Do not leave loose ends.
- Do not cover fingers and toes unless they are injured.
- Wrap the bandage around the limbs starting its far (distal) end and working toward its origin or near (proximal) end.
- Always check distal circulation, sensation, and motor function before and after bandaging.
What is blunt trauma?
Injury to the body caused by the impact with large objects or surfaces; nonpenetrating, trauma.
What is penetrating trauma?
Injury to the body caused by any object that punctures the skin.
Blunt objects can deliver a great deal of force to the body, causing life-threatening internal bleeding. True or False?
True
Always suspect internal bleeding if the patient has been injured and the signs and symptoms of shock are present. True or False?
True
Administration of oxygen will not help patients with internal bleeding. True or False?
False, it will help.
What are the soft tissues of the body?
Skin, muscles, nerves, blood vessels, fatty tissues, and cells.
What is a closed wound?
An injury in which the skin is not broken.
One of the more common soft tissue injuries with the elderly is called a skin care. What is it?
A tear in the skin caused by a twisting or shearing action.
What is a laceration?
A cutting open of the skin.
Wounds such skinned elbows and knees, road rash, and rug burns, are minor open wounds known as:
Abrasions
What is an incision?
A type of laceration. A cut to the skin that are smooth with apparent tears or jagged edges made with a very sharp objects.
What is a puncture wound?
And an injury to the body where an object has punctured and torn into the skin, usually proceeding in a straight line, damaging tissues in its path. A puncture can range from shallow to deep and it may also have an entrance and exit wound. Often the exit wound is larger and the more serious of the two wounds.
What is an avulsion?
The tearing loose or the tearing off of skin or other soft tissue.
What is an amputation?
The cutting or tearing off of a body part.
Because an amputation can be a surgical procedure, this injury is often called a:
Traumatic amputation
What is a crush injury?
An injury that occurs when a body part is pressed between two surfaces, the greater the force the greater the damage.
What should you always check for when dealing with any puncture wound?
An exit wound
When dealing with a puncture wound, never remove an _______ object.
Impaled
How does one save or preserve an avulsed or amputated part?
- Wrap the body part in a sterile dressing and place it into a plastic bag or plastic wrap.
- Keep the part cool, but avoid freezing.
- Do not put part in water or direct contact with ice.
- ID/label bag or wrapped part.
- Transport to hospital with patient.
A deep wound causing organs such as the intestines to protrude through the wound opening is called:
An evisceration.
How do you treat an evisceration?
- Do not try to push protruding organs back into the body cavity.
- Place a plastic covering over the exposed organs. If possible, apply a thick dressing over the top of this covering to help conserve heat.
- Provide care for shock. Do not give the patient anything by mouth.
What is the first concern when caring for facial injuries?
Make certain that the patient’s airway is open and breathing is adequate.
When is the only time that an impaled object can be removed?
When an object has passed through the cheek wall and is sticking into the mouth. Do so only if the object blocks the airway or is loose and could fall into the airway.
Why aren’t impaled objects removed?
Because they also seal the wound. If the object is removed the patient may bleed profusely.
How long do you wash out an eye injury?
20 minutes; do not wash it if there are impaled objects or cuts in the eye.
When caring for a patient with eye injuries cover _______ of the patients eyes.
Both.
Why cover both eyes if only one eye is injured?
Having both eyes covered reduces eye movements.
What types of burns to the eyes are there?
- Thermal or heat burns.
- Light burns: “snow blindness” and “welder’s” blindness are two examples.
- Chemical burns
Bloody or clear fluids draining from the ear may indicate the presence of a skull fracture. True or False?
True
What is the primary duty for injuries to the nose?
- Maintain an open airway
2. Control bleeding
What is the first concern for an injury to the mouth?
And sure and open airway.
What are the two types of soft tissue injury to genitalia?
- Blunt trauma: this injury is very painful but little can be done. An ice pack can help.
- Cuts: bleeding should be controlled by direct pressure. A sterile dressing or pad should be used. If neither is available, use any clean bulky dressing.
