Chapter 24: Soft Tissue Injuries Flashcards
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What are the most general categories of soft tissue injuries?
Open, closed, burns
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Stages of wound healing
Cessation of bleeding, inflammation, cell proliferation and remodeling, angiogenesis, collagen reinforcing
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What is crush syndrome?
When arterial flow is compromised by a crushing force for >4 hrs, renal failure and death result
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What is compartment syndrome and what’s the principle sign?
Swelling from an injury compresses blood vessels and cuts off circulation. Classic sign is pain out of proportion to injury
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What are the 4 types of open wounds?
Lacerations, avulsions, penetrations, abrasions
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Care for avulsions
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
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What is a contusion?
Bleeding beneath the skin
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What is a hematoma?
Where blood has collected within damaged tissue or body cavity (much more blood than a contusion)
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Treatment of closed injuries
Rest, Ice, Compression, Elevation, Splinting
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Brief general treatment for open injuries
Control the bleeding, splinting can help control bleeding even without a fx, don’t wash except for chemical burns and contamination
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Tx: Abdominal open wound
Cover evisceration with moistened gauze and secure with occlusive dressing, flex legs to relieve pressure on abdomen
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Tx: Impaled object
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.
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Tx: Neck injuries
Preven air embolism with occlusive dressing, manual pressure, pressure dressing over neck and through opposite axilla
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Tx: Bites
Treat all animal bites as infectious, sterile dressing, immobilize, transport
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What are two complications to consider with burns?
Problems with temperature regulation and infection
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What are the depths of burns and what can EMT expect?
Superficial: epidermis only. Partial thickness: epidermis and part of dermis; blisters and intense pain. Full thickness: all skin layers, possibly deeper, dry leathery skin.
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How to calculate burn area?
Rule of palm (1%) and rule of nines (front of torso: 18%, legs 18%, arms 9%, genitals 9%, head 9%)
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What’s a severe burn?
Full thickness burns in sensitive areas or >10% or circumfrential. Partial thickness burns >30%. Respiratory burns. Burns w/ fx’s
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What’s a moderate burn?
Full thickness 2-10%. Partial thickness 15-30%. Superficial >50%.
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What’s a minor burn?
Full thickness <2%. Partial thickness <15%. Superficial <50%.
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What modifies burn severity?
Preexisting medical condition, younger than 5, or older than 55.
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Tx: chemical burns
Brush off powder, was 15-20 min in water, rinse eyes
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Types of thermal burns
Flame, scald, contact, steam, flash
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Tx: thermal burns
Stop burning source, cool, remove constrictions, dry bandage, lookout for hypothermia and hypovolemic shock
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Beware of this with airway burns…and how to treat?
Possible airway swelling. Icing can reduce swelling.
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Tx: Radiation burns
Wash open wounds, then treat like a thermal burn
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General burn treatment
- 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.
