Chapter 24: Soft Tissue Injuries

Question 1

Discuss

What are the most general categories of soft tissue injuries?

Answer 1

Open, closed, burns

Question 2

Discuss

Stages of wound healing

Answer 2

Cessation of bleeding, inflammation, cell proliferation and remodeling, angiogenesis, collagen reinforcing

Question 3

Discuss

What is crush syndrome?

Answer 3

When arterial flow is compromised by a crushing force for >4 hrs, renal failure and death result

Question 4

Discuss

What is compartment syndrome and what’s the principle sign?

Answer 4

Swelling from an injury compresses blood vessels and cuts off circulation. Classic sign is pain out of proportion to injury

Question 5

Discuss

What are the 4 types of open wounds?

Answer 5

Lacerations, avulsions, penetrations, abrasions

Question 6

Discuss

Care for avulsions

Answer 6

If clean, flap should be replaced and bandaged. If amputated, bring the piece to the hospital in a bag with cool water or saline. NEVER REMOVE A FLAP

Question 7

Discuss

What is a contusion?

Answer 7

Bleeding beneath the skin

Question 8

Discuss

What is a hematoma?

Answer 8

Where blood has collected within damaged tissue or body cavity (much more blood than a contusion)

Question 9

Discuss

Treatment of closed injuries

Answer 9

Rest, Ice, Compression, Elevation, Splinting

Question 10

Discuss

Brief general treatment for open injuries

Answer 10

Control the bleeding, splinting can help control bleeding even without a fx, don’t wash except for chemical burns and contamination

Question 11

Discuss

Tx: Abdominal open wound

Answer 11

Cover evisceration with moistened gauze and secure with occlusive dressing, flex legs to relieve pressure on abdomen

Question 12

Discuss

Tx: Impaled object

Answer 12

DO NOT REMOVE unless interfering with breathin or in the chest and interfering with CPR. Apply bulky dressing and tape rigid item over the impaled object.

Question 13

Discuss

Tx: Neck injuries

Answer 13

Preven air embolism with occlusive dressing, manual pressure, pressure dressing over neck and through opposite axilla

Question 14

Discuss

Tx: Bites

Answer 14

Treat all animal bites as infectious, sterile dressing, immobilize, transport

Question 15

Discuss

What are two complications to consider with burns?

Answer 15

Problems with temperature regulation and infection

Question 16

Discuss

What are the depths of burns and what can EMT expect?

Answer 16

Superficial: epidermis only. Partial thickness: epidermis and part of dermis; blisters and intense pain. Full thickness: all skin layers, possibly deeper, dry leathery skin.

Question 17

Discuss

How to calculate burn area?

Answer 17

Rule of palm (1%) and rule of nines (front of torso: 18%, legs 18%, arms 9%, genitals 9%, head 9%)

Question 18

Discuss

What’s a severe burn?

Answer 18

Full thickness burns in sensitive areas or >10% or circumfrential. Partial thickness burns >30%. Respiratory burns. Burns w/ fx’s

Question 19

Discuss

What’s a moderate burn?

Answer 19

Full thickness 2-10%. Partial thickness 15-30%. Superficial >50%.

Question 20

Discuss

What’s a minor burn?

Answer 20

Full thickness <2%. Partial thickness <15%. Superficial <50%.

Question 21

Discuss

What modifies burn severity?

Answer 21

Preexisting medical condition, younger than 5, or older than 55.

Question 22

Discuss

Tx: chemical burns

Answer 22

Brush off powder, was 15-20 min in water, rinse eyes

Question 23

Discuss

Types of thermal burns

Answer 23

Flame, scald, contact, steam, flash

Question 24

Discuss

Tx: thermal burns

Answer 24

Stop burning source, cool, remove constrictions, dry bandage, lookout for hypothermia and hypovolemic shock

Question 25

Discuss

Beware of this with airway burns…and how to treat?

Answer 25

Possible airway swelling. Icing can reduce swelling.

Question 26

Discuss

Tx: Radiation burns

Answer 26

Wash open wounds, then treat like a thermal burn

Question 27

Discuss

General burn treatment

Answer 27

• Remove constricting things.
• If still hot, immerse in cool water or cover with wet dressing (not for more than 10 min b/c of hypothermia risk).
• Give O2.
• Cover with dry dressing or clean sheet.
• Never use ointments or lotions or antiseptics.
• Treat for shock.